Culture Focused Practice

All righty, folks, let's do the damn thing. I think it is no surprise to anybody who has listened to more than one of my podcast episodes, maybe even just one, I love EOS. I think that comes as no surprise. EOS can carry structure and feedback. However, if you're a leader or if you are, working with leaders, whenever leaders ask EOS to supply identity or certainty, then they're asking the tools to run the organization.
Just hear me out. The thing with EOS is that it makes the invisible work visible. It helps us figure out who owns what, what matters now, which numbers are changing and in which direction, obviously, and where the same issues keep returning over and over again. It does a variety of other things, but those are some very, like, consistent across the board things that EOS does for us.
We have to keep in mind that EOS is just a working concept and a series of tools. It is an operating system and one that we should not rely on to give us certainty about running our business or answer all of our questions about an accountability chart and, the truth about a person in a seat. And we also shouldn't allow it to cloud our judgment around complexity and simplification. If a problem arises, it's not like more tools solve the problem necessarily. Really what we want is for EOS to organize our operations. It shouldn't and doesn't decide identity, and the same with values. And also It shouldn't be allowed to dictate the trade-offs regarding a practice's integrity or a business's integrity. Those things like identity, values, integrity of the system, integrity of the group, those are all leadership decisions.
That can be fleshed out with using tools but shouldn't be dictated by the tools. So let's talk today about how EOS is a structure and it's not an identity. We have four agenda items on our docket. Isn't that it? Four items on the docket today. So first is structure creates visibility. Second is tools cannot choose meaning. I love meaning-making stuff. Third is rigidity can hide uncertainty.
I really love this one, as a side note. And then fourth is leadership keeps structure useful. Let's go. Number one, structure creates visibility. I'll be honest, this is one of the hardest things for people to... I don't even know about reconcile, but maybe reconcile, but also experience as they're implementing EOS or as they go to, even DIY implementation, which is what we did.
We did self-implementation however many years ago. And when I talk about EOS, I think it comes across as though, it keeps things clean. It really helps us ensure that we're staying on top of everything. All of that is absolutely true. What's also true is that when we went to implement it and start integrating it into the business, shit became very clear that was not clear before. I have always loved data. You know, there's a lot of numbers related things that for me did not come as a surprise.
In working with people who are integrating EOS into their practice, that is one thing that I, oh, I hate. It's, like, painful. It's necessary. You know, it's like a hurt so good sort of thing, where people will start to look at numbers that they haven't been looking at, and now they're faced with the reality.
It's just, it's visibility, but they're faced with something that they weren't, like, turning a blind eye to earlier, but maybe just didn't realize that they should be looking at. It's one of those, like, I didn't mean to bury my head in the sand, but my head was kind of buried in the sand.
Like, I didn't even realize. That's what happens is you go to implement structure. You're getting clear on roles and, like, data, and you're being very deliberate with how you're talking about issues, how you're solving them, and what it's revealing is friction, you know, especially initially. It's revealing, like, coordination issues.
It's revealing role overlap. It's revealing numbers that are moving in the wrong direction, you know, based on the scorecard. It's revealing recurring issues where you're like, "Fuck, I thought we solved that six months ago. Like, why is it still here?"
By it, I mean the structure, and again, EOS for us, EOS people do different sorts of structure, but we're sticking with EOS, doesn't necessarily remove complexity. What it does is, oh, man, it just turns the light on. You know, every corner, every nook and cranny, you're starting to see.
Like, holy crap, I did not realize all of these things. I wasn't aware of. You know, I was operating with a flashlight, now I've got floodlights. Like, whoa big difference. So even thinking about, as an example I love the accountability chart. I mean, I love all of the tools, but let's just stick with accountability chart because it answers a lot of questions.
Let's say we're doing L10 meetings, which are level 10 meetings. They're held on a weekly basis at, you know, 90-minute increments with your leadership team, same day, same time, on a weekly basis, et cetera. So let's say we're at a leadership team meeting, and an issue pops up that something related to a metric is off with a provider.
Something just simple like that. Let's say, oh, these person's numbers are down. It's like, oh, cool, well, the issue is these numbers are down. Fine, but my mind immediately goes to, okay, well, who owns provider metrics? And by owns I mean who's responsible for ensuring that the metrics for providers are, at a certain baseline or above, and who's responsible for making a move if they notice that the number is off?
Those questions are accountability chart questions. Who owns what? Whose responsibility is it to seek to resolve this issue? And then you get to a point where something like provider metrics isn't even a leadership team issue, it's a department head issue that they handle on their own, and then they bring highlights to the leadership team.
So my point is, with structure, like in an accountability chart, it immediately answers questions. Once you get clear on it, again, initially, like implementing structure, integrating EOS into your practice or your group it's gonna highlight all the ways in which your perception of roles is, I don't know how to say this nicely.
Like, it's just probably wrong. Like, what you think is happening versus what actually is happening. I don't think I've ever seen a case, maybe, but, like, it's more common than not, way more common than not, that people's perception of a seat and what the roles and responsibilities are for that seat is different from what the person in the seat thinks that they should be doing.
That's an accountability chart invisibility until it starts to become visible through structure. Again, structure creates visibility.
So let's keep going agenda item number two, tools cannot choose meaning. Look, maybe I'm just existential at my core. I don't know. I do feel like humans are meaning-making creatures, and we are pretty much existing in a meaningless world, inherently meaningless, meaning like we're the ones that, you know, create meaning.
I think there's something beautiful in that. That's a side conversation. Your tools cannot choose meaning for you. The tools, the EOS tools, the structure, they are not responsible for meaning-making at your practice, at your group, at your business. That's not the point. They can help develop things like values and priorities, and a sense of identity can result from using the tools, but who we are, how we operate, what wins out when we are making hard decisions, like what trumps another, variable, what variables are the most important, that is, the owner and visionary I would say primarily, but ultimately the responsibility for ensuring that is the leadership team, not the tools.
The tools might help you get to a point where you can figure it out. I'm thinking like the vision/traction organizer in EOS, you know, one of the first sections of the VTO is core values, and then core focus. And so those things alone can help you figure out what are the values that are most true to us, what are the things that we, want to...
I don't even know about instill, but like who are we? How do we exist together? I think of those as values. Like, how do we do this together, and then core focus being, you know, why are we doing this, why are we here, and what do we do? It's purpose and niche combined. So my point is the tools aren't gonna tell you what your purpose is.
They're not gonna tell you what your niche is. They're not gonna tell you what your values are. They're designed for you as a leadership team, as a visionary, owner, founder, whoever, to unearth. That's what it's there for, designed for you to bring something out, not to answer questions.
So we just talked about values, but let's do another example. Even if we look at scorecard, the numbers on your scorecard, whatever metrics you decide to track, those will not be the same as another group, as another company. There's no inherently accurate scorecard metrics. It's gonna be sure, yes, there might be a lot of overlap, especially within business types, you know?
So a mental health group practice ownership you're gonna get a lot of overlap compared to, let's say, building and selling widgets, you know, or building an app and selling it, something like that. We're probably not gonna have as much overlap with app builders or widget builders for group practice owners.
But within our discipline, we're probably gonna have a lot of overlap, and it's probably not gonna be the exact same from practice to practice. That's my point. So even if we have... Let's say we've decided on a scorecard. We have a kind of clear sense of what we want on there. That alone is you identifying the most meaningful metrics for your group.
The tool will not answer that. It will not tell you what's the most meaningful. It's important to you. What are the things that we need on here to give us the finger on the pulse of the business at any point in time that are lag measures and lead measures that capture the most important pieces to this business that help us, ensure the scaling that we want or the longevity that we want?
The scorecard itself isn't going to do that for you. That's a leadership team move, and the scorecard supports the decision. So the tool is used as a support. It's not used as an answer or a cure-all.
Let's keep going. Agenda item number three, docket item. Let's go with docket. Docket item number three, rigidity can hide uncertainty.
Look, I think I'm one of those fucking weirdos. I like uncertainty. I don't like... I don't know. I don't like being told what to do. Nothing feels certain to me in life. The only thing that feels certain is death. Like, anything alive is gonna die. Maybe not the immortal jellyfish, which is actually a thing, as a side note.
But even with the immortal jellyfish, they don't know how many cycles it can go through. I think they've captured up to 35 or something, but it might only have 50, 50 recycles in a life, and then it isn't able to do it anymore. Who knows? I don't know. Maybe other people know. I have no idea. My point is, any other living thing, aside from the immortal jellyfish that we know of right now, is going to die.
So that's about the only thing I know that's certain in my life. From a practice perspective, from a leadership perspective, when we feel uncertain, it's uncomfortable. A lot of people are uncomfortable with things being uncertain or up in the air
Rigidity is not an answer. Certainty is not an answer to uncertainty. So when we are feeling uncertain, we might attempt to tighten up processes or create really rigid rules or make sure that every single rule we have captures every exception or every tiny little bit of nuance in this process.
That becomes, for me anyway, that gets into this is less about the process and less about trusting people to broadly enact this process, and it's more about a person's discomfort with uncertainty. And so when I say rigidity can hide uncertainty, that's what I mean. Like, when we're not certain about something, we seek to, like, tighten our grip on it.
A lot of times we seek to tighten our grip on it rather than assessing, "Okay, let's go higher level and see if we're missing something." I had somebody reach out to me recently with a question about something, and for the life of me cannot remember what she was asking, but it was a great question because it was an anomaly for a process that we typically go through pretty seamlessly at the practice, you know, pretty regular process for a lot of my clinicians anyway.
She followed up with a question about it, and I was like, "Oh, gosh, I don't actually know. You know, I don't actually know the answer to this." And let's say she had done something wrong, which she hadn't, but let's say she had done something wrong, and her doing something wrong wasn't really wrong in terms of the exact written policy or expectations, but it was wrong like, "Oh, no, that's not the outcome we're intending."
Like that's not it. That's not what this is about or what this process is for or, you know, what this policy is for. I have plenty of options in response I could have done plenty of things. But let me just say this. A, a plausible option is that somebody would look at that situation and say, "Well, we need a rule. That way we're not... That doesn't happen again." That's what I mean by uncertainty and rigidity. So instead of seeing this as something that kind of went amiss, and maybe it's like a one-off circumstance or like a kind of an anomaly of a situation, I'm seeing it as we can't have that happen again. We have to, like, create more rules around this.
That becomes rigidity because there's always gonna be anomaly situations. There's always gonna be these exceptions to something. Not every exception and not every anomaly needs tightening up. Sometimes you just have fucking weird situations. We don't need a process to capture every single amount of nuance or exception or anomaly that might happen.
That would be a 200-page fucking handbook with a bunch of hyper-detailed things. Nobody's gonna remember that shit. I'm not gonna remember it. I doubt any of my clinicians would or any of my employees would So instead of doing something like that, we can step back and ask ourselves, okay, my feeling right now, my gut is I want to tighten this up, and maybe I can start to use that as a marker for hang on a second, am I feeling uncertain?
And then you could dig further and say, okay, well, is this a global situation that keeps happening, which might imply that you need more structure, or is this a, one-off? Is this an anomaly? If the latter, you probably don't need more structure. You just need to decide what to do in this situation, relay that information, and then, let sleeping dogs lie.
That's what the phrase is, right? I think I've said enough about this, so I'm just gonna move on. Agenda item number four, leadership keeps structure useful.
So i'm worried that this is gonna feel a little more abstract, so I'm gonna try to bring it down to make it a little more practical
Here we go
If you were shopping for cereal
Let's just say for yourself
You have a plethora of options. There's a whole freaking aisle at the grocery store dedicated to cereal and breakfast items, but a lot of it is cereal
And of all of the cereal options, you have a preference. There's something that you probably want more than something else. There's something that you buy for a partner because you know they want it. There's something that you buy for a child or your children because you know they're gonna like that.
There's something that ultimately is driving your decision around what you're going to purchase, what you're going to get, and why you're going to get it
That to me is the metaphor analogy, I don't know, for leadership keeping structure useful. Any of these tools could work for any different group at any different time for any different reason. It's your job as leadership to help the system, help the group sense, decide, and coordinate what needs to take place at the practice.
The tools can help you figure that out. These are the tools you get to choose from. We're gonna select the ones that are relevant for us at the point in time at which we're using them, and even the markers for what we include on our scorecard, for example, that's not something, again, that EOS tells us. That's something that we elect and we put into place and we track and measure and act on. And in doing that, leadership is the one that is saying, "This is important based on our vision, based on what we're seeking to build and do, based on the health of the group.
This is an issue. This is a priority. We need to adapt to this changing market or this recurring problem or set of new problems, or any number of things that you need to adapt to as a leader, as a person who's running a practice
Even thinking about, and this is kind of getting into maybe an example. It's kind of a high-level example, but every week you should be meeting with your leadership team for an L10 meeting. Every single week, unless someone's on vacation or dead. I think that's the concept or the idea in Traction, which is the book about EOS for anybody who doesn't know
And every time you're meeting for L10, you are repairing any sort of drift that's happening related to rocks or scorecard or moving on metrics or
identifying accountability chart issues and/or you're also ensuring that issues are being identified and that they're not staying shallow, and that you are really IDS-ing them thoroughly, getting to the root cause, solving them for good
So we have the practice identity, we've created meaning, we have the tools to support doing this, and then on a practical level, on a weekly basis, we're going in and selecting the cereal that we want. We're going in and saying, "Okay, every week we're meeting, we're keeping our finger on the pulse of the important things, and we're also solving problems consistently So we're putting that structure to use, holding the identity of the group, creating, cultivating, maintaining meaning, ensuring directional focus, and solving right now and future-oriented problems
So ultimately, that's what I mean by leadership keeping structure useful. It's being able to do those things, at the same time.
Okay, so why this topic? Let's talk about this real quick. I think that I just really want it clear that EOS is obviously a very important part of my business, I think a lot of people's businesses. But in general, structure is a very important part of business, period. And for any consulting I do, I mean, I'm leaning into EOS principles and tools.
Whether or not you're using EOS in a practice or in your group, I'm still thinking about things like scorecard, I'm still thinking about things like ownership via the accountability chart, for example. However, EOS is not the identity or the, like the boundary of the group, of who we are, and it's not the identity, honestly, for how I do consulting.
It's not purely EOS consulting work. So I think it just feels important to clarify that piece. Like, this is an important part of any business that needs structure. EOS is an important part of my own conceptualization and consulting that I do, but it's not the core of who I am or how I operate. Let's bring this together through the Integrity at Scale model, which was formerly the Leading Practice Framework.
We're looking at the structure component of the model, and again, structure for me is EOS and how that supports leadership and feedback systems. And all of this is inside that Integrity at Scale model, which is really a living system for a business. And if you need one key takeaway or task, I think you should choose one EOS practice.
So if you need something specific, either choose the accountability chart or choose issues. I want you to do one or the other. Name what it should help your business see or do, and then assess where that tool either became the goal or where that tool, if implemented, would become the goal.
This is like identifying where things will go wrong, just so I'm clear on why I'm asking you to do this. Ideally, it's thinking about, if I'm doing this thing or if I did this thing, where would it break down? At what point would I start to see that as the goal in and of itself rather than a tool?
And to me, that's important because if you can think about it in that way, the point at which it might break down or I might do it I'm gonna say, quote, "wrong," but I don't like that language, wrong in terms of I'm seeing it as the goal in and of itself, then I'm less likely to fall prey to that happening.
That's why I'm asking you to do that. So that's all I got for you today. Feel like this was quick and dirty. I hope so, anyway. If you have questions, of course, follow up with me on my contact page on my website, taravossenkemper.com/contact. Otherwise, subscribe to the podcast and slash or send this to somebody who you know desperately needs to hear it.
Have a great day. Thanks so much. Peace out. Bye.
Thanks for hanging out with me today. If this episode got your wheels turning, I would love for you to stick around. You can, of course, subscribe wherever you're listening. If you are interested in more ramblings about leadership culture, EOS, and all the weird fucking ways humans make organizations harder than they need to be, head over to my website and join the email list.
Until next time, make sure you take care of yourself and the people around you. This shit is hard, and we are better together. See ya. Bye