What is a dyad and how do I fit into it? What do I do? These are the questions every new healthcare leader asks themselves, as I did, when they first join a dyad partnership. Although there has been much academic writing regarding leadership dyads in healthcare, with a macro focus on structure and accountability and implementation, there is a paucity of guidance on the practical aspects of a dyad leadership structure and how it can be successful. What sets apart high functioning successful dyads from those that are unsuccessful? How can dyad partnerships be improved? How can we ensure we have an effective dyad from the beginning?
Be Trustworthy
Implicit trust is the core foundation of a successful dyad and must be all-encompassing; without such trust, the dyad cannot function as intended. A leadership dyad is, by definition, a high-trust relationship: partners must trust each other to follow through on tasks, keep each other informed, and provide support. There have been countless times where I’ve said, “I’ll handle this” and my dyad partner didn’t need to ask again because she trusted me to follow through, and to let her know when I did so. The onus is on me to communicate my follow through. That trust isn’t just efficiency; it’s the core of our working relationship. We know that it exists because we have explicitly talked about the need for a high trust relationship. The first step in forming a successful dyad is building trust, but it doesn’t happen automatically. Discuss what you each need to form a high trust relationship and take the necessary time to build the relationship.
You Must Communicate
While this may seem obvious, effective communication can be quite challenging. Each partner in the dyad should be very familiar with what the other is working on, regardless of the scope of the work. My partner and I make it a point to update each other frequently, even on things that seem trivial. You must intentionally make time to keep each other updated via scheduled meetings or informal “catch up” sessions. Share your calendars, update each other frequently, even if it seems like it’s “too much”; it’s ok to over communicate. Equally important is being responsive to your partner and never discouraging communication. Most leaders are involved in many projects, especially in rural settings where resources are limited. We often find ourselves pulled into projects because no one else is available or a colleague needs help. My dyad partner is my primary resource in any setting, but she has to be aware of everything I am involved in, and vice versa, in order to maintain situational awareness and help when needed. Sometimes I don’t even know that I need help until my partner lets me know that I have overlooked something. I trust her to do that and I communicate with her accordingly.
The Dyad as a Singular Entity
The dyad should be seen as a cohesive unit where two people act with a singular focus. Each dyad partner speaks for the dyad and has the authority of the other partner. It should be organizationally accepted that dyads function this way and that one partner speaks for both. Our colleagues and staff know that whether they come to me or my partner, they will get the same message. We operate and speak for each other when needed and trust each other’s intent when doing so. Trust permeates everything, that’s why it is the first and most important element needed for success. The dyad partnership is like a web: each partner weaves their part using their unique expertise, but the final structure is seamless and stronger because it’s interconnected.
Leverage Your Differences
In any dyad, each partner brings distinct strengths to the relationship. This is particularly evident in healthcare, where the most common pairing is a clinician and an operational or administrative leader. These differences aren’t barriers to overcome; they’re strategic advantages to harness. Rather than trying to master every aspect of your partner’s skillset, be it clinic throughput metrics or clinical decision making, the key is to trust each other’s expertise and lean into those complementary skill sets. When partners feel pressured to know everything, imposter syndrome and tension creep in. But when you operate from the assumption that your partner knows what you don’t, and has your back, you remove a significant source of stress and prevent decision fatigue. This fosters mutual respect and builds credibility in the relationship; every action leads back to building trust. You’re not duplicating effort; you’re playing to your strengths while covering more ground together. In our partnership, we don’t expect one another to know everything. What we expect is that the other will know what we don’t, and will be honest when they need help and point out when something is overlooked. That trust allows us to move quickly, make informed decisions, and support our teams more effectively. The most effective dyads aren’t mirror images of each other. They’re puzzle pieces that fit together because they’re different by design.
Align Around the Mission
Even the strongest dyads will face disagreements, on priorities, pace, people, or policy. What prevents these disagreements from becoming divisions is a shared understanding of the mission and the ability to have difficult conversations. When dyad partners stay mission-aligned, whether that means improving access for patients, stabilizing a burned-out team, or stewarding resources wisely, they can disagree without losing cohesion. A high trust relationship means that you can have difficult conversations and assume positive intent from your partner: they are trying to help you rather than criticize you. Decisions are no longer about who’s right, but about what’s right for the mission. In our partnership, when we’re stuck or frustrated, we’ve learned to pause and ask: “What outcome would best serve our patients and staff?”. That simple question shifts us out of ego and into alignment. Sometimes we table discussions and come to back to it with a fresh perspective. The most effective dyads don’t just share goals, they develop a shared purpose. And that purpose keeps the partnership moving forward, even when the path gets complicated.
Stepping into a dyad relationship, especially for the first time, can be challenging. It takes time and effort to build trust and figure out how to best communicate within your unique context. Treat the relationship like a core aspect of your job: spend the necessary time to develop it and be intentional in developing good dyad habits. Set out your expectations for each other from the beginning and work towards a common goal. When a dyad works well, it is noticeable to everyone around you and makes every other part of the job much more enjoyable and meaningful.
