Every practice is awash in relationships. But no relationship is more central to the s successful function of a practice than the relationship between the administrator and the practice’s physician(s). In the happiest settings, the lead physician and lead lay staffer are on the same page...and stay there with open communication, regular meetings, and formal planning. In many troubled practices, the main difficulty is not a marketing problem or an HR problem or a billing department problem. It is a failure of the managing partner (MP) and administrator to connect and function well in the so-called “dyadic management model” that has long been recognized as the key leadership structure in ambulatory healthcare.