When my children were younger, my work hours were long. I would routinely get home between 8 and 9 o’clock. In spite of the inconvenience, my wife and I committed to consistently sitting down at the table for a family dinner — no television or electronic distractions — just conversation. I believe this was one of the best decisions we made as parents.

If you Google “the importance of family dinners,” you will produce over two million references from lay and scholarly sources. Consistent family dinners have been associated with virtually every positive metric of childrearing (better grades, higher performance on standardized testing, improved self-esteem, etc.); conversely, dinners seem to be protective against almost anything parents might fear (obesity, promiscuity, drug use, etc.).

In essence, we performed our own, nearly two decade-long nonrandomized and uncontrolled sociological experiment. In that time, I learned one important lesson.

Cumulatively, I have experienced literally thousands of dinners with my wife and children. I would estimate that, on average, nine dinners come and go without anything of consequence occurring. Talk is sparse or inconsequential. Nothing is really new. School was fine.

Then, suddenly and unpredictably, during the tenth dinner magic happens, and it takes a variety of forms. Meaningful information is offered about friends. Aspirations for the future are revealed. Fears are acknowledged. Arguments erupt and resolve. A mannerism or mood is subtly different, and delicate inquiry lifts the veil of teenage obfuscation ever so slightly. The magic is simple: real communication occurs, and it is gold.

The one important lesson I learned is that the magic cannot be scheduled. The nine “meaningless” dinners are far from meaningless. They are a necessary prerequisite to experience the magical tenth. The meaningless nine establish the trust and comfort to allow communication to occur. They build your capacity for emotional pattern recognition, so you intuitively know when something is a little off kilter. You cannot surgically schedule the tenth, without embracing and relishing the nine.

I believe the same dynamic applies to leading people. There are numerous gurus of leadership development. Warren Bennis (author of On Becoming a Leader), perhaps the exemplar of all gurus, believes “ultimately, a leader’s ability to galvanize his or her co-workers resides in both understanding the co-workers’ needs and wants, along with an understanding of…their mission.” What I learned from my nine dinners is the development of empathy and trust is, at least in part, a time-dependent activity. It does not happen without face time.

If a colleague or co-worker has a behavioral issue that needs to be brought to his or her attention, and you do it in the context of your one and only real conversation, it is almost impossible to convey the message effectively. You will not have a receptive, trustful listener and you should expect a purely defensive reaction. If you design a truly brilliant strategy in a cave, and emerge like a prophet to enlighten the masses, even flawless oratory is unlikely to galvanize a team. If you expect to be informed about the little problems, before they blossom into crisis, it will never happen in a culture lacking trust and open communication. You must embrace and relish the nine, to receive the gift of the tenth.

Atul Gawande asks why some best practices spread rapidly, and others do not. He cites an example from pharmaceutical sales to physicians. Apparently, the company detail (i.e. sales) people follow “the rule of seven touches.” You must interact with a physician seven times before you develop enough trust, and enough of a relationship to influence behaviors.

Healthcare is facing a prolonged period of substantial, foundational change. The environment is one of ever changing laws and regulations, of accelerating consolidation into larger and larger organizations, of expectations of radical transformation of a delivery system evolved over a century. Change will come, and effective leadership will be a necessity for success.

As we drive this change, it is important to remain connected to the human part of what we do. It is not mostly about relationships. It is entirely about relationships.