The 5 Critical Elements of Leadership: The Link Between Leadership and Culture

Trustworthiness, clear communication, collaboration, courage, and the ability to embrace disruption are all critical leadership elements that become more obvious, especially when lacking, during challenging times when leadership is needed the most.

by Mia Cary, DVM

LEADERSHIP DURING A CRISIS—FOR example, those we see routinely in our veterinary practices and even during the challenging times of COVID-19—in many ways mirrors what is needed during everyday life.

Trustworthiness, clear communication, collaboration, courage, and the ability to embrace disruption are all critical leadership elements that become more obvious, especially when lacking, during difficult times when leadership is needed the most.

5 Critical Leadership Elements


The first and foundational behavior of a cohesive team is trust, and specifically a vulnerability-based trust. At the heart of this type of trust is the willingness and ability to abandon pride and fear so that each team member can simply be themselves. While potentially initially disconcerting, this can ultimately become quite liberating, especially for people who are tired of overthinking their actions while managing the politics that accompany many work environments. According to leadership expert Patrick Lencioni, vulnerability-based trust can be cultivated through shared experiences and the celebration of successes. It’s certainly not a one-and-done situation; foundational trust results from shared experiences in a variety of contexts over time.

Consider the “emotional bank account” concept first developed by Stephen Covey. An emotional bank account consists of positive deposits and negative withdrawals. With every interaction between two or more people, there is either a positive deposit when something good happens or a withdrawal that results from a negative interaction. The goal is to have more deposits than withdrawals, so you always have a cushion. When you have a cushion, a single withdrawal, such as not getting enough sleep, being tired, and sharing a sarcastic response, doesn’t have that negative of an impact. The cushion of many previous positive interactions makes it easier for the other person to be compassionate, to be quick to assume the best, and know the sarcastic remark is a one-off behavior. It therefore does not become a negative defining moment.

Take, for example, your relationship with a particular client. Imagine, if you will, that as she enters your practice, she is greeted with a warm welcome by a client service representative and escorted into a clean, inviting exam room where she is offered coffee or bottled water. There are several positive deposits that occurred in a row, and already a cushion is being built. If there is then a bit of a wait until the veterinary technician enters the room, she is more likely not to be bothered, especially compared with the client in the next scenario. Imagine that this second client enters your practice and is not greeted but rather told to take a seat and that someone will be with her soon. She then waits for 15 minutes without another contact, the whole time wondering how long she will have to continue waiting until she is at least recognized. Obviously, in the second scenario, the emotional bank account is quite low.

Consider your practice and your team—have you shared enough of yourself and built up enough positive deposits with your team? Do they know you want the best for them and that you trust them? If not, it’s never too late to start making deposits.

In addition to creating a culture based on trust, the most effective leaders also trust their team members to deliver. Strong leaders know the reality of everyday leadership in that every person, regardless of role, has the ability to serve as a leader and positively influence those around them. Team members are empowered to drive for excellence by taking calculated risks that will help the team move rapidly and effectively toward shared targets. Team members are encouraged to fail fast, fail often, and learn from the approaches that don’t end up leading to the expected results. This creates not only an environment that is nimble and forward-facing but also one that allows team members to have fun and continually grow.

Clear Communication

Have you ever left a meeting feeling unclear on what exactly was accomplished and what your next steps should be? This, unfortunately, happens frequently in the modern workplace. Strong leaders set an expectation of clarity and clear communication. And they walk the talk. Team members know who is doing what, why they are doing it, and by when they need to do it. If you’ve read any of author and entrepreneur Kim Scott’s work on radical candor and radical compassion, then you’ve been exposed to her powerful communication model based on caring deeply and challenging directly. This is clear communication at its best. Rooted in empathy and a deep desire for others to succeed, radical candor is a leadership skill that can be practiced and strengthened regardless of where you are on your leadership journey.

The first and foundational behavior of a cohesive team is trust, and specifically a vulnerability-based trust.


The strongest leaders know that together is better.

The strongest teams are the most diverse.

Social scientist Scott E. Page states that 1 + 1 can = 3, but only when the two 1s are different. While we espouse the importance of diversity and inclusion, are we doing everything in our power to create diverse teams? Shane Snow introduces a related and interesting concept in his book Dream Teams.

Historically, hiring managers in most industries were trained to look for “culture fit.” Skills and product knowledge could be taught, required competencies could be developed, but culture fit with the rest of the team was paramount. Snow suggests that instead of culture fit we should be looking for “culture add.” Instead of worrying that different perspectives might create conflict, we should instead be heralding the benefits that different minds, perspectives, backgrounds, and personalities bring in terms of creating positive conflict and friction. Take a look at your team—does everyone look and think the same? The conflict and friction created by diverse teams, when nurtured in an environment of mutual trust and respect, lead to novel ideas and innovative approaches that ensure forward progress and momentum.


It takes courage to speak with radical candor, encourage conflict, and embrace a culture in which calculated risk is not only accepted but celebrated. It also takes courage to be vulnerable and authentic. It wasn’t too long ago that professionals were encouraged to have a work self and a home self and never the twain shall meet. Thankfully, the tide has turned. While we may modify our communication style to meet a specific situation and we may choose to share a little or a lot about our personal lives based on our comfort level, experts such as Brené Brown have made vulnerability and authenticity attributes to be encouraged and celebrated. Strong leaders are courageous, and the strongest have found that sweet spot where confidence is high and ego is low.

Embracing Disruption

The ability to embrace disruption without flinching is an obvious benefit when times are turbulent. Strong leaders realize that embracing disruption in terms of new ideas, novel approaches, and untested theories is how we keep sharp in good times and in bad. Leaders who approach their work and their colleagues with an open mind are able to evolve faster while creating a culture that is fun, invigorating, and attractive.

Stanford University psychologist Carol Dweck, PhD, introduced the term growth mindset to describe a mindset that, by default, embraces disruption. A person with a growth mindset views change and disruption as an interesting opportunity to explore rather than something to be feared or ignored. Dweck describes a mindset continuum with the fixed mindset on one end of the scale and a growth mindset on the other end. And the good news? Growth along this continuum can be cultivated! Take a moment to consider your own approach to disruption—are you more toward the fixed end or more toward the growth end of the continuum? If your default is to have a growth mindset, congratulations! If your default is to have more of a fixed mindset (and remember, radical candor!), that’s OK! Being honest with yourself and committing to start being more open to change, new opportunities, and disruptions will start you on the path toward a more open, growth mindset. There are many useful resources to guide you on this path, including Dweck’s book Mindset: The New Psychology of Success.

The first and foundational behavior of a cohesive team is trust, and specifically a vulnerability-based trust.

How Does All of This Relate to Veterinary Medicine?

Leaders have the power to shape the culture of an organization. This is why these five leadership elements are as important in veterinary practice as they are in any other business setting. Pick up any veterinary publication or attend any veterinary conference and you will find at least one article or session that either outlines the current wellbeing gap in our profession or offers best practices for bolstering wellbeing, or a combination of both. In a unique and important twist on this theme, earlier this year during an Indiana Veterinary Medical Association meeting, American Veterinary Medical Association Chief Economist Matthew Salois, PhD, shared the following thoughts: “Things like yoga and achieving work-life balance and eating healthy, these can all at a microlevel help you adapt to stress. But a caustic, disengaged workplace is still a caustic, disengaged workplace, even in spite of those things. So if you are a manager, if you are a leader, you all own this. We can all make this better by focusing on our workplace, the environment that’s created, and the culture that we generate.”

If you are a manager, if you are a leader, you own this. So do I. This is on all of our shoulders. What are we doing to create healthy, thriving cultures where every individual is empowered to be vulnerable, to be courageous, to freely collaborate, where diversity is celebrated and inclusion is the norm, where communication is clear and consistent, and where disruption is embraced? Are we walking the talk, or are we hiding our heads in the sand?

As the adage says, if we aren’t part of the solution, we’re part of the problem. What’s your choice? 

Mia Cary
Mia Cary, DVM, specializes in leadership, communication, strategy, teamwork, innovation, and wellbeing with the purpose of activating others to thrive. Her professional experience includes leadership and education roles at the American Veterinary Medical Association, the North American Veterinary Community, Boehringer Ingelheim, and Novartis Animal Health. She currently serves as CEO and change agent for Cary Consulting, serves as CEO for the Pride Veterinary Medical Community, serves on the board of advisers for the Veterinary Entrepreneurship Academy, and is a past president of the American Association of Industry Veterinarians. She resides with the Cary crew in Greensboro, North Carolina. 


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