Culture Focused Practice

Hey, friends. Dr. Tara Vossenkemper here. You're listening to the Culture Focus Practice podcast. We're gonna talk about ownership versus reporting today. Look, I'm just gonna be honest. Like, anecdotally, this shit gets me every time in my experiences that happened to me, and it still can, very, very subtly creep its way in and happen again.
My guess is that at some point, if you are on a leadership team or you have worked on a leadership team, it's probably happened to you, too, if it's not currently happening. What I've noticed over my work, my years consulting with people, running my practice, is that leadership teams in particular can get really, really good at talking about problems without actually solving them.
So it looks really healthy what we're doing. We're talking, we're sharing updates, we're discussing issues, we're making sure that everybody is informed. Everybody seems to really care, but we keep having the same fucking discussions over and over. We keep having the same problems over and over. That is not a sign that your leadership team is dysfunctional necessarily.
Maybe it is, but that's not what that points to. To me, what that starts to point to is: Who is responsible? Like, where does the ownership actually lie? That's what today's episode is really about. So we've got three agenda items, and that's pretty much it. Oh, and a scenario. We are gonna do a quick little scenario.
So, let's do this. Agenda item number one. Here is the key distinction. Reporting creates visibility. Ownership creates movement. Movement. I like communication. I like conflict and tension. I like knowing what's going on, being able to say, like, "Hey, in this area, what's up?"
Let's get some details. Let's talk this through." So I'm not trying to dismiss communication because it needs to be there. Like, we need healthy communication. I'm looking for another word. Healthy and, uh, robust, coherent, rich, something like that. We need that on a leadership team. And we need visibility, so we have to know what are either the functions of the team or what are the numbers or what are the projects like?
We need visibility as well to be able to function effectively. If you're an integrator, especially if you're operating on EOS, your integrator for sure needs visibility. Your integrator needs to know everything, all the moving parts and, like, what people are accountable for, et cetera.
But here's what's really important and I think this is known. My history is I'm a practicing clinician. I'm a licensed therapist in the state of Missouri. This is the same in therapy as it is in running a business. Information alone doesn't create change. Like, insight alone isn't really enough to create any sort of behavioral change.
That is not the only prerequisite for change. So same as with your business, information alone doesn't create change. Like, you might see this metric... I'm thinking about
our marketing numbers. Like, we had information on this for however many fucking months, if not years, and change wasn't happening. So I might be reiterating too much, but having the marketing metrics was not enough to do anything. Like, it's sort of like an ellipses, you know, dot, dot, dot. Now what?
Like, okay, now what comes next? There's a very meaningful or significant difference between saying this is what's happening and then having a person, which might be you, might be somebody else in that seat, be responsible for what happens next. That what happens next piece is the crucial part. What I can say is, I mean, I can say a lot of things, but one of the things I'll say right now is especially with the leadership team, I'm basically almost solely at this point in the visionary seat.
But that's a whole different can of worms. But let's say ultimately most of my time and energy is spent in the visionary seat, and actively moving myself out of seats that I don't belong in, you know? But one of the seats that wasn't getting tended to was the marketing strategist seat.
What I will say is that having a person in that seat, and then also somebody moving into our director of finance and admin seat, which is the one I'm currently in that I fucking suck at, that has alleviated so much stress, just, like pressure and weight knowing that this number that I'm aware of and that I feel almost, like, powerless to, like, continue to keep hold of, to try to move it consistently, that number that's super fucking important for the practice, for the group, is now being tended to and watched by another person, by a right person in the seat, and by a person where it makes sense that their role is the one that's watching this number.
So for the marketing person, it makes fucking sense. Like, they should be reporting on and responsible for, not just reporting, because reporting is just visibility. That's not ownership. They should be reporting on and responsible for the movement of inquiries, for example, which is the fucking bloodline.
You know, that's the oxygen for the business if we're using, like, a Fix This Next perspective. So while reporting helps people understand reality, ownership is where you're shaping reality. My marketing person might say, "These numbers suck. Here's what we need to do. Here's what I propose we do. Here's how I'm gonna track it.
Here's what I expect to see." My integrator is gonna say, "That sounds great," and I'm gonna say from the top, like, "Thanks," you know, and, like, go on my merry little way.
I think something to note here is that, and you might fall into this camp, sometimes leadership teams will have meetings, and it feels really productive because we've talked about an issue, everybody understands what the issue is, we're all on the same page, like, "Oh, this is great." Like, "Okay, good job, team." And then we, like, disperse and go do whatever we're doing for the week, you know, maintaining our roles and responsibilities for the week, and then we come back, and it's almost like starting over.
It almost feels like Groundhog's Day if I think about it, where it's like, "What? We're talking about this again?" Like, "Why are we talking... I thought this... I felt good last time we left. Like, didn't you all feel good?" Well, we all felt good. We talked about it. If you're, like, having that, if you're in that, dynamic, if you're stuck there, that, again, I said this sort of earlier in a different way, but, like, that points to nobody is actually responsible for that number.
And if we're thinking about ownership, we're thinking about one person has to say, "That's what's up with this number," and one person has to say, "Here's what I wanna do with it," assuming that the integrator is like, "Yeah, that works with, you know, in the context of everything else." It's one person's responsibility, one function, one seat's responsibility, assuming you have a person in that seat.
If you are in five seats, I think this is where we get into some problematic areas because you might be carrying way too fucking much to be able to consistently tend to all of the numbers required for the health of your business. It's really fucking hard. As a visionary, if you are like most visionaries I don't wanna say that we tend to be flighty or flaky 'cause I don't think that's really fair language.
I think a lot of us tend to want to create and seek novelty and have a lot of ideas and, you know, to use EOS language, can be the spark plug, so to speak, the one sort of igniting passion for the full group. That's great. One of the things that most of us don't do super well, some of us do, I'm sure, but I'm not one of those some of us, is consistently maintain a system or, like, a metric or a number.
So if you are a visionary type and you're in five different seats or even, I would say even, like, two or three seats total, you're on thin ice, mister. You are really... If you can do that well, fucking kudos, man. Please tell me your magical ways. Most of us are not gonna be able to do that well, especially because of the consistency with needing to own and fucking move that needle of that metric, for that metric that we are responsible for in whatever seat we're sitting in.
So let me wrap this part of the agenda up. Understanding the issue, shoop, we know this. Awareness of the issue is not the same thing as changing it. So reporting and ownership are two very different things.
Agenda item number two, leadership teams often create this dynamic together. So if you're thinking, "Well, I don't do this. I'm not guilty. It's my integrator. They're not holding the line," or, "It's my clinical director. It's my marketing person," fuck off. It's you. It's me too. We all do this. If your team does this, you also have played a part in that dynamic.
It's all of us, bro. It's all of us. I'm not saying that we avoid ownership on purpose. I don't think any of this is intentional, honestly. I think that when we're talking about an issue and we all feel like we're on the same page, we get it, a lot of us genuinely feel better. It's like a different practice.
It's a different mental and behavioral practice to say, we feel better dot, dot, dot, but what is changing so that we continue to feel better? Like, what's going to change? Feeling better cannot be the only marker for whether or not somebody is taking ownership of something. There has to be this other, action item or behavior.
There's like what's the next expectation? What's the next step in this process so that how good we feel after talking about it continues, you know, forever? That would be awesome. I think that a lot of people end up falling into this let's say like leadership dynamic, this trap of we're on accident avoiding ownership.
A lot of those people tend to be like highly conscientious. I think if you're on a leadership team you're gonna be highly conscientious, period, but tend to be like highly conscientious. They're hardworking. They care deeply. They really want to be good at what they're doing.
They might communicate effectively. They are trying really hard. They really wanna understand. But again, if our dynamic is that we are inadvertently rewarding awareness of an issue as opposed to movement of the issue, then we will remain in a place where we're just doing visibility and reporting rather than ownership.
When we do that over time I'm kind of saying the same thing but in a different way, a lot of leaders, and again, I think as the visionary, if you're the visionary of the practice, this also falls on you, we end up thinking or it just sort of, like, settles into our system that bringing information forward, that's it.
Like, I'm done. That's enough. What I will say is that as a visionary, one of the markers for whether or not this is happening might be you are feeling responsible for everything, including metrics that don't belong to your seat.
So whatever seats you might be in, if you're in more than one, you might have a more than one metric, you know? But when you start feeling responsible for, let's just say marketing metrics and you're not the marketing person that might be a sign that your leadership team is falling into this dynamic. And like we're talking about stuff, there's information sharing, we're doing it, we're good team.
Now the visionary feels stressed as fuck all the time because nothing is moving, but we all feel good. Like everybody feels good at our meetings, I don't understand what's happening. It could very well be this thing, the ownership is not taking place.
The nuance here is also that the integrator owns metrics that aren't like directly associated with their seat. But what I mean by that is anything that is like cross-departmental falls with the integrator. So if we're doing something like let me think about this. Something like revenue, for example.
You might think, "Well, that's a director of finance and admin," or, "That's like my finance person." Maybe, sure, like that person could report revenue, but are they alone responsible for ensuring the gross revenue, the revenue health of the practice? My answer is probably not. Because revenue is not just associated with billing health, AR, AP.
Sure, it's associated with that stuff. It's also associated with provider health. Are our providers full? Are they maintaining their caseloads? Are they churning people too quickly? Are they spending their clinical hours doing clinical work. So not just are their caseloads full, but are they actually full on the schedule? And it's also associated with marketing health. Do we have enough people coming in and being converted, which is our client care, to sustain our providers and to support our revenue?
Revenue is a result of the health of all of these things, and so it's an integrator thing. So the integrator isn't the one that says, "I need to move the needle on revenue." In our case, she is the one that says, "What the fuck is happening? Why is revenue low? Let me look at all this data. Let me look at all the people in the roles.
Oh, it's over here." Isolates the problem, and then might apply pressure to the seat that is most, lacking, let's say, like needs the most pep in the step with regard to their metrics increasing.
I think I'm sharing this because there's a slight difference between Somebody fully being able to own a metric versus reporting, and that the person who is reporting on the metric, let's say in a leadership team meeting, for example, should be the one who fully owns that metric. So for your finance person, maybe the thing they're reporting is something like aging percentage over 60 days.
Or something they're reporting on is claims submitted. And so that is patterned, and that could be something that aging in particular, that they can work hard to keep low.
And it's isolated to that role. Maybe not claims submitted, maybe that's a bad example, but aging, let's say, is isolated to that role versus something like gross revenue is cross-departmental. So let me just like close this out.
The dynamic at play, the leadership team dynamic is such that if we feel better, if we tend to think like, "Hey, we're good," and ownership can kind of fall by the wayside.
I'm saying for ownership, ownership of something should be the person who's actually responsible for moving that metric in whatever direction you want it to go into. And some of the things that people take ownership for, we need to be careful that they actually can be responsible for fully owning the metric.
Using revenue as the example, it's to say the integrator, it's a cross-departmental number. It doesn't just belong with finance person. Now I'm gonna move on. Let's do the third agenda item.
Ownership requires something reporting does not. Also, that's kind of a good segue from the example I was just saying.
If we're thinking about ownership, what we need to think about is decision-making power, the ability and need to prioritize, and often some sense of comfort or confidence in taking action before certainty exists. I would say nothing is fucking certain except death. That's, for me, that's it
And if that is the case, which I would say it is the case, but if that is the case We still have to do things before we feel certain. We're probably not going to feel certain, so we need to move the needle still. Reporting is super observational. We know this. Ownership is we're doing this thing. We're going in this direction. We're gonna make this move, and I'm gonna keep track of the metrics to see if it actually matters. So another piece to this, and this can be really hard for not just the owners or visionaries of the practice, but also people who are leaning into taking ownership for the first time.
Ownership also means accepting responsibility for what happens next. So even if you do something, if a person says, "Let's do this," and it goes horribly wrong, like it just doesn't work well, I don't mean to be an asshole, but like, "Yeah, that's on you, bro. Like, what didn't work well? What do we need to do different next time?"
And if a person continues to do things that don't work well over and over and over and over, maybe that's a sign that this is the wrong person in the seat. I think that's something to consider. Let's not go down that path, though. Let's also account for people's need to develop in a role. So if you have people initially who are in a leadership team seat, and they're new to this concept of, like, ownership versus reporting, we gotta give them a little bit of grace.
We have to give them a little bit of space to be able to make some mistakes. Ideally, they are learning from their mistakes, and they are learning, like, "Oh, this is what ownership looks like. Oh, I tried that. It didn't work. Why didn't it work? Probably 'cause of this. Okay, don't do that next time. Let me try this next time."
That's the sort of thing we wanna see, and you see that sort of thing with conscientious people. But also, those people need to be able to integrate the feedback from the mistakes that they made. So if something doesn't go well, why didn't it go well? How do I avoid that in the future, avoid that next time when I'm trying to move the needle, with regard to the metric?
This shit's uncomfortable. I think it becomes really uncomfortable for people. From a visionary perspective, from, like, an owner/boss perspective, it can be uncomfortable because we've already learned a lot of mistakes, and sure, we have a fuck ton more to learn, you know, but we've already learned a lot from the mistakes we've made over the years.
And so the idea of somebody stepping in, saying like, "Ah, God, they're gonna make mistakes, too. Okay, I gotta let them. I gotta let them make mistakes," there's something in here that's like we have to let people learn how to be a leader, be in leadership and be a leader. There's a caveat there, like if it's something that's gonna cost you a crazy amount of money or is gonna really erode cultural health, don't let it happen.
Now, there are, like, parameters around the extent to which a mistake, can happen, so that aside. But from a leader perspective It is much safer for people to report on something rather than fully own it. It's easy to say, "Well, I've, I just-- I'm doing my job. I reported on this number, and that's what it, that's what it is."
And then they look to the visionary, or they look to the person above them and say like, "What do you want me to do? " Well, if I'm up top, I'm gonna say, "I want you to figure out how to move that number." That's how I'm, like, pushing back ownership to that person, you know?
And if they continue to say, "Well, I don't... What do you want me to do?" basically, maybe not exactly that, but, like, if they continue to ask, "What should I do? What do you want me to do?" That, again, that to me is like, yeah, that's the wrong person. That's not the right person for your seat. I want you to take ownership.
That's what I want you to do. So my point is that ownership is risky. It's risky. It carries weight in a way that reporting on a number does not, and it really increases the expectations of the people that we have in our leadership team seats. So that's all I got for the agenda items. Let's do a scenario.
I'm gonna read this, and then I'm just gonna talk out loud. Who knows where it goes? "Leadership team has been discussing therapist retention concerns for over a month." Oh, fucking hell, retention. "Each week, the issue appears on the agenda. Updates are shared, conversations are summarized, leadership team members describe what they've observed, who've they spoken with, and what concerns still exist.
Everyone leaves the meeting feeling informed." Yes. "Yet, nothing materially changes. Eventually, frustration starts to build." That shit would have build for me after week two, if I'm being honest. "One leader feels like they're carrying the issue alone. Another believes they're helping because they're consistently providing information.
A third assumes someone else owns the outcome because the topic always seems to belong to somebody. Nobody is avoiding responsibility. Nobody is disengaged, yet the issue remains unresolved. The team slowly realizes they've become highly effective at discussing the problem without ever establishing who is ultimately responsible for creating movement."
Okay. The part where it says nobody is avoiding responsibility, yes, they are. Not on purpose, I'm not saying they're actively avoiding it, but nobody is taking responsibility. So for me, what comes up right away is, all right, retention. I'm thinking of therapist retention as retaining clients.
That's it. Or provider retention, if we wanna use the word provider, as retaining patients. That's what I'm thinking of when we're talking about retention. I'm not thinking of retaining your provider or therapist employees, which is separate, although my answer is gonna be the same. My thought is whose responsibility is this? Like, according to the accountability chart, if there's an accountability chart, if you have one, and let's say you don't, let's say you have some sort of org chart, at least some concept of what are the major functions of the business and what are the seats, what are they called? Or titles, if you wanna use that language. Let's assume that you have one. I'm gonna use the language accountability chart, 'cause that's what we use, because we operate on EOS. So accountability chart, there are five core roles or responsibilities under each seat, broadly speaking. And when we're thinking of roles and responsibilities, we're thinking of, like, thematic, broad, high-level things that this seat title is responsible for.
So when I say, "Where does this live on the accountability chart?" I genuinely mean, if I look at my accountability chart and I look at the titles and I look at the roles or responsibilities for each seat/title, who owns it? That's the answer to this question, and if the answer, if we're talking about therapist retention, like retaining clients, from my perspective, that's a clinical director or a director of clinical ops.
That's theirs. They own this. So I'm gonna say to my DCO, "Look, this is yours. This is yours to own. What I need from you or what you need to do," or... Well, no, I wouldn't even say that. I would say, "This is yours to own. What do you think you need to do?" And really, my integrator would probably be the one saying this, if I'm, like, being real honest.
I might voice it, and then she might come in, like swoop in and say, "Yeah, actually, what do you think about this? Where do you wanna go next?" Et cetera. If your leaders understand this notion of reporting versus ownership, perfect. That's the insight piece, that's the awareness piece, that's step number one. Step number two would be we have to help them start to do things differently. They might not be able to translate right away that insight into behavior.
So my integrator or I might play a role in saying, "Hang on," Let's just, like, slow down this meeting real quick. We're talking about retention. Who owns it?" Okay, it's the clinical director or the DCO. I'll say DCO for us 'cause that's easy. Cool. DCO owns it. From there, me or my integrator might just start to ask questions.
What are you thinking about this? What do you see as the problems or the recurring issues? I always ask the question, is it global or specific? Is this, like, a global practice-wide problem, or is it specific to a couple of people and they're bringing down the average? What is the amount of time that we can expect to see change?
If it is specific, who's gonna work with that person? What's the process that's in place for retention? And if there's no process, it might be on that person. I might say or my integrator might say, "Okay, your to-do is to develop a process. "
The whole, like, process development piece could be done, you know, it might be something where they consult with the integrator just to make sure, I don't know, whatever, like cross-departmentally things are fine. But ultimately, that's on one person to own. I'm gonna keep saying this language, but it's like, yeah, it's on one person in one seat to own this thing.
And at the end of the day, at the end of the meeting, when this continues to come up, in meetings, we're not all talking. We might all still be talking. Like, it could be that this is now a team-wide discussion. But ultimately, we're gonna look to that CD and say, "What are you thinking? What's happening?
Why is this still a problem?" And the CD should be able to say, "Yeah, okay, we've worked really hard. This and this and this person, they've all increased their retention. It's these two that are really bringing down the averages. We've coached them. They're gonna get new supervision. They're gonna do this next."
But if things don't change in a matter of three months, two months, one month, like, if I'm not seeing substantial changes soon I'm probably gonna recommend that we terminate them, or I'm probably gonna do this sort of disciplinary process. I don't have any idea. That is your business decision conversation.
So anywho I think that's it for the scenario. I don't think I have much more to add. I think it's all the same. Ultimately, if we're thinking about reporting, it's not bad. We need reporting. We need to be able to healthily and effectively communicate. We need to keep things visible. We need information, organizations, leadership teams, et cetera. But when we treat that as the end-all be-all, we're basically screwing ourselves over.
We have to know what's happening, and then we have to have the right people, the right seat, own the outcome, and decide what to do moving forward. So while these things can sound similar when we talk about like, "Well, they report this number," that's great, but who owns it? You know, That distinction is really fucking important.
So that's all I got.
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