Leadership: The Bacon Effect

Your office manager has been looking at the schedule. Patients are waiting longer for appointments, the practitioners are feeling stretched, and finding room for an unexpected follow-up has become a daily negotiation. 

You may agree. You have been feeling the pressure too. It would be easy to say, "We need another practitioner" and launch into talking about candidates, compensation, and how soon someone could start. 

But before you get there, ask two questions. 

"What work do we need another practitioner to take on?" 

"How will this new hire pay for themselves?" 

The first question helps define the job. Do we need more appointment capacity, coverage at another location, or someone who can serve a patient population we currently struggle to accommodate? 

The second asks for the business case. Will this person bring in new work? Will they allow us to serve patients we are currently turning away? If they take work off another practitioner's schedule, will that person have room to do something else the practice needs? 

"We are all busy" describes how the practice feels. It does not yet explain what another person will accomplish. 

You are not asking your manager to defend the request so you can reject it. You are asking them to help you think it through. Hiring may be exactly the right answer. But before committing, you want to agree on what will change and how you will know the decision is working. 

That is an opportunity for mentorship. Instead of handing down a yes or no, you are helping your manager build a recommendation that connects the needs of the business, the patients, and the staff. 

What bacon has to do with leadership 

In the 1920s, Beech-Nut hired public relations pioneer Edward Bernays to help sell bacon. Rather than relying on a direct sales pitch, Bernays arranged for a physician to ask thousands of other doctors whether a heavier breakfast was preferable to a lighter one. According to his later account, roughly 4,500 responded favorably. He publicized their responses, and newspaper coverage connected hearty breakfasts with bacon and eggs. [chibe.upenn] 

The campaign did not establish that bacon was healthy through a clinical trial. It used medical authority to promote a commercial interest. That distinction matters, especially for those of us working in healthcare. [chibe.upenn] 

What makes the example useful here is the shift in attention. Bernays moved the conversation away from buying a particular product and toward what constituted a proper breakfast. 

Decades later, communication researchers developed agenda-setting theory to explain how media attention can influence which issues people consider important. The idea is not that you control someone’s conclusion. You influence what receives their attention. [thisiscapitalism] 

Applying that distinction to leadership gives us a practical question. Before we ask people to think differently, have we helped them look at the right problem? 

The question can narrow the problem too soon 

Go back to the hiring request. Compare two ways the owner might respond. 

"How soon can we get someone in here?" 

"What work do we need another practitioner to take on, and how will that work support the position?" 

The first question moves straight to recruiting. The second leaves room to find out what is actually causing the pressure. Perhaps referrals from a new physician group have grown faster than anyone planned. Perhaps patients at a satellite office are waiting because coverage there is thin. Perhaps practitioners are spending hours on tasks someone else could handle. 

Each answer leads somewhere different. The first may justify a hire right away. The second may call for a hire with a different schedule or skill set. The third may call for a different solution, at least for now. 

The economics work the same way. A practitioner who adds capacity for referrals you are currently delaying or declining has a clear path to covering their cost. A practitioner who mainly absorbs existing work needs a different explanation, such as freeing a senior clinician to build referral relationships or take on more complex cases. Both can be good reasons. They just need to be stated. 

Your manager may already have much of this information. Most practice management systems can show appointment wait times, visit volume by location, referral sources, and billed revenue by practitioner. Pulling a few months of that data turns "we are slammed" into a recommendation you can evaluate together.   

There is an important limit here…If you have already decided you cannot fund another position this year, don't ask your manager to build a business case while you wait for them to reach your conclusion. Say so, and turn the conversation toward what can be done within that limit. If you have already decided to hire, ask for help defining the role instead. 

These questions should never become a polite way of steering toward "we cannot afford it." Your manager may come back with a stronger case than you expected, and you should be prepared to act on it. 

A useful test is whether you are willing to hear something that changes your mind. If you are not, give a clear answer and explain your reasoning. That is more respectful than pretending the conversation is open. 

The next time a request comes up, such as a new hire, a piece of equipment, or a schedule change, resiste the urge to respond and instead write down two questions. What problem would this solve? How would we know it was worth the cost? 

Ask the person who raised it to come back with what they think, using whatever data is readily available. Then talk through their response together. Before the conversation ends, agree on a decision or next step, who owns it, and when you will review the result. Your experience still matters. So does your responsibility to make the call. But when you are developing someone else, the most valuable thing you contribute may be the questions they learn to ask the next time, when you are not in the room.