In every successful practice, there is usually someone behind the scenes who keeps communication clear, operations moving, and challenges from becoming crises.
That ability has a name: managing up.
Despite how the phrase sounds, managing up is not about office politics or impressing leadership. It is about building strong working relationships through clear communication, trust, and proactive problem-solving. In healthcare practices especially, it is one of the most valuable leadership skills an administrator or operational leader can develop.
The strongest practices are rarely the ones without challenges. They are the ones where physicians and administrators work together effectively enough to address challenges early, honestly, and productively.
That kind of partnership starts with understanding how leaders process information.
Why Communication Style Matters
Physicians spend their careers learning to absorb information quickly, assess risk, and make decisions efficiently. In a busy ENT practice, a physician may move from surgery-scheduling discussions to patient consults to staffing conversations all within the same hour. Because of that, how information is presented matters just as much as the information itself.
Lead With the Bottom Line
One of the most common communication mistakes is spending too much time building context before addressing the actual issue. Many administrators understandably want to soften the conversation or fully explain the background first. In most cases, however, physicians and business leaders respond better when they hear the core issue immediately.
Instead of saying, “The front desk team has been noticing concerns with patient flow lately,” a clearer and more effective approach would be, “There is a scheduling bottleneck increasing patient wait times in the afternoons.”
Once the headline is clear, the supporting details become much easier to discuss.
This approach is not abrupt. It is respectful. It demonstrates confidence, clarity, and preparation. Most importantly, it allows leaders to quickly understand the issue and focus their energy on solutions instead of trying to determine what the conversation is actually about.
The Importance of Addressing Problems Early
This becomes especially important when the news is difficult.
Every practice encounters operational pressure points. Provider schedules may become overbooked for weeks. Audiology staffing may suddenly become strained. Referral patterns may soften. Patient satisfaction scores may dip after implementing a new scheduling process. These situations are normal parts of running a business, but they are also the moments when many administrators hesitate to speak up.
Bringing forward problems is never easy, particularly when working with busy physicians who already carry significant responsibility. There is often a temptation to wait until a perfect solution is identified before raising the issue. Unfortunately, delayed conversations tend to create larger problems later.
Strong Practices Prioritize Honest Conversations
The practices that operate most effectively are not the ones where issues are hidden until they become urgent. They are the ones where physicians and operational leaders trust each other enough to have direct conversations early.
That trust is built through preparation and honesty.
Leadership Means Being Prepared
When presenting a challenge, it helps to arrive with organized information, a clear understanding of the impact, and a few possible paths forward. That does not mean having every answer. In fact, most physician leaders do not expect perfection. What they do expect is transparency and thoughtful problem-solving.
For example, an administrator might say, “Increased delays in room turnover during clinic hours are beginning to affect patient flow by midafternoon. The issue appears tied to staffing coverage and appointment spacing. Here are several options to consider over the next month.”
That conversation feels very different from simply saying, “The clinic has been really hectic lately.”
The difference is leadership.
Operational Leadership and Clinical Leadership Work Together
Managing up is not about shielding physicians from operational reality. It is about helping them see the full picture clearly enough to make informed decisions. In many ways, administrators serve as the bridge between clinical excellence and operational excellence. Physicians are focused on patient outcomes and care delivery, while administrators balance staffing, scheduling, compliance, culture, finances, and day-to-day execution.
Neither side succeeds alone.
Trust Is Built Through Consistency
The healthiest practices recognize that operational leadership is not separate from clinical leadership. The two depend on each other. When that relationship is strong, difficult conversations become easier because both sides understand they are working toward the same goal: building a stable, sustainable practice that serves patients well and supports the team behind it.
Trust grows gradually through consistent behavior. It develops when administrators communicate proactively instead of reactively. It grows when leaders stay calm under pressure, avoid unnecessary drama, and focus on solutions instead of blame. It strengthens when physicians know they will hear the truth, even when the message is uncomfortable.
Over time, physicians begin to rely on those individuals not only for execution, but for perspective.
What Managing Up Actually Looks Like
That is what managing up really looks like.
It is not about hierarchy or personality. It is about partnership. It is the ability to communicate clearly, address problems early, and help leadership navigate challenges with confidence instead of confusion.
And in practices that continue to grow successfully year after year, that skill becomes invaluable.
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