Culture Focused Practice

Hey. Hey, Dr. Tara Vossenkemper here, and you're listening to the Culture Focused Practice Podcast. Thank you for being here. Thank you for being with me. Today, we're talking EOS, baby. I love EOS. You already know this.

Okay, so just bear with me. I think a lot of people think about EOS as a checklist and, sure, like to some extent there are things that you can check off as you go through this, but the reality is that it's a rhythm. It's a way of being in a practice, it's a way of operating. It's not something that you just rote do, and then it works. It's something that you embed and bake in and integrate into systems to ensure that it's a part of how you live and breathe as a group.

So in this episode, we're gonna talk about what it actually looks and feels like when EOS is working in a group practice. EOS isn't just about having a beautiful accountability chart.

It's not just about having cleaner, well run meetings, although I would say those are benefits. It's really about team alignment. It's really about enhanced clarity. It's really about emotional and quite fucking frankly, logistical relief. That's what we're getting at with EOS.

So let's dig into the signs that let you know that EOS is actually working for you, that you are actually integrating and implementing it correctly.

Before we go further, make sure you like, follow and slash or subscribe to the podcast. One of the three is probably fine, but the more you do that, the more it reaches people who also can benefit from the content that we're talking about.

This is assuming of course, that it resonates with you if it does not, maybe don't like, subscribe or follow.

So to go over a quick agenda, we're gonna talk about what working looks like. We're going to focus on what doesn't count as evidence of EOS really being integrated or implemented in your practice.

We're gonna talk about real signs from real practices and we are going to do a few takeaways.

So let's go. If you have ever wondered, is this EOS doing anything anyway? Is this really effective? Does it actually work? Cool. Welcome to the Club. And maybe I seem like I'm all in on everything, but I'm kind of skeptical whenever I hear people, you know, talk effusively or emphatically about how great something is.

I just, I'm always like, ah, I don't know. But is it, is it really so I can understand if you have questions and doubts about the effectiveness of implementing something like EOS, especially if you've talked to somebody who purports to be operating using EOS, but you know, that shit's a fucking mess at their practice.

I mean, that would give me pause if somebody was recommending it to me, but I knew some of the inner workings of what was happening and it was messy that I would definitely feel skeptical, even more skeptical than somebody just talking about how great it was. A lot of practices will seek to implement or start to try to integrate or implement EOS and then they.

They're like doing it, but they're not really doing it. It's like, it's like the letter of the law versus the spirit of the law. You know? It's like they might be doing the letter of EOS, but not the spirit of EOS. I'm also not an EOS spokesperson, so this is entirely my own perspective, just to be clear about that.

But for the ones who are doing like the spirit of EOS, they're integrating. They're implementing, they're really running on EOS. Let's talk about that first agenda item, what working looks like.

First clarity increases. You are gonna have so fewer redundant questions across the board. I'm not just talking about your ops team is gonna come to you less.

I'm talking about your clinicians, your ops team, your. Any support staff you have, any person in place is gonna be asking you and your leadership team less questions. They're just gone. All the answers are there. Things have been clarified, they have been communicated effectively. There's places for things to live in a way that actually makes sense, and it's not just this fucking hodgepodge meeting folder that everybody has access to.

It's clear. So with clarity comes a decrease in the amount of questions. The amount of redundant questions in particular, which for me is a godsend 'cause I don't have time for that shit. I don't think anybody has time for that shit.

Second, again, we're talking about what working looks like. Second is that accountability increases.

This is probably my favorite thing. I say everything is my favorite. Maybe that's not fair. I really love the accountability increase. With an accountability increase, what that means is we have significantly less follow up. And obviously the flip side of that is more follow through. You know, it's like flip sides of the same coin

For me, having to follow up less is always gonna be a really smart move because I'm not going to remember to follow up. The reason I have people in place is because I cannot consistently remember all of the things that need to get done, especially things that are consistent, which seems counterintuitive, but it just, that is just the way that my brain works.

I'm not gonna hold onto something that's done. If it's done, it's outta my brain like I'm, I'm done with this once. It has some like intense emotional resonance for me.

Broadly speaking, like a policy, i'm not gonna remember if it's in writing. I'm just gonna trust that we're able to access it whenever we need to, and then I can reference it at some point. That's what I'm talking about, like I need less follow up with me directly. And honestly, I think your leadership team would probably also benefit from less follow up, especially with the redundant questions.

So not only are we getting at the clarity increases the redundancy of questions, but also when we have an increase in accountability, we have less follow up with key people, which is great. So Great.

And I think also, this goes without saying, but I don't want to babysit. I didn't like it when I was younger. Fuck, I don't wanna do it as an adult. It was bad enough being young and babysitting. And geez, as an adult, I don't wanna babysit adults and adults don't wanna be babysat, they don't wanna be micromanaged.

So when we can have less follow up and just more consistent follow through, that's great for every single person involved. Everybody wants that feel. Third thing, tension gets surfaced early. This, I already said that. The last one was one of my favorite things, but this might actually be one of my favorite things.

I am a pro calling the elephant out as it sits in the middle of the room with its pink spots and giant hide. I wanna talk about it. What is actually happening, what's going on? And I wanna preemptively talk about something and slash or I want to prep for what I know. Is coming. And so if you are operating, like truly operating from an EOS perspective, there are very few things that will feel surprising.

Maybe this isn't case in point, but just as evidence to support the thing that I'm saying right now. I've been conducting bi-annual reviews. I'm almost done with all of them. Every single thing that has come up as a source of great feedback from my team on the biannual reviews is something that's already on our VTO or it's already on our issues list for our L 10 meetings.

We already know nothing is new, and that is an incredible feeling. Not only does it validate the direction that we've gone and sort of the essence and feel of the entire group, but also it validates that using EOS surfaces things early in advance of them coming out elsewhere.

If you are the metaphorical canary in the coal mine, just sort of historically, and you have like a really sort of a sensitive emotional barometer, maybe you're gonna be good at this already.

At least with regard to emotional things in particular, and maybe like the feel of the practice. But when you do implement EOS and it's running and it's working, you're also gonna start to realize there are logistical and operational things that could surface that you weren't really privy to, but they're coming up because people are taking ownership, people are being held accountable and doing their own follow through. Everybody has more clarity and so anything that doesn't fit or have a nice place to go naturally is gonna rise up and end up on one of those issues list items.

That, that really is probably one of my favorite things about EOS is that we are constantly ahead of the curve. At this point, initial implementation was a little more reactive. We were like putting out fires and fixing a lot of things at this point, after doing it for a few years and really operating true to EOS to the extent that I know, it's been preemptive and that has been a relieving experience to say the least.

Last piece about what working looks like with regard to EOS. This looks like you being able to leave for a solid week or two and you come back and everything's fine. Everything's okay. That's what it looks and feels like, and you trust leaving and coming back. That's what it looks like.

Again, another example, my integrator right now is on maternity leave. She's, she's out, she's gone. We're not bothering her with questions. We're not seeking her out. Of course, there's some weight that's felt like, I feel some of the weight, I have some of the things that she's responsible for. My billing specialist does.

My client care coordinator does. My DCO has some, so it's, it's dispersed amongst a few key people. But she has nothing to worry about because everything was clear in advance of it happening. There's so much clarity in the system and all the structure and roles already that when she stepped out and clearly laid out what everybody would need to be doing in her absence, we took it in stride and now we're able to go and run with it again.

Relieving. That's how it feels is relieving.

Okay. I think I've covered what working looks like enough, so we're gonna move on to what doesn't count as evidence. I actually love this. I am really, uh, probably not unique in that I don't like when people pay lip service to things without the sort of felt experience of what it should be like.

I don't, I don't like that. I don't think most people do. It feels very performative, sort of inauthentic. So let's talk about what doesn't count as evidence of e os working in the wild. There's four items here.

One is a pretty meeting agenda. I love L 10 meetings. I love them. Part of why I love them is the way that they're run.

Fine. Having a meeting agenda is great and you can have it in writing, but if you're not following the L 10 meeting agenda in the way it's intended to be followed, you are not operating from an EOS perspective.

Additionally, and this is maybe a caveat piece too, to like having a pretty L 10 meeting agenda, if your team isn't engaged in the meeting, that's not evidence of this working that points to, there's a different problem that's taking place.

Both of those things point to, these are different problems that are taking place. One is that you're not following the meeting agenda in the way that it's intended. The other is that your team's not engaged in the process.

Like that highlights a different issue. For the record, let me backtrack just a second. If you as a collective group, as a leadership team, you run on EOS, you're really focused on running good L 10 meetings and you start doing it and you realize there's something that's not quite right and you wanna make this change to the agenda and you put it on the issues list and you as a group decide, yeah, let's make this change.

That to me is the spirit of EOS. It's being able to implement a structure that allows you to also make modifications within the confines of the system that respect the original structure, but also work for you. That's not, this isn't, you know, the intention with EOS is to just rigidly follow every single rule there is.

It's to implement and integrate. Make modifications where and as needed while also, again, seeking to respect the original structure and not, I would say you want one of your two off course. You know, if you say you're running L 10 meetings and you're just not hitting any of the agenda items, that's not EOS, that's now whatever you want it to be, so.

Just to recapture this, a pretty L 10 meeting agenda doesn't mean one that you are following the agenda, which you should be if you're not, and two, it does not mean that your team is engaged, so having that agenda does not count as evidence.

A second thing that does not count as evidence is having a rock does not equal achieving traction.

When you go to first set rocks, the very first time you do them, if you're implementing EOS in the order in which Gino Wickman recommends implementing EOS, then you will set rocks before you have a vision.

Rocks are your most important quarterly priorities. They're quarterly goals, basically. After you have a vision, your rocks by nature of working through your vision traction organizer, are reflective or at least pointing to the five-year tenure or 20 year target, whatever timeframe you decide upon, they are headed in that direction. That's what they're connected to.

So when I say having rocks doesn't achieve traction, like those things are not equivalent, what I think I'm trying to say is that you might set shitty rocks even after you have a vision.

If you're not setting your rocks via your vision and like connected back to your one year plan, then you're probably not setting accurate rocks. Additionally, you could be setting rocks that feel really important, but, and this is kind of saying the same thing that I just said, but they're disconnected from the vision. Or maybe they're important, but they didn't go through your core focus as a filtration, so you're building something that's not really related.

Or you're just not setting smart rocks, like increase sales, not a smart rock. Like by what percentage? What's your baseline? Now, who's responsible for this is like there's, there's so many questions that are left by that. So it could be that you're not setting smart rocks. It could also be that you're not connecting it to your vision.

Both of those things mean that your rocks will not equal traction, and so having a rock does not count as evidence of EOS being integrated correctly or run effectively.

Okay. What also doesn't count as evidence is you just filling out the tools. So if you fill out a vto, a vision slash traction organizer, for example, that does not mean you're living it out. Having a scorecard and you fill it out every single week, but you don't review it on a consistent basis and you don't make decisions based on it, and you don't drop down low numbers to your issues list and you don't have baseline data. That's you having this tool and maybe filling it out but not living out the intention of it.

So just because you have tools doesn't equal your living them out in the way that they are intended, which again goes against the spirit of EOS from my perspective, of course.

The last piece here, what doesn't count as evidence is confusing activity with impact.

I always think that people, you know, there's like a flurry of activity and sort of like everyone's productive. We're doing shit. We're busy. I sent out 50 emails. That is not the same thing as having an actual impact on the culture or the clarity of the systems or the process itself, or the community or the vision or anything else related to EOS.

It also reminds me of Cal Newport. He writes in Deep Work, which is one of my favorite books. I love Cal Newport's work. I love Deep Work in particular. If you haven't read it, you should. In that book in particular, he talks about sort of this focus on productivity and how there's this need for people to, like, see movement, and see, well, you moved your mouse. You know, I typed a thousand emails, so I must have been really busy.

But the reality is that if you're moving your mouse all the time just to look, make it look like you're busy. If you're working, you know, remotely or something and that's the way that the company you work for is tracking your quote activity.

Or if you're sending a thousand emails, what you're not doing is getting anything fucking done. I hate email because it takes me away from getting shit done. Period. I can't think.

If I'm writing an email, I'm actively not spending time working on my rock, working through my to-do items, troubleshooting big concepts that I need to grapple with to forward the vision of the practice.

So activity is not the same thing as impact. That might be a hill I will die on. I'm not sure yet. I'll let you know. Those are the points of evidence. So let's move on to agenda item number three, shall we? Real signs from real practices. I love these. I'm pumped to share them with you.

Four things, boop, boop, boop. Four things. 1, 2, 3, 4.

Number one, here's a sign that your practice is running well on EOSA team member voluntarily raises a process issue. Love it, love it. And maybe you like solicit feedback on a consistent basis, but you have somebody coming forward and saying, Hey. I, you know, interfaced with this system and, uh, kind of didn't really work for me. Something seemed like it was snagging somewhere.

This is a few months ago, but as an example, I had a clinician who. Brought up to me an issue with our phone system, and I hadn't heard it yet. And she basically said something about how her client struggled to get in contact with her because there was like multiple menu options that didn't make any sense.

And long story short, we had our phone tree set up all fucking wrong. So then people are calling in, they're getting the wrong menu, they're entering the wrong number to try to connect with their clinician. What a shit show.

That's what I'm talking about. This is voluntarily being shared with me by somebody who is a clinician at the practice. Really important information, obviously. Has a huge impact on the entire team and the client experience of the practice and was fixed in like 10 minutes, so that's a great thing.

Another sign that you are operating EOS effectively, that you've integrated it effectively. Maybe hear me out. Bear with me. Maybe a meeting ends early because you actually solved shit. And it's done. And you don't have to keep going.

I will say for leadership, this is not gonna happen for us. There's a constantly things to talk through, troubleshoot, et cetera, constantly. But for my ops team, they are smooth fucking sailing man. Like, they frequently will end their meetings early because their systems and their processes are just so tight. They're so tightly run and so well done with the right people in the right seats, that it, that's really not uncommon.

And so they do an L 10 style meeting specific to operations, and very frequently it's gonna end early. Which to me, highlights the right people in the right seat. Again, this goes back to activity doesn't equal impact.

If you don't have shit to talk about and there's not problems, don't waste your time in a meeting making things up in order to feel like you're working. Nope. Don't just go back and do what you need to do. If you're done, you can be done. It's okay.

The third thing for real signs is that people are asking for metrics instead of dodging them. I had a clinician literally emailed the DCO, she copied me on, but she emailed our DCO and said, I'm worried about my numbers. I was out of town. This other thing , I was sick, et cetera. There's a couple of things that happened in the one of the recent quarters. I'm worried about my numbers. I wanna talk through it.

Hell yes. A clinician seeking us out to say, I have some concern about this. That's what I'm talking about. That's an example of, oh, this is actually working. The numbers aren't scary. They are food for the fodder. They're, you know, grist for the mill of the conversation that needs to happen between DCO and the clinician. Okay, what do we need to do now? We move forward and we have this thing in front of us that we're grappling with together and we're seeking to solve it. That's incredible.

Fourth thing, I'm so terrible at transitions from item to item, I'm sort of like a, and by terrible, I guess I should say abrupt. I just, you know, okay, that's done. Moving on. You know, that's, that's just what happens. Fourth thing, speaking of moving on, you hear less about, well, who's, who's gonna do this?

And more about, oh, that's me. I've got that one. That's DCO. Oh, that's integrator. Oh, that's visionary. I will say that this is highlighted the most at our leadership team meetings because we just hold the weight of the practice mostly, and, and I shouldn't say that, that's not entirely accurate, maybe. We hold the weight of the practice in a unique way, and so, that's really it. It's not that we hold the entire weight of the practice, that it's just carried by us in a unique way.

And so whenever we have something come up in leadership, and you know, obviously in the middle of the meeting we're working through our issues, list items, and there's a, a handful of to-dos or maybe there's a something that needs to be documented or maybe there's communication that needs to take place.

There's never a question of, well, I, you know, I think maybe I, I can do that. I'm not that busy this week. No, the ownership is decided by the accountability chart and the responsibilities of, of the role, and because the right people are in the right seat.

We all step forward and take ownership when it's appropriate. Only when it's a question of, Ooh, hang on. Where does this live? That's when we decide, okay, who's doing this? And it's a discussion about, uh, well, it's a little more culture than it is process, so maybe it's visionary or, ooh, it's a little more clinical than it is operations, so let's go ahead and have the DCO do it.

That's how those things are decided. Not who's the least busy?

Sometimes that's a variable. Capacity can sometimes be a variable in those, um, sort of collaborative type to-dos, you know? But broadly speaking, it's gonna live with the appropriate person based on the responsibilities for that role. And then beyond that, if there's overlap, it's gonna be where does this mostly live? And then that person will take it.

And again, those, that's a real sign that shit's working with EOS at your practice. So.

I think the last thing I'll say here is that when EOS is working, you of course feel an operational shift. I think that's kind of a given. You're gonna see how the system sort of change and the structure comes to life in front of you.

And what feels more important to me is the emotional shift that comes with it. And I think that this is less talked about. You're gonna feel the impact. Your entire team is gonna feel the impact initially when you implement, you might have some pushback and you might have some fallout from people. You might see some turnover.

That's really common, at least I'm talking anecdotally right now. In group practices in particular, based on what I know, super common. Once that settles and you have it implemented and it's running well, then you see the benefits. Especially the emotional benefits, like you really see them come to life.

People are more satisfied, they feel safer, they feel more trusting of the system and the people that are there. When you have the right people in the right seats, they feel clear, they feel communicated with and like they know who to go to, the whole tone of the space settles. Like shifts and settles in in a way that is satiating, not in a way that's restrictive and rigid.

So when you go to implement EOS and you're getting this going and you're embodying the spirit of it, and you feel a sense of relief and you feel clarity and you feel energy, and you're not just looking at the scorecard every week, scratching your head and being like, uh, you know, rolling your eyes and feeling frustrated, that relief and clarity and energy, highly likely, it's a marker for what's gonna happen for the rest of the team if it hasn't already started to take place.

That's what the fuck it's about. Relief, clarity, vision, traction, god, I hate myself for being this cheesy, goodness gracious. I don't actually hate myself. For the record, I love myself.

Okay, that actually wraps us up. That really does do it. I hope this is helpful. My EOS mastermind starts so damn soon. Still taking signups. If you're listening to this right now, go to www.taravossenkemper.com/eos-mastermind. You will have the option to join the Mastermind.

A six month mastermind, twice monthly meetings that are like trainings that are 90 minutes and then twice monthly optional working meetings. Of course, we're gonna talk concepts, but we are going to bring them to life. That's the point of this whole thing.

If you're not really feeling sure about the Mastermind, you think I wanna do this, but I don't know if it's the right time. I don't know if I should, I don't really know if it's that sort of thing back and forth. Just email me. We can set up a time to talk really fast. hello@taravossenkemper.com. Then you can get your questions answered if you have them, and we can talk through to make sure that actually is the right fit for you and the right time.

So do one or the other. And otherwise, thank you again and always for being here with me, for spending this time with me. I super appreciate it. I love hearing from you. I'll see you next time. Okay. Peace out. Bye.