Observing and probing the actions of doctor CEO’s can be instructive as it relates to nailing down abilities that help predict success. One of the most interesting came up again this past week in a consultation. A doctor for the past 4-5 years had been focused on practice building. As most of you know, developing a practice to a pre-designated patient level can involve sequentially tackling facility, equipment, staffing and marketing items with, in many cases, considerable overlap. This doctor was very effective and so her confidence grew with each milestone accomplished. Now, staff and partner doctors report that she is crossing from confident to overbearing. It seems to be a case of only she knows what is best, after all, look what has been accomplished in the past few years. A good discussion raised the need for understanding how to develop a buy-in from the now larger group of doctors and staff, tactics for arriving at joint outcomes drawn from many viewpoints and how to reconcile underlying interests. With a new goal, running what has been built, and having the practice team positive and engaged in the practice the Doctor CEO will continue to be confident but not over confident to the point of overbearing and divisive in the practice