Scaling with Intention: Leadership, Delegation, and the Art of Building a Culture

Clinicians dream of practice ownership as the ultimate freedom—your name on the door, your schedule in your hands and your vision guiding the future. But reality is far more complex. When Dr. Thanh Mai opened his first practice, he discovered that independence came with an unexpected challenge. Success would hinge less on his clinical expertise and more on his ability to lead.

Wearing Every Hat

When Dr. Mai launched his practice cold, he didn’t step into a turnkey operation. There were no ready-made systems, no team to rely on. He was the doctor, the janitor, the office manager, and the marketing department rolled into one.

“You need to be a great doctor. We also need to be a great leader, and a great manager. And you have to kind of shuffle between the three things.”

That trial by fire gave him deep empathy for every role in the office. But it also taught him a hard truth: a thriving practice can’t rest on one person’s shoulders.

The Calendar as a Mirror

The turning point came when Dr. Mai realized leadership was less about what he said and more about how he spent his time.

“Don’t tell me your priorities. Show me your calendar. Because your calendar reveals your priorities.”

At first, every hour was spent with patients. But that left little room for staff training, team meetings or strategic planning. By deliberately blocking out time to work on the business—not just in it—he created the space to build a sustainable practice.

The short-term trade-off was less clinical income. The long-term reward was a stronger team and a business that could thrive without his constant presence.

The Hardest Lesson: Leading People

Dr. Mai admits that patient care wasn’t the toughest challenge. Leadership was.

“The most challenging thing is actually managing and leading a team. Because you can’t do everything yourself, and that by far is the biggest challenge and opportunity that you have as a business owner.”

Delegation didn’t come naturally. Like many clinicians, he was used to being the expert. But scaling demanded a shift toward empowering others, trusting them to take ownership and letting go of the need to control every detail.

Betting on People

Processes and systems matter, but for Dr. Mai, growth ultimately came down to people. He has no hesitation about investing heavily in top talent.

“An A player is worth two or three times a B player.”

That philosophy extends beyond salary. It includes ongoing training, sending staff to conferences and granting them real autonomy. The investment pays off in loyalty, innovation and a culture where employees take pride in their work. Patients notice the difference the moment they walk in the door.

Scaling Beyond One Location

With his first practice thriving, Dr. Mai began to expand through acquisitions. But growth for growth’s sake was never the objective.

“If we actually care about people—’cause that’s what fires us up—then it’s almost as if we feel like we have an obligation to keep going because we need to help more people.”

Each acquisition required careful scrutiny. Revenue trends, cultural alignment and whether the practice was too dependent on its original owner are all critical to consider. By decentralizing authority and integrating each new location into proven systems, his team avoided the pitfalls of “key man risk” and accelerated growth.

Leadership as a Daily Practice

The story of Dr. Mai’s growth is not about chasing bigger numbers, but about deliberate choices. He chose to build culture from the ground up, to invest in people even before it felt affordable and to step back from being the sole problem-solver.

The result is a business that grows not at the expense of its leader, but through the empowerment of its people. For clinicians considering expansion, the lesson is clear: leadership isn’t a skill you add once the practice is thriving. It’s the very foundation on which sustainable growth is built.

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