In a recent article published in The Harvard Business Review, Jesse Sostrin points out the leadership paradox: “You need to be more essential and less involved. When you justify your hold on work, you’re confusing being involved with being essential.”

This was the biggest leap in my transition from a solo-practitioner with one location to a business leader with multiple offices and scores of team members. I had to figure out a way to active the people around me and inspire them in our vision, without micromanaging and bottlenecking every project.

I’ve done this the wrong way. When I think every decision needs to come through me and that every new hire needs to have my approval, the practice suffers. When I give talented employees lots of responsibility and encourage their dreams, letting them achieve results in their own way, the practice soars.

I’ve long told clients, “If you can’t pack a bag right now and hop on a plane with me to a vacation destination you’ve never heard of and literally leave in a few hours, you don’t have a real business. You have a job you can’t quit.”

The key missing ingredient in practices that run like a real business and those where the doctor has a job he can’t quit is the presence of strong leadership. If you want to make some meaningful steps in the right direction, ask yourself why your practice exists. Really. Given all the other choices in the market, including the option of doing nothing, why would a parent or patient choose to do business with you? If you don’t have a good answer, you won’t last long in a competitive landscape.

Then, ask yourself if your culture supports the clear reason why you exist. If your culture doesn’t align, it almost always points to the wrong people on the bus or the wrong person driving the bus. Fix your leadership and everything else will follow.

You can pick up Sostrin’s book, The Manager’s Dilemma, here.

Worked at Burleson Orthodontics. Attended University of Missouri–Kansas City. Lives in Kansas City, Missouri.