The Toxic Impact of Bad Bosses in Osteopathy

I talk about the core principles and lessons inside Liz Wiseman's "Multipliers" and translate them into how you can apply them as an osteopath.

Podcast Episode Transcript

This episode is for you if you’re a principal with a team or you’re hoping to bring on your first practitioner. This episode is also for you if you’re an associate and you want to know whether you should stay or leave.

Because listen up real close principals, Multipliers by Liz Wiseman will completely change the way you think about being a principal so you can get the most from your team all while driving your practice forward. It will change your associates life. It will be the book you recommend every other principal you know to read.

Why? Because most of us know a bad boss when we see one. Or when a friend is complaining about how unorganised, obnoxious or dismissive their boss is, and we think “I’d never be like that” or “If my boss treated me like that, I’d quit!”

Multipliers by Liz Wiseman looks at the difference between good leaders, who she’s called Multipliers, and bad leaders, who she calls Diminishers.

Liz explains how to recognise the different types of Multipliers and Diminishers, while comparing the skills you should strive to develop with the ones you should avoid with every fibre of your being.

This is Behind The Osteopath. I’m Alan Zaia in an osteopath and Founder of Osteohustle where we plan, build and grow your dream career. I need to say thank you to everyone who’s got in contact with me over the time we’ve been doing this – your support has been amazing.

In this episode, I’d love to hear from you. If you’re on your phone, click on the episode, scroll down and you’ll see a Q&A section or my email is in the description. Tell me if you’re a principal or associate etc and how you relate to this book and the discussion of leadership as an osteopath.

Finally, if you find value from what I’m going, if you can, please leave a 5 star review. I really am putting myself out there to hopefully evolve our profession by talking about the hard things. Thank you!

Okay. Context.

I first read this book in 2021 and again now for this podcast. If you’re a principal and this book resonates with you, go and read it yourself. As always, I won’t be covering every point as I want to keep these episodes under 30 minutes.

Alright. Let’s dive in.

What’s leadership got to do with being an osteopath?

Leadership is not confined to traditional corporate settings because effective leadership contributes to the overall success of your practice. How?

You can maximise your team’s potential, create a learning environment where everyone improves everyone.

You can empower others and they can absolutely empower you, improve problem solving skills, communication skills as well as ethical decision making.

I believe that we need more leaders in osteopathy. We need more principals to study leadership because as Liz puts it: “The need is universal. Everyone comes to work hoping to be utilised. And it’s not just for millennials. Certainly new and younger workers expect, if not demand, to be treated differently than those who came before them. But I’m not convinced millennials actually need or want anything different than other generations. Contributors of all ages and stages want their ideas to matter, their voices to be heard and workplaces where they can grow.

The point being that leadership is an essential skill I believe every osteopath should study.

Alright, let’s start with the first key lesson.

Multipliers strengthen, Diminishers destroy

Multipliers use their intelligence as a tool rather than a weapon. They apply their intelligence to amplify other people’s intelligence and capabilities. Liz explains in her research that people got smarter, ideas flourished, hard problems were solved easier. The point is that Multipliers are not just intelligent in their own right, but they are also intellectual multipliers.

Whereas Diminishers are still intelligent in their own right too, but their intelligence only flows one way: from themselves to others. What this does is lead to people feeling like they can’t bring ideas to the table in fear of them being squashed, ignored or simply not acted upon despite saying they would and most interestingly, when people solved an problem for themselves, diminishers would say that you should have come to me about it first. Overall, Diminishers drain intelligence and capability out of the people around them.

It’s easy to automatically think of ourselves as a multiplier, because, let’s face it, we all have an ego and we all think that we would never squash someones ideas. And Liz explains this as the accidental Diminisher.

So, I urge you to really pay attention to your thoughts, feelings and actions and ask yourself: am I bringing out this persons genius, or squashing it?

Building on from that, the second lesson asks you:

What could you accomplish if you could get twice as much from your people?

Because Multipliers don’t just extract everyone’s intelligence, they get the most capability from people.

So, Liz has done heaps of research, too much to cover in this podcast so that’s why you should grab the book to get all the details, but one bit of research involved interviewing that found that multipliers got a lot more out of them than Diminishers. The interview involved asking each person to put a percentage on their capability that a Diminisher got from them verses a Multiplier.

For Diminishers: the number ranged between 20 and 50%.

For Multipliers: the number ranged between 70 and 100%

And when they compare the two sets of data, they found that Multipliers got 1.97 times more from their people’s capabilities. That represents an almost two fold increase – a 2X times effect.

Liz explained that “the reason for the difference is that when people work with multipliers, they hold nothing back. They offer the very best of the thinking, creativity and ideas. They give more than the jobs required and volunteer their discretionary efforts, energy and resourcefulness. They actively search for more valuable ways to contribute. They hold themselves to the highest standards. They give 100% of their abilities to work – and then some.”

So, what could you accomplish if you could get twice as much from your people?

And how do multipliers access people’s genius and max out their capabilities? The answer is in their mindset and the 5 disciplines of the Multiplier.

I want to make sure everyone is on the same page here and say that the book outlines five key disciplines or practices that Multipliers typically show in their leadership approach. These disciplines are not necessarily separate leaders, but rather attributes of effective leaders.

The five disciplines are:

  1. The talent magnet: attracts and optimises talent
  2. The liberator: requires people’s best thinking
  3. The challenger: extends challenges
  4. The debate maker: debates decisions
  5. The investor: Instills accountability

And now we’re going to summarise each one. I will miss stuff out. Again, read the book yourself too.

Multiplier discipline number 1. The talent magnet: attracts and optimises talent

Starting out with a banging statement: Diminishers bring in top talent and make big promises, but then they under-utilise their people and disappoint them.

What I’m about to give as an example is not an attack on any principal who has done this and I’m going to give this example because I know it happens a lot and this podcast is meant to be about talking about the hard things, so don’t come and attack me – work with me by leaving your thoughts in the Q&A section. Again, if you’re on your phone, click on the episode, scroll down and you’ll see the Q&A section.

Here’s the real example.

An associate goes to an interview. Nearing the end of the interview, the associate asks: “One of the reasons why I’d like to be an associate here is to learn from you since you’re more experienced than I am. Do you have a mentorship situation in place, or maybe something where I could shadow you?”

And the principal replies, “absolutely, we can set something up to meet together once every two weeks for an hour or so. How’s that?”

The associate then accepts the job and everyone’s excited and happy.

Fast forward 1 month, the principal cancels the meeting because they’re busy.

3 months later, haven’t had a meeting yet, but because they’re new and there hasn’t been much communication, they don’t want to rock the boat so they don’t say anything.

6 months down the line and nothing’s been mentioned about the meetings or shadowing.

The associate says that they’re leaving to go to a different clinic.

Woah. Right?

Now for the principal, this is sudden and for no reason. What the hell just happened?

For the associate, this has been coming because expectations weren’t being met that could be met elsewhere.

Here’s the thing that Liz says that fits perfectly: Multipliers make sure everyone has clear expectations for what the role involves, ensuring that everyone fully understands their responsibilities, including themselves and sticks to what they say they’re going to do.

There’s loads to unpack here, but I’ll leave it for now as I want this to be under 30 minutes.

Imagine if things went the other way.

The associate, let’s call them Taylor, accepts the role, everyone understands their responsibilities, the bi-monthly mentoring hour sessions are going great and this is where Liz would say that under the leadership of the talent magnet, the genius of A players gets discovered and utilised to the fullest. Then, because Taylor is getting smarter, they turn into A+ players who are given recognition for their work and contribution.

And if you have a team of 3 or more lets say, Taylor’s genius is made known to the other practitioner so that the next time they need a problem solved that they know Taylor would be great at, they go to them! And the cycle continues!

Speaking of cycles, a quick point is that if you’re a talent magnet who helps people to reach their capabilities, that helps to attract more talent through reputation. Whereas Diminishers hire people and under utilise them which leads to people becoming disinterested and wanting to go somewhere else, developing a reputation as a place not to work.

We all know how small of a community our profession is. Word gets around fast. So, if you’re a talent magnet, not only will you get a better, more fulfilled associate who helps drive your practice forward, you’ll also gain a reputation where people come to you!

Multiplier discipline number 2. The liberator: requires people’s best thinking

Multipliers understand that they don’t have all the answers, and they actively seek out the collective intelligence of their team. They liberate their team to think and contribute by creating an environment where people feel safe to express their ideas, take risks and innovate. This discipline is about valuing and leveraging the diverse perspectives and strengths of your entire team.

Because when you’re a liberator, you encourage open communication, complete collaboration and the sharing of all ideas. You trust your team’s abilities and empower them to take ownership of their work.

In return for you, your team will feel more engaged, motivated and committed to achieving the practice’s goals because they are working on something that’s bigger than themselves. They are more likely to bring their best thinking to the table, which can lead to creative solutions, improved patient care through knowledge sharing as well as practice growth when it comes to figuring out how to boost word of mouth and improve marketing in general.

The best part for me about most chapters but for this one in-particular is the practical aspects. How do you become a liberator?

Liz speaks about 4 things:

Firstly, you’ve got to play fewer chips. Here, you’re allowing others to contribute by talking less. Imagine you have a set of 10 poker chips, each worth 1 minute. The longer you speak, the more chips you have to pay. This forces you to allow conversation to happen while also forcing you to prioritise what you feel must be said.

Second is to label your opinions. Put simply, you must communicate whether your opinion is a soft opinion or hard opinion because unless you say so, others will interpret and may get wrong. So, soft opinions are when you have a perspective to offer and ideas for someone else to consider. This allows others to comfortably disagree with you. Whereas hard opinions are when you have a clear and potentially firm point of view and this is only used for when it really matters.

The final 2 are about mistakes.

So, third is to talk up to your mistakes. When you make a mistake, you need to talk about them openly and publicly because mistakes are an essential part of progress.

Fourthly and last up is to make space for mistakes. So here defining the sandbox. Where it’s okay to mess around, where it’s okay to fail verses where failure isn’t an option.

So, for example, okay to fail would be for coming up with suggestions for trying a certain marketing strategy. Where as when failure isn’t acceptable, we’d be speaking about patient safety, professional boundaries, gaining proper consent, knowing what to do in an emergency etc.

So as a liberator, when you’re learning as a team, By defining where it’s encouraged to experiment verses where it’s not okay to fail, you’re creating an environment where people can take risks, learn from their mistakes and continuously improve without disrupting confidence or creativity when it matters.

Multiplier discipline number 3. The challenger: extends challenges

Bearing in mind what I’ve just said about being a liberator, it may be hard to know that Multipliers are not afraid to challenge their team members to stretch beyond their comfort zones. They believe in their team’s potential and push them to reach new heights. So, this discipline is about setting high expectations, providing opportunities for growth and encouraging continuous learning.

For me, the idea of providing opportunities for growth is the most interesting because as a profession, I’d say we have a long way to go when it comes to providing opportunities for associates who want to take on challenges, more responsibility and different roles while being an associate. Going back to what I said earlier about that Everyone comes to work hoping to be utilised, if someone hits a ceiling and wants more but doesn’t get it – they’ll look for it somewhere else by starting their own clinic by themselves or with a partner or they go looking for a different associateship, one with new challenges and fulfilment.

Following what Liz says at Osteohustle, when we work with clinic owners with teams and talk about challenging their team to excel even in ways they never expected to, we get the principal to ask the hard questions, give the person belief that they can meet the challenge and help them to create a plan around how to achieve it, we find that it leads to increased confidence, higher performance and a sense of achievement.

Being the challenger also keeps your practice adaptable in a constantly evolving world – take a recession or covid for example – what do you and your team do when it comes to something you have no control over? I think we’d all agree that it would be better to know that you’re surrounded by a team who already come together to overcome challenges way before the pandemic hit. I’m giving extreme examples, but they’re real examples and again, it’s better to tackle something as a team rather than doing everything alone.

Multiplier discipline number 4. The debate maker: debates decisions

So, the debate maker discipline is about finding out different perspectives, weighing up different options and making intelligent, informed decisions and this is because Multipliers understand that the best decisions are often the result of healthy debate and a mix of viewpoints.

Similar to being a liberator, you want to create an environment where everyone feels comfortable expressing their opinions, even if they differ from your own. Essentially, this leads to more diverse, critical-thinking skills which leads to better, more effective solutions for your practice.

Now, this is a simple concept but hard to get good at on a consistent level. Liz explains the 3 practices of the debate maker. She also details how to become a debate maker in a way that I cannot summarise into a 30 minute podcast – this is another cue for you to read the book because it’s bloody fantastic, but I hope that gives you a flavour of the debate maker and it’s importance.

Multiplier discipline number 5. The investor: instills accountability

If you have trouble with delegating, this discipline is for you.

This is where Liz compared micromanagers, we all know what micromanagers are, with investors who she describes as “giving other people the investment and ownership they need to produce results independent of the leader”.

As an investor, you provide your team with the resources, support and guidance they need to succeed. You trust them to deliver on their promises but you also hold them responsible for their actions through accountability. And the way you do this is by offering feedback, you know you coach them and give them the space to learn from mistakes which helps them grow and become a kick ass person to have on your side. The discipline of the investor is about setting clear expectations and ensuring that everyone takes ownership of their role.

My favourite of the 4 great ways to become an investor is to give 51% of the vote.

And what this means is that if you have an associate come to you and they express to you that they’re worried about the consistency of patients they’re treating, and being a multiplier, you’re going to work together to figure out what it is they can do to improve either their number of new patients via marketing or how to improve their return rate percentage via a whole host of different options like communication, their confidence and effectiveness of writing out treatment plans, knowing how to provide a better patient experience etc.

You’re going to tell them that they, not you, are in charge and accountable.

Tell them how you will stay engaged and support them, but that the remain in charge.

Finally, you’re going to give them a percentage to make expectations concrete so everyone is on the same page.

For example, tell them they have 60% of the vote and that you have 40% – so they are still in charge and responsible, but you have your side of the deal to hold up too.

This final discipline is the one that I believe if you truly embrace, you’ll be able to let go of that feeling everyone gets who’s ever been “someone’s boss” and wanting to help them but something’s holding you back.

What’s holding you back could be numerous things but ultimately, you have started this practice, you’ve worked your guts off to get it to where you bring someone else on board and if you get that feeling of “oh, I’ll just do it because I can do it the best” or there’s something in your head where you don’t trust them to do things right or you want to help but you don’t know how to.

And it’s at this point where I want to make you a promise – I guarantee you that if you become an investor in your team, it doesn’t matter whether it’s you and one other person or a team of over a dozen, your practice will hit a whole new level and everyone, including yourself, will be incredibly more satisfied and fulfilled with your career and the overall success of your practice, people will want to stick around and even if they don’t you’ll have a reputation for getting the most out of people, as we discussed with being a talent magnet, it will help a hell of a lot with stress as you’re able to get more from the people you work with. It is an absolute win:win, no brainer, wish you’d done it sooner skill.


In summary, I believe that leadership skills are essential for every osteopath to study and apply, regardless of their role within a practice. If you want help with getting the most from your team, email me with the subject line: MULTIPLIERS and I’ll know you’ve come from this podcast.

If you’d like to share your thoughts or experiences, please use the Q&A section or reach out to me via email.

Your support means a lot, and if you find value in this podcast, if you can, please leave a 5-star review. It helps spread the message and encourages discussions on important topics within our profession.

Thank you for listening to Behind The Osteopath.

I urge you again to really pay attention to your thoughts, feelings and actions and ask yourself: am I bringing out this persons genius, or squashing it?

See ya next week for book 5. Subscribe so you don’t miss it as soon as it comes out.

Written by Alan Zaia M.Ost

Founder & CEO of Osteohustle. You’ll find Alan coaching osteopaths, travelling in a van or writing our weekly newsletter, The Hustle.

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