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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.
Hey folks, Dr. Tara Vossenkemper here. You're listening to the Culture Focused Practice Podcast. Thank you for being with me, spending time with me, tuning in, using your ears, et cetera. I always say to my kids, open your ears, not your mouth, please. Like when they're not listening, I will not say that to you right now. Okay. So in the past few months, I have been stepping back from my group. I'm not gonna say that this is like I did it on purpose and I planned for it and I was seeking clarity. It's really none of those things. I just had to do less because I couldn't keep going the way that I was. Like that's really what it boils down to. The benefit of doing this is that it became clear to me that we have been hitting a ceiling. I didn't realize that's what was happening, but i'm fairly certain that's what is going on, is that we've been hitting the ceiling, whatever worked to get us to this point, globally speaking, will not get us to the next leg or the next level of our development. And what has come up recently for me is the understanding or the realization that there have been a few very key things that haven't clearly belonged to any one role, which is highly problematic. So today's episode is gonna be another blend of episodes where we're gonna talk some content and there's just a couple of owner's room style questions throughout, but the focus of this all is that we don't have capacity problems, we have ownership problems. Now before we go further, I'm gonna ask that you subscribe to the podcast so you can get any new episodes as they drop. And of course you can help other people find it who need to hear the message. That feels very important to me. I also wanna let you know what the agenda is. So there's just two items on the agenda. One, what stepping back actually reveals. Two, what real ownership looks like. That's what we're gonna do 📍 today. So if we focus on agenda item number one, what stepping back actually reveals? Let's open it up with a prompt. What feels unclear right now? And is that because I don't have enough information or because no one actually owns it? This is easy and it ties in super clean with the previous episode about the marketing strategist. What feels unclear to me is marketing. I can tell you things to do. I can tell you what could be done. I can talk to you about rhythms and cadence. I don't wanna execute it, but you know, that's a side conversation. But what feels unclear is the ownership piece. So the question again is that because they don't have enough information or because no one actually owns it? Actually, it's a combination of both. One is ownership, but ownership would also imply access to information. To me, they're one and the same. Real ownership is access and awareness and attunement to the information needed to do the job well. And I don't think I can actually tease those apart. I think that they are like intimately tied together, but it is both like I don't have enough information and no one fully owns the marketing role. We're owning marketing execution, and I've said this in the previous episode, but nobody owns the strategy and how the vision overlays with the strategy, with the marketing strategy in particular, nobody's owning the metrics related to marketing, and by ownership of course, responsible for moving the number. Reporting on a number is not the same thing as owning the movement of the number. Those are very, very different. One is I can go and report anything. I could read off a sheet and report something. That doesn't mean that I'm taking ownership of the movement of whatever that number is or whatever that thing is, and if you're curious about marketing stuff, listen to that episode. I won't go into a bunch of details. So it's marketing that feels unclear to me right now. You know, it's interesting. There's another big thing I really wanna hand off. It's payroll and benefits administration. I really want that to go to one person that doesn't feel unclear as much as it's just, it's a lot to do. So the interesting thing for me in talking about this is that these are both two major things that need to be passed over, but the felt sense of them, like how they live inside of me is very different. I feel like consistently with marketing, I am stepping into a fog and I can't find the center. Or like you walk into a hurricane and maybe like the eye is calm, but you have to get through the winds right around the eye, and then there's all the shit going on even further around that. There is a central point that I can't find, and then to try to find it, it's kind of constantly moving. It is like a fucking hurricane. It's constantly moving. It's like picking up speed sometimes and it's gonna hit a certain city at other times and really overwhelming and huge, and it lasts for multiple days. If there's no central thing to ground the marketing related stuff, then it just feels chaotic. Marketing feels like walking into a windy fucking storm, and I can't figure out the direction it's moving, how long it's gonna last, what we should be doing and when or why, what we're grounded in? Where's the central point? All of it. I could actually find metrics. I could actually dig into this. But that goes into the, if I'm already at capacity, I'm not going to do more. I don't want to do more to be able to try to sustain something. It's not capacity, it's ownership. So let's segue. That's actually a great segue. That might be one of my smoothest segues ever to the content. I'm really proud of myself. I shouldn't be, but that's all right. So if we're talking about what stepping back actually reveals, let's remember agenda item number one. One of the things is that lack of ownership creates lack of visibility. So again, this is the intimate connection between ownership and having enough information when something doesn't belong to somebody, it's really hard to see what's going on with it. And so, you can't make decisions. You're getting like bits and pieces of information, but you don't really have a sense for how they fit together big picture. Or you might have somebody telling you, well, I'm posting to social media weekly or four times a week. Cool. But what about the metrics? Like what's the ROI? What are you noticing about user behavior? What next dot, dot, dot. Posting to social media is executing something, if that's related to a plan or not. That's execution. Ownership is saying these posts on this day at this time result in this type of engagement. That engagement seems to connect to this sort of behavior on our website, and that ties in with this number of inquiries increasing. That's ownership, that's what that looks like. And it might be something like, so I'm gonna start doing things intentionally based on the metrics in order to increase the number that we're seeking over here to increase. When we don't have ownership, we don't have visibility, we don't know what the fuck is going on. I don't like being in that space. I don't wanna walk into a hurricane and not have a sense for any of the details around it. I'm not gonna walk into a hurricane period. For the record, I live in Missouri right now, so there's no hurricanes here. We do have tornadoes though, for anybody who cares. Okay, so lack of ownership creates lack of visibility. Another thing that happens when you do or can step back, what it can reveal is that when we say something like the team owns it, that usually means nobody owns it. And again, ownership is responsibility and being held accountable for a metric, an outcome happening or moving. When we have shared metrics or shared functions across a group, this shit pisses me the fuck off actually. There's nobody that we go to and say, did this get done or not? Tell me about this number. What's going on with it? Everybody can kind of sit back and say, well, I don't know. I thought that was so and so was doing that. Or I sent my number over to this person and they're supposed to take it up from there. Oh my gosh. It's like inviting the blame game. That's what shared ownership is. It's inviting the blame game. Everybody might be aware of what's happening. And obviously awareness is important, but what's more important is somebody being accountable for the movement of the metric or the project or the function, whatever the fuck needs to happen, somebody being responsible for it. So when the team owns it, if that's like, our team reports on this, I look, I love you, but I don't give a fuck who's responsible for it. That's the most important piece. Okay. Third piece, if we're talking again, what stepping back actually reveals. The third thing it can reveal is that the owner becomes the default integrator of loose ends. I will pull my fucking hair out right now. That's exactly what happens. Anytime, and this case in point, this happens with marketing, even when I tried to sort of conceptualize it, which I love what I did for the record. Like I'm not mad at myself for doing that, but trying to conceptualize how do I package this and pass it over to the integrator? The integrator stepping into something they're unsure of, how do I like do this well so they can step in and have a vision or have a view of what's happening. All of that was trying to put a bandaid over a freaking giant gash. It's like pseudo ownership. It's like I'm trying to give responsibility to my integrator or have her be responsible for this thing, but it's not her role to fully own it. My point is all of the stuff I did for marketing, and marketing is the example with the loose ends we're talking about, was really a bandaid for not having the right role in place. So even if I say I'm gonna step back from this marketing related stuff. What do you think happened without having a clear owner in the role? It still ends up coming back to me. I still become the loose end. I'm still the one poking at, hang on, hang on. These numbers aren't good. This number doesn't match with this one. Or, we have more unique visitors, but less inquiries. Something's up with the website. I wonder what's going on. These are the things that float through my mind. It's like default ownership of loose ends. I'm the one thinking about this because nobody else is responsible for it. And again, it does not make sense that our integrator is responsible for a core function of the business, like marketing and client acquisition. So my point remains the same: when nobody owns this, the owner becomes the default owner and the default integrator of all of the loose hanging ends; loose tendrils. As a total side note, just to give you a glimpse into my life of stepping back, I really love macrame. My mom had this giant macrame like hanging plant thing and this other giant macrame thing on the wall, and I bought a book and some materials to teach myself how to macrame. It'll probably last for a month or something. That's what I always end up doing. Like, Ooh, I wanna do this, but I will have some plant hangers soon. That's my goal. So that's a side note. I was thinking of loose ends and then like macrame hanging, you know? Okay, I'm gonna keep 📍 going. Agenda item number two, what real ownership looks like. I love this. Okay. I have a prompt that is gonna seem like it's not related, but I swear it's relevant. What feels off right now, even though I can't fully explain it? This is the whole like launching off point for conceptualizing ownership. As I started to step back, and again, not because I knew I needed it, but more because I just couldn't keep doing what I was doing. As I started to step back, I don't even wanna say that I started noticing things. It's more like I just started to feel certain ways and questioned things. And for me, sometimes what happens, is that my pattern recognition is faster than my cognitive awareness. And so I have been told on a lot of different occasions and by other people that I have pretty solid, pretty high pattern recognition. So I can catch things quick, but sometimes, like I said, I know something is off. It's sort of that feeling like something's off, something's slightly like not working. This isn't it. I don't know what it is, but this isn't it. That happens before I can articulate what the thing is. My guess is a lot of visionaries have decent pattern recognition, so my point is, that's what really started happening as I started stepping back, it was like, something doesn't feel right. Again, I can say now we're hitting the ceiling and like we need these roles in place. I still am not clear on all of the roles though. I also know something is up with our director of clinical operations role. Something's off right here. I think we might be missing a support role on the clinical side. I think we're missing another more like director role over on the operations side. But for me, the marketing strategist feels like the most important role because it's the fucking lifeblood. Like making sure clients are coming in the door, or inquiries are coming in the door is the oxygen to the business. So that feels most pressing. Not even lowest hanging fruit necessarily, but that has to happen. Like sort of the instant that I realized, oh my God, we need somebody owning this that became priority, you know? So my point is, when that's in place, I think that will allow for, I don't even think more space and time to think and feel into the accountability chart necessarily, but I think it will allow for more ownership for that role, obviously, and also for my integrator then to shift into more fully integrator, because some of what has been happening is that we're needing more like gas to the engine or more power, and it's not happening with what we have right now. And so again, I feel like all of this is kind of like hitting the ceiling. Every time I say that, I think about the scene in Charlie in the Chocolate Factory, the old movie, which I freaking love with Gene Wilder, where they break through the glass ceiling, the glass elevator at the top, and they're like flying away. It feels more like a conceptual hitting the ceiling for the leadership team than it does like the business. Needing more people coming through the door feels like, oh no, we need ownership for this marketing strategist role. We need a person in that seat. We need ownership of the metrics, like period and ownership of the movement. That to me, takes care of the gas, so to speak. But there's gonna be something else that comes next. That's where like, I can't fully explain that yet because we don't have that marketing strategist in place yet. We don't have that gas coming fast enough. So it's like a little bit like this weird in between, and like I'm saying about these roles, you know, there's this DCO role and maybe clinical support, and I think, on the operations side, we're needing a more director based role. My integrator needs to be moved up a little bit. All of that stuff I think will come further into focus when we have a marketing strategist in place owning gas. I don't actually even know if that's how it works. I grew up like around cars. My dad and brother were working on cars constantly. You think I would have better car analogies? I don't have any fucking idea. I still text them or I'm like, is this a fair price for the, you know, mechanic? Anyway, okay, so I'm gonna move on from that question. So the stuff that feels off, even though I can't fully explain it. Our accountability chart, something feels off about it. I can't explain it. And also I don't think I have enough information, and I don't have the right person in the marketing strategist seat yet to be able to then clarify what feels off fully. 📍 Okay. Now let's talk a little more like content based about what real ownership looks like. One, it's tied to a role. I think this is a given, I feel like I've been talking about this the whole time. Metrics, functions, outcomes, projects. These are all tied to a specific seat, and what we know about EOS is that for one seat, we have one person. We don't have three people in a seat sharing the responsibilities. You have one person in a seat, period. They own if it moves they own. If it's done, they own the success or lack of success of whatever that metric outcome function is, period. So it's tied to a role. Second piece, ownership requires movement, not reporting. Again, I feel like I've already said this, but I wanna say it again. If somebody owns something, it means that if it's not working, it's that person's responsibility to figure out why and to change it, not just to communicate about it. Here's the caveat: if you're running EOS and you're running L 10s, which if you don't know about an L 10 meeting, you should because they are incredible. If you're doing them well, they're incredible. So if you're running L 10s, and again, using EOS, sometimes what can happen is that people will bring any problem to the L 10. Let's say a clinical director might bring a problem to L 10, but they haven't actually thought through, why is this not working? How could I change it? They just say, oh, I'm noticing this is a problem, and they report on it and say, this is an issue, and then it becomes like a conversation. Ideally what happens is that the clinical director figures out what the issue is, tries to change it. If they're having trouble, then they bring it to L 10. If it impacts multiple other departments, then they bring it to L 10. Ownership is responsibility. It's saying, I have authority over this thing, and I'm accountable for it, so therefore I can do things to try to change it. If I run into hiccups, I bring it to the team. And this is all very different from just reporting on it or just communicating about it. Okay. Last piece, for what real ownership looks like: ownership changes, escalation patterns. So I already started talking through this, but let me just say it again in slightly different words. When ownership is clear, the beauty is that problems move clearly through the system. So they start with the owner. If that doesn't work, they get to bump to the visionary. Whether that's at an L 10 meeting or the integrator is noticing this isn't moving, and they're starting to either apply pressure or help to remove barriers for the owner, which is the integrator's role, to remove barriers and hold the department heads accountable. If 📍 it doesn't get solved from there, then it goes to the visionary. The visionary is not the owner by default. The person in the role is the owner. And thus the responsible party, and again, it gets escalated up to the integrator. If the integrator is like not keeping their finger on the pulse and isn't really tuned into this thing for whatever reason, that's when you would pull the visionary in. So that is much cleaner than i'm noticing a problem as a clinical director. I'm reporting on it in L 10 where the integrator, other department heads are, and the visionary, and now we're all talking about it and trying to solve it. That should not be the first line of defense. That should be part of the escalation 📍 process. I think we're done. Actually, that wraps us up. I'm gonna do a couple of key takeaways for you, and by a couple, I mean like a handful. It's all the same, right? Number one, stepping back doesn't always create clarity, but it can reveal where clarity is missing. That to me is important to note because I think it's really hard for owners to actively step back. It is for me when things feel so fraught either with tension or like shit needs to get done. I can't step back like I can't afford to. I don't mean financially for it. I mean like emotionally, logistically afford all of it. It could be financially too. So if it happens to you like it happened to me where I just couldn't continue, the benefit is that it can create clarity and so it can also reveal where clarity is missing. Second key takeaway, what feels like capacity is often unclear ownership. I think I'm gonna harp on this forever now. Man, it's such a major piece. Third, shared ownership sucks, creates confusion, don't do it. One owner. Clear ownership creates visibility and movement. That's what we're after. Four, ownership lives in roles. It doesn't live in teams. It doesn't live in conversations. Honestly. It doesn't even live with well, Judy owns this. No. If Judy is in a role, the role owns it. And Judy happens to be the person in that role. That's a different thing. Last key takeaway. The goal isn't to do more. This is not ever what we're after. The goal is to make sure that things belong in the appropriate place, and that the right person in the seat, the right role is held accountable for the thing that lives with them. So that really officially wraps us up. Of course. Thank you as per usual for spending time with me. Time is valuable. I cherish my time, and I really appreciate you using some of your own to be with me. That's one thing. Second thing, I said this already, but make sure you subscribe or better yet, don't subscribe unless you already have. Then great, and if you haven't, yeah, go ahead and subscribe, but better yet, send this episode to somebody who you think needs to hear it. That would be awesome for them and also helps more people hear the message that they are in need of hearing. So I will see you then officially on the next episode. Thanks. Bye.