Bad physio is not on. Ever. But I've rarely worried about a 'bad physio'. Skill can be fixed, stuff can be taught and clinical ideas, developed.
What kept me awake at night was a leader who'd gone rogue. They thought they were the real deal.
That's the spiky spiral - slow, polite, invisible rot. Everyone feels the slip in standards. Everyone pretends not to. Nobody wants to call it out.
The best teams I ever ran didn't need cosy chats. They needed the truth - early doors, clean and just uncomfortable enough.
One blunt line at the right moment saves six months of drift.
Most leaders know exactly what needs saying… they just don't have the balls to say it.
Avoidance looks kind, but it's cowardly. Patients sense it first, then tell me second. The team copies it. And suddenly the whole place feels soft and pudgy and a bit unexciting.
Clinics don't lose their edge because of mistakes - they lose it because the person in charge protected feelings instead of standards. I've seen it too many times.
It's always fixable.
If nobody winces once in a while, you're not leading - you're pretending.