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The Culture Focused Practice is where business and humanity collide. Hosted by Dr. Tara Vossenkemper (group practice owner and consultant), this podcast dives deep into how practice culture drives business success. Learn actionable strategies to shape a thriving team, implement and use the Entrepreneurial Operating System (EOS), and tackle the tough leadership decisions that come with growing your group practice. Whether you’re scaling up or streamlining, this show offers real-world insights to help you build a people-powered practice that lasts. Join Tara for candid conversations, expert interviews, and no-fluff coaching that puts your culture first.
Alright y'all. So we are just impromptu going to record this vi table. And the premise of the whole conversation is delegating, but also letting accountability live where it should live and maybe even some coaching, dare I say, or supporting people to step into more accountability within their role.
So Taylor and I are just honestly having a same page meeting, and I realized, this is a podcast conversation. So this is very different in that there are no prompts. This is just us processing 📍 and talking.
Essentially we're talking about the difference between what happened when you passed over integrator specific accountability or ownership to me.
So how did we each get to the point that we actively wanted to be rid of things and actively wanted people to stop coming to us? I think that's the crux of the question for me is, we are in mid conversation about some people on our team, they might be coming to us with questions that we don't think we need to be involved in answering. It's something where, no, this is your role, like you can just actively own this and do it. I know for myself, and I think probably the same for you, Taylor, maybe a little bit less actually, but I think to some extent, I didn't use to feel that way. I used to want everything to come through me.
How did that change? If we want people to be doing the same thing, then like to take full ownership of something, not only in terms of like actively owning it and being accountable for it, but also in terms of feeling confident to make a decision.
How did that happen?
So much of our working relationship has been about transition. Just from the get go, that's kind of been baked into how we work together, how we function.
Because really you think about it, I took on office manager stuff and I took on billing stuff and then I took on director of operation stuff.
Yeah, I think it was a couple weeks in where I was like you were a gem. And so I knew that I wanted somebody like you to be doing this stuff. I feel like early on in our,
Yeah
conversations where I was saying something to you and also it's gaging your interest.
Like, I don't know what this looks like, but in the future, dot, dot.
Mm-hmm.
I don't know when. Well, who knows?
Honestly, it was like this time of year, five years ago. Yeah. I was sitting on my partner's sister's farm 'cause that's where we were living at the time.
Mm-hmm.
And you were basically like, I think you're gonna be my COO someday. And I remember feeling like,
oh, that's so funny.
I'm so giddy. Yes, I want that. I love that. I'm excited to do that.
So I think ultimately, I'm very comfortable with being in transition and kind of being in process for the most part. You know, I sometimes will struggle with the emotions that can come up with
mm-hmm.
Change particularly, when it's people related and, I feel for people. But I'm comfortable with let's figure this out or let's do this gradually. And that was very much baked into the nature of our interactions, and how my time at the counseling hub started. So it wasn't like I was in a position for a long time and then suddenly something different came along.
Yeah.
But I think also you were very intentional, like you're saying, you knew from the beginning basically that this is the direction you wanted to head in.
Mm-hmm.
So we were just very open in talking about, one, this is where I see this going.
Mm-hmm.
But also, sometimes I wonder how much of the magic that I feel like we experience is related to us, who we are
mm-hmm.
Rather than how we do things. Because I think you are very comfortable in being direct with me and I am very comfortable in receiving your directness.
Mm-hmm.
Without there being a lot of emotion attached to it. And so when talking about I wanna do this thing, I wanna go in this direction I didn't need a lot of specifics in terms of timeline or if I felt unclear about expectations around something, let's say, or how to do something, I will tell you, and I have told you, like, I'm game to take this thing on, but I'm feeling anxious about it, because I don't understand this piece of it, or I wanna walk through step by step what might this thing look like? I also think part of this for me is comparing and contrasting like what happened in the transition?
You giving me things to our DCO being in the DCO role.
Mm-hmm.
That transition was very different in that it wasn't necessarily, you giving up things to her because the DCO position at that time was a new position. We had transitioned from you passing that over to the CD and then the CD left and so then you kind of took it back on, but we also had CTLs that were doing some of it, and then we brought the DCO on about seven, eight months later.
Yeah.
Yeah.
Mm-hmm.
So I wonder if some of that was just a much more clear and direct transition of power or accountability, so to speak, from like, I'm handing over billing to you. It's going from Tara to Taylor or whatever. Whereas with the DCO role, it was like, well, we passed it over to the cd, but then some of it got passed back and some of it has changed. Like, I just wonder if some of that was a little bit more just murky.
Whoa, that is so funny. I thought you meant the exact opposite.
Really?
I thought you meant the opposite because the CD and the DCO role, at least in my body, like when we get into the really nitty gritty, I think there's nuance between what's DCO, what's CTL, what the supervisor, you know, all that. But I think there's overlap between the roles that we have on our clinical side. In terms of the core responsibilities from the get go, it has felt, you know, this,
that feels more clear.
This, this, and this, and yours it has felt like emergence constantly, just sort of constantly questioning.
I think that's also just reflective of me that the operation side of things, it's not that I don't see what is happening, like I can't see the things, but to categorize them and then like pass them over, that really starts to feel like, ugh, confusing, super confusing, basically.
And so then I think for me that your role has felt more like emergence, even though I knew I wanted you to be COO sort of from the onset or pretty early on, that has felt like emergence.
It felt so much more clear because for me, so much of operations is so black and white.
Yeah,
But the clinical side of things feels like it can be a little bit more flexible or like up to interpretation maybe.
I think when you're doing operations, a lot of the time it is black and white, but it's less about the specifics and it's more about, I think the ownership piece that feels like accountability and ownership where if your HR becomes a core responsibility of the director of ops or of the integrator, which for us it is, HR is a core responsibility, and then visionary sits here and then integrator sits here, like all this stuff. But to transition the person and now the whole team knows. If your core hr, okay, so that means what that means you are responsible for like hiring and firing.
Are you doing benefits administration and oversight? Are you doing processes and policy? It's like what does this specifically look like? Like what are the things that are held by hr? And also I think, what's my comfort level in saying like, oh, integrator now owns full disciplinary oversight. And I'm out. You know? I think probably because it's not like the details of the processes necessarily, but it's I think the ownership and accountability for the integrator or like a director of ops role, that is probably what felt overwhelming, I think is probably the word.
If I'm like being honest. It felt overwhelming.
This is just a theory I'm tossing out there. I wonder if the ambiguity for you about maybe the operational side of things and like what lives, where and when do I pass this thing over? What's appropriate for this person to have? I honestly wonder if that made it easier. Ultimately,
oh, that's interesting. Mm-hmm.
Versus the clinical services side of things. I don't know if you feel this way, but I see that side of things as being very precious to you. I mean precious as in like important, like cherished, I think it's like a child. I want it to be done well,
yes.
And I have specific ideas about what that means and what that might look like.
Yeah. No, that's fair.
In practice, whereas the operational side of things, it feels overwhelming because it's ambiguous, but ultimately it feels almost like there's less attachment to the specifics if the intentionality is there and the outcome is ultimately, like things are clearer for the team, or this thing is done exactly the same way every time.
Yeah. I do know what you mean. There is absolutely nuance on the operation side of things. I'm thinking of like our client care coordinator, our billing manager, like our operations assistant. These people in these roles, I dunno if it's because they've been with us for so long, but there's a high level of trust that if there needs to be nuance, they're able to effectively navigate that. And they do it overall well, and if they don't, they also know to go to you or they feel comfortable going to you and they will.
I think also they don't have anybody reporting to them. So there's something about like, they're responsible for clients, but they're not responsible for it's ensuring clinical quality. They're not responsible for helping clinicians identify development. They're not responsible for, they're not doing anything.
The stake are very different.
Yeah. So the practice feels like a well-oiled machine. Like the whole thing feels really, I don't wanna say streamlined, but like sleek and clear and like not a lot of rough spots.
We like clean it. We tend to it well, but the op side especially, I don't even think about it ever. I mean, I care for the people. I think about them, you know? There's no fear, there's no doubt, there's no worry, there's nothing on that side.
If there is, it's very, very small and it might pop up if something happens that's a little bit outside the realm of norm, you know? There's so many clinicians, like there's so many different personalities. There's so many different people. There's so many different needs and yeah, maybe precious is the word, but not in that I cherish it more just in that this has a higher likelihood of breaking just because of the sheer number.
Almost harder to repair should something break. Operationally, if something's broken, this is a silly example, but we have a really old AC unit, and we were like, oh, we're probably gonna have to get that replaced when we bought the house. And our realtor was like, actually, you wanna keep that for as long as you can, because the old ones are so easy to fix when they break.
Operations are kind of like things break it's easier to fix.
Mm-hmm.
But with the clinical services side of things, when things break, I think it's a little less clear about what might be broken. And what might it take to fix the break? Is it a person issue? Is it a process issue?
This is not a slight at our DCO, I know she's the right person for our organization and I think she's done a great job in a lot of ways in the role.
I wonder too, if there's something about, she's younger in terms of experience and it's a big role. She's very solid in her counselor identity. But it can be a big leap, I think, to go from being an informal leader and strong in your counselor identity, to then leading other counselors, including people who are developing their counselor identity.
And also to be in charge of not only, ensuring compliance with processes, but also involved in the development of processes, and making decisions about, well, this is what I think should happen with this kind of service, or this is how we should implement this kind of service.
Yeah.
I don't think those are, impossible tasks, nor are they impossible tasks for her. But it's a lot of new learning, and kind of on the job experience. As compared to my training was in policy planning and administration.
Yeah.
So I came in with lived experience of leadership and organization and management, and also my formalized training was heavy in that area, and also I think just kind of a natural inclination to that kind of thinking. I think it is kind of a little bit of what I said earlier, like the magic is about who we are. Like it's a little bit about who I am, but also my training.
Yeah,
And the role kind of grew with me.
Yes. Yeah. You weren't stepping into something major. It was like
Yeah. Yeah.
It's been in development. It continues to be in development.
Yeah. And I also think there's a little bit more freedom or flexibility in building the steps as you're walking up the stairs versus giving someone a fully flushed
giant role mm-hmm.
And saying, do this, you know what I mean? There's a little less room for error or a little less flexibility in that approach.
I guess maybe the question is, can you train somebody? The answer is for sure yes. But I think I'm wondering like, okay, what's the felt sense of doing this? How do you train somebody to take full ownership of a role?
Yeah.
And then again, I feel like with us, because it was ambiguous to use your language, like your role and sort of what this looks like over time. Things were just allowed to sort of develop. That works best for me. And so having that freedom and flexibility to allow the role to almost design itself based on what's needed at the point in time that it's needed, you know?
Yeah.
That's not what it is for the DCO role. I don't feel rigid about it, but it just feels so clear to me. It feels so obvious that it's this. Mm-hmm it's clearly it's 1, 2, 3, 4, 5. These are the responsibilities. However, I know what we're coming up against is it too big?
Do you tease out a second role, like to have somebody be responsible for quality compliance all clinical services including supervision NBCC stuff or like the programming, services, like workshops, groups, any sort of new services, if we're doing developmental tracks.
Is it too much? My answer is still, I don't know.
Yeah. What do other people do? So I'm thinking like, what do other practices, our size, what's their org chart? What's their accountability chart look like? How do they approach these kinds of things. I don't know. I haven't actually looked into it. But I just was thinking like, what if there was a clinical director, and that person was accountable for all clinical services, including adding a new service. And that would look like outlining what it would take, not only to implement it but also overseeing the implementation and like any trainee and all the blah, blah, blah, blah, like mm-hmm. That would be the clinical director. They would also be directing,
pause as soon as you said that, immediately I was like, there is something there because I sort of feel like, Ooh, what service though?
I think there is something about... I feel like I'm a clinical snob, maybe a little bit. Like I have really high opinions and thoughts.
Yeah. I don't dunno if I call you as snob, but because it feels very clear to you.
Mm-hmm.
I don't know if you make the assumption that it's also equally clear to other people. I don't know if that is what happens.
I don't think I think about it, but probably. I think it's obvious, so I assume that it's obvious for everybody, you know,
and I don't think it is. And I also think that automatically makes ownership.
Yes.
Buying of murky.
Yeah.
Yeah. Challenging,
because I do have opinions, strong opinions about clinical services especially. Mm-hmm.
Yeah. So how can our DCO or our CD really have full ownership? Yeah. Yeah. So I think that is at play. To what extent? I don't know. but let's say theoretically in another world or in an ideal world, you have that clinical director, it almost makes me wonder, it feels similar to me as like, there was a point where you had to stop seeing clients and you had to stop working with students. It was taking you away from the bigger picture things.
Mm-hmm.
It's similar with the CD or the DCO or whatever this role is whoever owns the clinical services there gets to be a point, if I'm talking social work, micro meso macro Yeah.
The micro has to stop in order to be able to focus on the macro.
And so if I'm taking our current DCO, if I'm using that as a template think operating on micro meso macro all at the same time, that's intense. That's a lot of shifting in between. I think in an ideal world I would design a position where let's say the CD would not need to be having the kind of direct oversight that our DCO currently has of clinicians like that I think would need to pass. It almost makes you think of like clinical team leads. I know the way we have it set up now is that there is not accountability there. But it almost seems like
consultation
there would need to be either the CTLs transition into a more accountability focused role where they would actually be accountable for their teammates numbers for potentially some disciplinary stuff. Again, this is not us. This is some practice somewhere else out there.
Yeah. Theoretically.
Theoretically. And that the CD would be directing the assistant CDs the clinical provider, supervisors, whatever you wanna call that role.
Mm-hmm.
There almost would need to be a middleman at
some
point. Yeah. In between the CD and the issues that are happening on a micro level with the clinicians so that the CD would be able to have this bigger picture, almost puppeting of like, okay, we're gonna add this service and it's gonna look like this. Just what we're wanting, the projects that move the business forwards. Like I'm just thinking about like, sure, maybe you would decide the vision, like, I wanna add
the service or this thing, or do this thing. I
really want a nurse practitioner to do med management. That's the vision. So then the clinical director would be doing the work of, okay, how would I integrate that service into our existing clinical services?
Even your language, how would I integrate that service? My thought was like, actually I wonder, what percentage of that would live with the integrator? to what extent would the integrator build this out initially and say it's gonna live here in like this and then pass on some of the more specifics to the DC or the CD or the DCO.
Yeah. Yeah.
My other thought on all of this, though, you know, I don't like a lot of cooks in the kitchen. It's almost like there's no right answer in any of this. It's literally just what is your philosophy? What are your foundational beliefs? And I don't mean from an EOS perspective, I think, I mean, I know I don't want a lot of cooks in the kitchen. I don't like that it's messy. Everyone ends up doing slightly different versions of something, nope. That's like the minimum effective dose, you know, what's the smallest number of people we need to do the most effective job?
So, for me, the idea of having a bunch of CTLs as like many owners of disciplinary processes and a team and being accountable for numbers, philosophically like for Tara that's a fuck no. I don't think that it's wrong to do that though.
Like for another practice owner, somebody who is more interested in having disbursement of disciplinary stuff and assuming they have really a really clear process and they're more in like, you know what, it's fine if there's nuance. Like as long as everyone's following these key steps, it's okay.
I just feel like there's a much higher likelihood of a mess happening because of that.
My pushback to that though, Tara, is if we're talking about scalability.
Yes. That's my other thought. You
know what I mean?
Yeah. Okay, you need more people at some point, and if I'm thinking about the role, let's just say DCO role and let's assume it's a practice. That's roughly the size that we are, but we're removing the people from the role. So we have DCO role here.
Let's say that we're saying these are the core responsibilities for this role. Then my thought is, okay, if we were to tease this apart, would we want more people underneath, let's say four people underneath reporting and check CTLs, let's say clinical team leads reporting on accountability or being accountable to their team of clinicians.
Where would discipline live in all of that? Or would we wanna tease out the brain modes required for the various things that we want of a DCO? Would we instead want something like programs, services, workshops, groups, like things that are our professional development, like our PD stuff, the developmental tracks, would that be one role in and of itself? And then the other is purely clinical in focus, like it's just individual clinician development. It's just clinical quality, compliance, oversight support, et cetera. Oversight, soup of soup, like doing supervision of supervisors.
I feel like this is the discussion we've been having also.
Yeah, and I think you touch on a good point, which is that EOS only can inform us so much, and that there's also individual philosophy. This is your specific business.
This is our specific practice. How do we wanna do this in a way that makes sense to us.
Sometimes that's gonna align really naturally. And sometimes EOS isn't the end all be all. There's always gonna be nuance because I mean, you're taking something, a framework that is applicable to a popcorn company and a mental health practice.
Real estate, mental health. Yeah.
yeah. It's not gonna give you everything you need. And I think sometimes too, we butt up against, not like we think EOS does it wrong, but it's like the unique framework or makeup of how we do things just doesn't,
it's not a one for one translation.
Yeah. It's like a
kind a square peg in a round hole sometimes. Yeah. You know?
I love EOS. I still love it. Yeah, it's incredible.
Yeah. It drives how we think about and how we have these conversations. Yeah.
Mm-hmm that's what I was thinking it's not the most nuanced because we get to fill in all that space and it's such a key part of how we think. Almost like it gives us the ability to even have these conversations clearly. It's like laying out things in such a clear way that now we get to, I don't know, play around with the nuance, play around with, okay, what works and 📍 what doesn't.
Let go back to, there's one more thing that I'm thinking about.
I don't even know how to say the question. I don't even know exactly what it is that I'm asking, but there is something still about ownership and accountability. Maybe the question is, how do you effectively teach that? I don't feel like I do it well. Like I don't feel like I taught you ownership or taught you accountability.
Not that it's my soul, you know, you're human. Of course you've had experiences like this in life, period. But I think it just makes me wonder, how do you have somebody do this? Especially if it might be at like the extent of your limits.
Like I'm thinking about some of the conversations we've had. In the recent past, you know, even about like marketing oversight. It is also kind of cloudy. The translation from in my head to out of my mouth. I feel like that's cloudy and maybe it seems more clear in my head, but it's hard to like say, and I think sometimes that doesn't work for you. You don't like abstract as much.
Yeah. It's harder for me to grasp onto.
Yeah. And so my question is still the same. Is it coachable? Is it trainable? It must be to some extent. To what extent? How do you assess it also? Like assess coachability.
I honestly think that's a different question.
How do you assess coachability and then how do you coach or how do you
Yeah. They are different questions.
So I think that's interesting. Like how do you assess coachability? That, I don't know. I mean, honestly, I think that's kind of at the root of what you've been trying to play around with some of the hiring stuff, like the permeability.
Mm-hmm.
That to me translates to coachability. In some regards, it's not a one-to-one to use your language. Mm-hmm. But in terms of how do you assess for it? I don't know. But I think
I can tell you the qualities what makes someone coachable? I think there has to be a higher level of flexibility of thought.
Hearing you say there has to be a higher level of flexibility of thought, it makes me wonder if you are thinking about coachability from a higher level role, like a leadership role.
Yeah,
yeah. Okay.
Yeah. Yeah. I do. If we're talking about non-leadership roles there's obviously the capital L leadership, but I also think informal leadership.
Yes.
If we're not talking about those kinds of roles or, so we're talking about your entry and mid-level positions.
I don't necessarily think there has to be a high level of flexibility of thought. I think there has to be some component of flexibility.
Because I think the way we talk about operating business or structuring business and is that it, things are gonna change. Like when we talk in your masterminds about setting things up, we talk about them in the sense of like the living practice. Yeah. It is going to be changing.
So I do think that at entry there has to be at least some level of flexibility or ability to pivot or like ride the wave, but I think particularly with a leadership role or a leadership position there is a high level of flexibility required.
Because I think the pivots required are bigger. You think about what the changes, the tweaks we might be making on scale... i'm in a very like watery and space time. Something like, like waves, like
Yeah.
Those closest to the thing that makes the ripple have the biggest felt sense. And those further out , it's just gonna be like a gentle little, whereas leaders might be riding this bigger wave. Yeah.
Yeah.
I think necessarily there has to be an ability and a comfort with alright, here comes this big wave, I'm going with it, you know?
Mm-hmm.
I think some of that is just like by nature of when you have a structure the way EOS does and the way we do, where you have your leaders kind of more insular and your folks more out.
I think, I don't know if that's by design, but I certainly think it's a function of that kind of a structure. But I also think it is by design for us specifically. Yes. The intentionality behind things is that when we make changes, it should be minimally or not at all felt by the rest of the team.
Yeah. Where it's like a nice gentle wave.
It's so gentle that some people might not even feel it. Yeah. It might not even be perceived unless we tell them specifically about it.
Yeah, you're right.
But so , to your earlier question about like, how do you assess for coachability? I don't know how you assess for it necessarily, but I can tell you like the traits or the qualities are someone who can be, flexible or who is comfortable to some extent knowing that there will be change and that the expectation is one of flexibility.
Like, here's the thing that we're giving you to do right now, but it's not written in stone. You gotta be okay with that.
Mm-hmm.
You gotta be okay to also to be able to sit it down and like poke at it and pull it apart together.
Yeah. That can be a very vulnerable experience to say like, this is your role, we're all gonna sit and talk about it and pull it apart. Not you, but the role. Yeah. Yeah. And like what might be happening in the role. Mm-hmm. So there's also a certain sense of self-assuredness or like
Yeah, almost a solid sense of I don't wanna say identity 'cause I don't think.
I think it is. so like if we sat down and we put the integrator role under a microscope, I can engage in that. Yes. I can engage in that conversation, in that discussion, because ultimately I have separation from that thing.
I am who I am.
Mm-hmm.
And our discussion about this thing isn't gonna change. Now I'm gonna have feelings about it, despite my best efforts, you know, I am, yeah. But I'm still gonna be able to engage in that conversation, you know?
Mm-hmm. There does have to be some sort of sense of identity, sense of place, sense of confidence in your ability.
Yeah. To
do this thing and also your place in this structure, in this organization. If that's not solid or if that is in question, then it becomes really difficult to have the conversations that we have to be able to have about accountability chart and who is fully owning a thing and what does it mean to fully own a thing. I think sometimes what works between the two of us is me being able to say like, no, Tara, that's me. You need to let go of this thing. I just need to do it. Or you know, like, if you're okay with it, I'm just gonna do this and I can let you know Yeah. But you just need to let me do this thing.
If you don't have someone who is confident, for lack of a better word
Yeah.
And able to hold their own and own their ownership, that becomes really difficult.
So the caveat to this is it might be because I own the business and because I'm the visionary, let me just put that out there, but the other piece is I like that part and it never feels personal. And maybe it's because primarily I'm the one that's like, i'm not sure about this. What do you think about the, you know, like. Maybe that initial poking or questioning?
I think that's that's you. I don't think that's necessarily because you own the business. I think that's what I wonder because of who you are
But it's the same for my own role where I'm like, I don't fucking know. Like, this isn't working, this isn't it, this isn't right. You know? I like doing that.
And like my life, like I love the practice, I love the people, I love the role I'm in. And also there's so much fucking more to life. This is a part of me. This isn't everything about me, you know? So I think I don't care when it happens and I forget that some people. Maybe a lot of people.
Yeah. I don't know actually. Like yeah, I do. There is more of a, it's like tied together
Yeah. The attachment is stronger.
Yeah. And so then it becomes hard to poke at this role because this role is, well, I'm doing this role and like, are you saying I'm not doing a good job?
Where it's like, no, that's not at all what this conversation is about. I mean, maybe like you're not actually doing good at these things, but it's really more about the role.
Yeah.
And obviously this is a separate conversation from is it the right person for the seat? Because that can be about, yeah, you're not actually doing a good job, like you're not doing what we need done.
Even that conversation takes like a strength of identity to be able to engage in.
Yeah, it does.
I love you and I value you.
Yes.
And there's not anything wrong with you. Right. However, your skillset is not in alignment with what this thing is. Yeah. That's hard. That's hard to say. That's hard to receive, but sometimes that's a part of the conversation that's like what capacity essentially gets at when we're talking about gets it once it has capacity to do it.
Yeah. Yeah. That and unique ability was popping in my mind too. Yeah.
Mm-hmm. Yeah. Goodness. This shit is hard, man. It's hard because there's people. Sometimes it's clear, sometimes it's not. Well, I do still feel, full disclosure for anybody listening that the DCO role is one that we're actively grappling with. I think maybe you said that earlier and maybe not.
So I'm sorry if I'm repeating something you've already said, but it is something that we're trying to make sense of this role and the unique ability, I would say, of our current DCO and like, what aspects, if we split this out is the role too big? Is the integrator involvement to date?
Has it been too little? There's been too much visionary involvement, which doesn't work well.
Yeah,
something's slightly amiss, you know?
And what we think likely is a combination of those things.
Yeah. A little bit of like a couple of things. Yep.
Yeah. Yeah.
It's hard to figure out sometimes. It feels like, honestly, IDS a little bit like you're trying to isolate what's the root variable? What's the root cause, what's the key variable, what's the most likely thing? And I still feel like the answer at this point is, I don't know.
Yeah.
I'm not sure.
It's also compounded because you and I have very different perspectives about
Yeah.
What that root thing might be. And we're coming at it from totally different angles, and so that adds another layer of complexity to it of
mm-hmm.
You know, it's that idea of there is no one reality ultimately. Yeah, yeah. Everything is so colored by the experiences and personality and perception and it's just another layer of trying to wade through and see as clearly as we can what's going on here?
And thus how can we fix it? How can we make changes?
Yeah. And when you said some variation of, I'm not gonna get it verbatim, that we're approaching this from two really different, like, our perceptions of what the root cause are is very different.
What's super interesting about that, I feel like we both still think there's the same problem. Like the problem looks the same, but like our version of like why, you know, or like the most probable why is different.
I wonder if that's why it continues to feel kinda confusing because we are not on the same page and I don't think either of us is wrong.
I don't think either of us is wrong, and I also don't think either of us feels strongly like, no, it is this thing.
Yeah. And so now I'm going to win you to my side or make my case, so to speak.
Yeah.
I think for both of us it's like, well, I think it probably is this thing. But it could also be this. Yeah. And so then when you're saying, you know, you're, from your perspective, I'm thinking, well, yeah, it could be that too.
It's fluid like water, sticking with the 📍 water.
Yeah.
One more thought. So here is also maybe like a callback to the origin of this whole thing is sort of the concept of delegation and accountability.
I think it's hard to answer if this question remains unanswered. Like if we can't be clear on the role it's hard to then fully delegate something because it's like I have this role. I don't know if it's the right one. I've got the right person in the seat, the right person for the business.
Are they the right person for the seat? But the seat isn't even fully defined yet. Yeah. So then I'm also gonna further ask them to do something and take ownership of something in a seat that we're not even sure should be in existence in the way that currently is. Like we're building off of something that I do not think it's faulty. Like I think that we're hitting our ceiling. Something needs to shift and.
It's exposing the cracks. It's kind of like the thing of when you add more pressure onto something, that thing was working fine.
Love it.
Yeah. But you add more pressure onto it, it exposes like, oh, there are these cracks, these stress points that we didn't realize.
Mm-hmm.
And so then now we're at reassessing, what support do we need in place?
Mm-hmm.
To be able to withstand this greater pressure.
Yeah. And how different is that support from what we originally had? Is it multiple supports?
Yes. Yeah. I think that's a game that I like to play with myself. I think I do it without thinking, but I used to think about it a lot. If I multiply this by two, what would break first? Like, what's the next thing that's gonna go? I remember hearing that question phrased, like, if you've multiplied your business by two or by 10 or by, 20, what's gonna go first? It was like, holy shit. Well, this or this, or Oh my God, this, you know, it's like the first thing that's gonna go, we already know, we're already hiring for another role that needs to exist where it's like, oh fuck, we need this thing.
Like, this thing isn't working. I'm thinking even with the capacity piece, what I really want, and this again for anybody listening who cares,
it's a marketing strategist. That's the seat that I want, that I think we need, not that I want, but that we need filled somebody to fully fucking own everything related to marketing. If we do that, then, so like this DCO thing, like the seat and sort of grappling with it is a little bit.
I say a little bit on the back burner, it's still there and still relevant and still important, but almost marketing strategist needs to come first when that happens. And let's say, demand increases and then, capacity increases. Yeah. Or capacity then decreases. We're bringing on more clinicians.
That's gonna circle us right back to the dco. And so then it's gonna be, well, okay, what does this role look like?
What does it need to be next?
We're also giving ourselves some space to test, like we are talking about, there's multiple variables that could be at play here.
And so by just saying like, well, this is still on the table. Yes. It's still in the zeitgeist of things we're considering. We can kind of test, like you mentioned, you alluded to the integrator role. Mm-hmm. That's an easy, like, okay, well next quarter let's see how things might feel differently if we.
Adjust how the integrator is involved. So it's like, okay, how can I be more involved in the rock setting process and in helping filter the vision and Yeah. You know, it gives us time to kind of test that hypothesis.
Yeah. Yeah.
And then see how that might also then translate down to that role and Yeah. Where the cracks are showing or where things might be resolved.
Yeah.
Until capacity changes and then
Yep. And then it shift
shifts
again. Yeah.
Yeah. Which is why we need flexibility and people engaged in these kind of roles.
Yeah. That's the living piece. The living practice piece, the feedback is constant, you know, not even a feedback system Sure. But also just general feedback like we're taking in how we feel, like how things are running, where things are slowing down, where they're going too fast. All of it is what are the bottlenecks?
What are the inputs and outputs telling us? Like, 📍 yeah. All right. Anything else? Let's wrap this up. What else? Let, what else do you think it up? Let anything else before we say goodbye.
Mm-hmm.
All right. Yeah, I don't think there's anything either. This is one of those things. Sometimes I think to myself, why are people listening to me? And then us just talk about things, I still don't really get it.
I hope that it's helpful, like I want it to be helpful. Yeah. If not anything, but to normalize the experience and process of being in a leader or the owner of a group practice.
Yeah.
Yeah. But I hope this is one of those things where it's like, it feels like a really important conversation.
I don't doubt the importance of the conversation, and I'm not really sure if it's especially helpful. Hi, baby. Yeah. So I think that's really it on my end.
Yeah. I mean, I have to imagine, and so like, if you're listening and this is not helpful,
that's good feedback for us. Let us
know,
no, that's really true.
Yes.
I have to imagine that it is like helpful for people to hear, how we grapple with things and how things show up and how we Oh, sure. How we think about them and that it's not just super cut and dried or crystal clear or straightforward, that there is a lot of processing to be done.
Yeah.
You know, a lot of back and forth.
Yeah.
Yeah. We still don't know. We're still actively in process. This is how we're thinking about it, but we don't ultimately,
yeah. There's no
know what the outcome of this is gonna be. Yeah,
yeah, that's funny. You know how it is. It's weird to live something and it be so normal and then for it to be helpful for others or for there to be the possibility that it's helpful for others is interesting.
I remember being super early in practice ownership and saying to somebody wanting to go and just see a practice run. Like I just wanted to be immersed in it. So, yeah, if I think about it from that perspective, then yeah, I get it. 'cause I absolutely wanted that same thing.
So Anyw, who, Alrighty, thanks for impromptu recording with me. T Dog.
Yeah.
📍 Everybody listening. I think, you know, subscribe to the podcast to get more impromptu and also planned episodes and slash or share this with a friend who you think needs to hear it. So peace out. We'll see you on the next episode.
Bye. Thanks. Bye.