Leadership Is the Difference in Allied Health

28 Jan

Same constraints, very different outcomes. What separates those who thrive from those who struggle

For the past year, I’ve deliberately avoided creating content about leadership.

That’s not because leadership isn’t important. It’s because it’s very easy to make generic content about leadership. I know I personally haven’t learnt a single thing from the cringe, AI generated posts about leadership on LinkedIn.

I also needed time.

After co-founding and scaling a national Allied Health organisation to more than 300 clinicians and over $15M in annual revenue, I stepped away from executive leadership in February last year and have now spent almost a year working solo. That space mattered. It gave me the distance to reflect properly on my own leadership and journey.

That reflection, combined with a year of working closely with hundreds of leaders across Allied Health, has made certain patterns impossible to ignore across the sector. I’m clearer now on what leadership actually does in this sector, and why it so often becomes the difference between organisations that stabilise and those that struggle.

That’s why now feels like the right time to write and speak more directly about leadership, and to help organisations build it intentionally.

Same sector, same constraints, very different outcomes

Allied Health providers operate under a fairly fixed set of constraints.

NDIS pricing, ongoing reform, workforce shortages, increasing regulatory requirements and rising expectations around governance apply to everyone. These conditions are real, persistent and largely outside the control of individual providers.

What stands out is how differently organisations perform under those same conditions.

Some businesses retain staff, adapt to change and build resilience. Others experience chronic burnout, high turnover and are constantly putting out fires — even though the external pressures they face are broadly the same.

The environment explains part of the story. Leadership explains the rest.

Leadership is the variable leaders actually control

It’s understandable that leaders spend time focusing on what they can’t control. Pricing decisions, policy reform and workforce supply shape day-to-day operations. Ignoring those realities would be naive.

But spending most of your energy there rarely leads to better outcomes. Leadership decisions are the variable.

Where leadership shows up in practice

how change is communicated.
how roles are defined.
how expectations are set and reinforced.
how pressure is absorbed or passed down.
how responsibility is handled when things go wrong.

Leadership doesn’t remove constraints. It determines how teams operate within them, and how much strain those constraints create over time.

Leadership is a skill

One of the most persistent myths is that leadership is something you either have or you don’t.

In practice, leadership is a skill that develops through deliberate effort.

A useful way to think about this is through the following framework:

Talent × Effort = Skill

Skill × Effort = Achievement

Which means:

Achievement = Talent × Effort²

Inherent talent, or being a “natural leader”, can help early on. But effort is the multiplier, and it compounds. Sustained effort, applied deliberately and consistently, is what turns ability into skill and skill into meaningful achievement over time.

In Allied Health, great clinicians are often moved into leadership roles early. Usually before they are ready and without preparation, training or structured support — and they are then expected to “figure it out” alongside their clinical load.

Leadership, like clinical practice, improves through practice. Practice without reflection, however, rarely leads to sustained improvement.

Reflection is the multiplier most leaders neglect

Clinicians are trained in reflective practice from the beginning of their careers. We reflect on assessments, outcomes, interventions and interactions. We review what worked, what didn’t and what we would do differently next time.

Leadership reflection is rarely treated with the same discipline.

Most leadership failures aren’t the result of bad intent. They come from unexamined habits, avoided conversations and reactive patterns that never get revisited. Leaders stay busy, but they don’t always slow down enough to examine the impact of their decisions.

Reflection is the skill that improves every other leadership skill.

Leaders who reflect become better communicators, better decision-makers and better at regulating themselves under pressure. Leaders who don’t tend to repeat the same patterns, even when they genuinely want things to improve.

In my experience, critical and consistent self reflection is the single most important habit a leader can develop.

Leadership is about setting people up for success

A pattern I see frequently in Allied Health leadership is clinicians leaning into problem-solving rather than leadership. Because they are used to solving problems clinically, they step in quickly, give direction and resolve issues themselves.

That instinct comes from clinical training, but in leadership roles it often turns into micromanagement rather than coaching.

Leadership isn’t about doing everyone’s job. It’s about designing the environment so people can do their jobs well. That shows up through:

clear role definition and expectations
systems that reduce friction rather than create it
access to supervision, support and development
consistent decision-making
clarity around priorities when things get busy

Micromanagement often looks like high standards on the surface. In reality, it usually reflects insecurity or a lack of trust in systems. Strong leaders focus less on providing answers and more on creating the conditions for performance.

Even as a Physio myself, I led a high-performing multidisciplinary team made up largely of Speech Pathologists, Occupational Therapists, Psychologists and Behaviour Support Practitioners. I couldn’t provide their clinical answers, but I could still lead them effectively by setting clear expectations, building strong systems and creating conditions where they could succeed.

Purpose matters

This is where many organisations get stuck.

A lot of providers rely on vague statements about caring, quality or being client-centred. The issue is that everyone says those things. In a market that is becoming more crowded and more competitive, generic statements don’t differentiate anyone.

Having “capacity” is no longer a differentiator. Everyone has capacity. Instead ask yourself:

Why should a clinician come and work for you?

Why should someone refer to you over your competitors?

If you can’t answer those questions clearly, that’s not a marketing problem or a recruitment problem. It’s a leadership problem.

Frameworks like the Golden Circle popularised by Simon Sinek are useful here as a reality check. Many organisations can explain what they do and how they do it. Far fewer can articulate why they do it.

Values only matter if you actually live them

Values statements are easy to write. Living them consistently is much harder.

At my old company, I personally interviewed over 700 full-time and part-time candidates. In every single interview, when talking about our value proposition, I said the same thing:

“Family and health always come first before work. Whether it’s your own health, a family member’s health, a friend’s health or even your pet’s health. Take time off whenever you need it.”

The important part wasn’t just saying it. It was actually living it, especially when it was inconvenient.

Values mean nothing if you don’t live them, and stand by them.

Constraints reveal leadership, they don’t excuse it

Constraints exist in every system. What differentiates organisations is how leaders respond to them.

Blame is understandable under pressure, but it’s a dead end. Focusing on what sits outside your control leaves very little room to lead. Pointing at funding, reform, recruitment, competitors or “the market” pushes leaders into a defensive mindset rather than a problem-solving one. Taking ownership, even when the constraints are real, is what creates movement.

That theme came through clearly in a recent podcast I recorded with Liam Fagan.

We went in with no real agenda. The only topic we set was Allied Health and sport, and we deliberately avoided a plan or script to see where the conversation led. It’s no surprise that It didn’t take long for leadership to become the focus.

When you compare environments with fixed rules, constant pressure and limited margins for error — leadership is where the real differences show up.

See episode below for anyone who enjoys thinking about Allied Health through that lens.

Why this is the work I’m leaning into now

After a year of reflection, consulting and working alongside leadership teams across the sector, I’m increasingly convinced that leadership capability is one of the most under-invested areas in Allied Health.

Not leadership as a title, but leadership as a practised skill that can be developed, reflected on and strengthened over time.

This is the work I’m now leaning into more deliberately, through speaking, training and hands-on support with organisations that want leadership that actually holds up under pressure.