Leading Like a CEO – How to Run Your Practice Without Running Yourself Into the Ground [Part 3/3]
Hey, hey! Dr. Tara Vossenkemper here, and you are listening to the Culture Focused Practice podcast with yours truly. Thank you for joining me today. You are tuning in for the third episode in a three part series, all about boundaries, or, oh, goodness gracious, all about burnout. So episode one is. Sort of burnout traps.
So the, the hidden things that lead people into burnout, the ways in which you can recognize burnout in your life. Episode two is boundaries. That's where I got that word from boundaries that actually work more importantly. And so burnout, if you listen to the previous episode, isn't just about working too much.
It's about a, it's about a variety of other things, but a way to fix that quickly, like a quick fix, although not a. I would say not a long-term solution necessarily is implementing boundaries. So that's what episode two is all about. This episode, episode three is probably the one I'm most excited about.
This is really about leading like a CEO, leading like a visionary, leading like a boss. It's about running your practice without allowing it to run you into the ground. Period. Because it will, if you let it, it's like the blob, you know? Well, no, that's not a good example actually. 'cause the blob overtook everything.
It's like something that will give as much space and push any bounds that you set. And so we have to, again, those boundaries come into place. But also we have to be thinking about this differently. So when we lead, like A CEO, we'll talk about this, but leading like A CEO is really a huge mindset shift. So I love boundaries.
I think they're incredible. They, they don't really address the root cause of burnout. They're important. They're important. They're still required throughout your leadership and ownership and CEO type mentality. Like we still have to have boundaries.
But in and of themselves, they don't explain the whole picture. Maybe that's the best way of saying it. They're a fix and a bandaid, but not like a framework and an operating system. So boundaries don't give us long-term sustainability. They stop the bleeding, like being a bandaid, you know, they. Are helpful in helping us feel better sort of immediately, and also maybe short term to medium term, but they don't address the root cause of what's going on.
And that real sustainability, the real, I feel better. Holy shit I'm doing. This comes from shifting how you lead and shifting your mindset and your behaviors with regard to leadership. It's a huge mindset shift going from practitioner who runs a business to CEO or visionary or boss or owner, not operator. It's a huge mindset shift. You go from managing people, so to speak, to steering a business. They are not one and the same. It requires a different level of thinking, of decision making, of leadership, of accountability, of systems, of roles, of responsibilities, of processes.
Uh, it requires everything to be slightly different. Mostly because you're not engaged in any of those things. You should not be engaged in any of those things in the same way as a CEO slash visionary as you were as a practitioner or like a practitioner slash business owner.
No shade at somebody who's in that space. For the record, I'm not trying to come at you or you know, there, there's no like subtle digs that this is not my intention. This is intended for people who wanna shift out a burnout, who wanna grow their practices, their group practices, or who are on leadership. Also wanting to like shift into more of a, I'm thinking about the business instead of, I'm constantly caught in the weeds, so I'm not trying to hate on people who wanna stay in a practitioner, like an owner operator model, or a practitioner operator model.
That's totally fine. This is not intended for those folks though. And so if you get offended or if you feel like, well, that's not fair, I like what I'm doing, cool. Then I would just skip this episode. If you are in a place where you think, yeah, absolutely, I wanna shift into that mindset, then you should keep listening.
So. Again, if we're shifting our mindset from, I'm a practitioner who runs a business to I'm the CEO or visionary, or owner, not operator, et cetera, there's a couple of things that come to mind for me. So there's a book called the E Myth Revisited, maybe the E Myth, and then the E Myth Revisited. I don't, I don't know who wrote it. I think I've referenced. Referenced it here before. One of the key concepts from that book, oh God, I hope it's from that book. Put my foot in my mouth, which is the story of my life. If it's not that book, one of the key concepts from that book is going from working in your business to working on your business.
This is part of that mindset shift that, that like line, instead of working in your business, you're working on it. That line is the exact shift that I'm talking about.
So for example, working in your business is fielding client phone calls. I love client phone call. I did it for a long time. But if you are the one fielding client phone calls, you are linchpin in this process. You are in the business. Versus on would be you have an intake coordinator who fields all the calls, handles problems, and then comes to you with any issues they might not be able to solve. If you have an employee issuer issue, for example, and you're involved in every single mediation of every single thing that might go wrong, you're in the business. Working on the business is something like having a conflict process or a resolution type process or mediation type process, or a direct supervisor who fields those sorts of issues.
If you're doing billing, you're working in the business. I love my biller. I think she's incredible. She's so incredible. I don't wanna do billing. I'm not good at it. I'm not good at it, and I don't wanna learn about it. I don't wanna have anything to do with it. If I had to have something to do with it, that would be me being in the business instead of on the business.
The same goes for carrying a caseload. It took me a very, very long time to think about a world where I didn't have clients of some sort, where I wasn't carrying a caseload.
And even then, some of the shift away from it is because of circumstances. That's being in the business, shifting out of having a caseload and into sort of oversight maybe of caseloads for other providers, for example, is on the business. And even that sort of oversight might be specific to a clinical director. And you might just be looking at big level, high level metrics related to provider performance, for example.
So I think that's enough examples. I think you're getting the concept of what I'm talking about. If you are doing a lot of the daily things and you're in the weeds with a lot of the stuff that has to happen in order for the business to operate, for the practice to operate, you're in the business.
And moving from, you might like that right now. At some point, if your intention is to grow, it's not gonna work. You can't do both. It's hard to be in the business and be needed on a daily basis. To, it's hard to do that and then shift into thinking about the business, thinking about the practice and how systems intersect and flow together, and how processes unfold and how to introduce new services and how to fix a recurring problem.
I mean, you need space and time to be thinking about these things.
So there's a few key leadership. Shifts. So leader shifts, that would actually be a combo word. That's good. Three key leadership shifts. Shift to that I wanna talk about. One is, um, one is, and of course these are all probably easier said than done, but I'm gonna cover them anyway.
One is to stop thinking like a practitioner and start thinking like a business owner or higher level leadership. So as practitioners, I think many of us are trained to listen and help and process and give a lot of space and be with folks in their journey or their experience and really center them. In our worlds as a business owner or even like higher level leadership, we have to make decisions.
We have to delegate, we have to make decisions. We have to be focused on results, on metrics, on things that we know will move us forward in the direction of the vision that we're, you know, the direction that we're all trying to grow towards and grow into the vision that we're trying to grow into.
I don't think you have to lose the humanity of people when you're focusing on results. So that's something that feels very important to me. I might be interested in is what we're doing effective. How do we know why are we moving here and not over here when data tells us we should go there? You know, I'm looking at metrics.
If I lose sight of the people who are part of what's making this incredible. For me, that is losing humanity. So you can be interested in metrics and data and delegation and decision making and not lose the the people aspect, the relationship aspect of the business that you've built and created.
So stop thinking like a practitioner and start thinking like a business owner. That's number one. In terms of a key leadership shift.
Number two, man, letting go of help or guilt. I goodness gracious, I don't know if this is unique to my specific profession or if this is just global and helping professions. I think it's probably unique to my my field of therapy and counseling. We have a lot of help er guilt.
Um, we have a lot of help or guilt. I'll just say that we have a lot of feeling bad about charging for services and holding people accountable for a policy about a missed session or a late canceled session or recouping money if, if insurance doesn't cover something and you have a policy about this, we feel bad for following up and trying to get them to pay for services.
I have, I have so many thoughts about this. I've absolutely been in situations where the money coming in does not equal the money going out. And we are in the red for a month. I. Or two, maybe, if it's a really slow period and it's only because I have cash reserves that I'm able to pull over here and do, you know, pay this over here.
Nobody has that responsibility except the owner, the person running payroll, but specifically the owner. I have horror stories of colleagues and friends who have drained all of their cash reserves, if they even have them. A lot of people don't- it's a pretty low profit margin field, at least group mental health practices.
A lot of people have drained their cash reserves and maybe taken out loans when covid hit, for example, whenever, um, really slow times and months, if there's any, any, if there's any issues with billing insurance. If you are a practice that accepts insurance, then there's billing related issues. I'm saying all of this to say that that helper get guilt.
That help er guilt should basically be squashed because you are liable when shit hits the fan with regard to finances. And so if there's not a profit, there is no sustainability. Profit is not padding your pockets. Profit is business sustainability. That's what it's about. That is a huge shift for people where they feel bad about making money and they don't wanna exploit their employees.
Yeah, don't exploit your employees. Absolutely not. And recognize and internalize that you have to have a profit in order to be sustainable when things aren't going well for a month or two or three. Again, I've had horror stories.
So number two is letting go of that helper guilt. And number one is stop thinking like a practitioner and start thinking like a business owner. Again, we're talking about three key leadership shifts.
Third one, your job is not to fix. Your job is to lead. This is a different skillset. It's an entirely different type of energy. I love fixing problems. I love conceptualizing solutions. I love thinking like creative problem solving and what's the problem and how do we fix it?
And you know, I love that. It's not my job, not all the time, not with every single problem that comes across my desk or inbox or meeting. Leadership, real leadership is about strategy and vision and trusting the people that are in place to solve problems that are relevant for their roles. Not everything should go through you or you become the bottleneck and that takes you away from focusing on the vision and from really thinking about strategy moving forward.
Your job is not to fix every problem. Your job is to lead people. So we're gonna shift and I'm, I'll expand on that a little bit as we go because it's really about empowerment and so let me just keep going 'cause I think it's gonna come together a little bit more.
So those are three key leadership shifts to make. Uh, we're moving on now to delegating like a CEO delegating, like a visionary. I remember listening to, was it, it had to have been Mike Michalowicz. He's so fucking funny, man. I don't know what he was talking about, or if I heard him present or I, I couldn't even tell you when I heard him say this, but I remember something where he was talking about people thinking that they're delegating, like, I'm gonna delegate a task to you.
And then that person comes back and says, Hey, I have a question about this. And then you answer that question. Then they go off and do it, but then they come back and they're like, Hey, but also I have a question about this. And so you answer that question and then they go off and do it. But then they come back and they're like, Hey, but also, hey, I have another que another question it's about this. And then you answer that question and the cycle just continues to repeat.
That's not delegation. That's not delegation. That is task delegation, but it's not true leadership delegation. So how to delegate like a CEO? There's three key things here.
One is that there's a difference between task delegation and true leadership delegation. Task delegation is gonna be do this thing, okay, do this thing, okay, do this thing. Okay? Do this where you are, you know, sending people specific tasks to do. Leadership delegation is, I want you to own this. I want you to make decisions and I want you to keep me updated. That's it. A key piece here is that they're gonna make mistakes.
And so you have to be okay with, we don't have to be anything, but I think it would be beneficial if you were okay with the fact that your leadership will make mistakes. They're going to, and if you are on leadership, your colleagues will make mistakes. It's going to happen. You made mistakes. Don't act like you're innocent of this.
We've all made mistakes. We've all made massive mistakes when it comes to building or growing our group practices. This isn't, it's, it's the process of growing and learning and evolving. And so it's not fair that we expect our people not to make them, period, just period. So there's a big difference between task delegation and true leadership delegation.
That's one thing.
Another thing about delegating like a CEO, like a real visionary, is that most group practice owners, and I would say even like, again, higher level leadership, if they have people to delegate to, usually bad at them, bad at it. Excuse me. They're usually bad at it. Delegation is really about empowering people.
It's not directing them with exactly what to do. So to me, this isn't just about leadership. Now we're not just talking about task delegation and leadership delegation. We're talking about, broadly speaking, delegating a project. Even if I have a project for my client care coordinator, I might say, Hey, I want you to come up with something. I want you to do blah, blah, blah here. Like, I trust you to do this, and you are involved in the day to day. So much more than I am. I don't even know half the policies that we have regarding client care. She knows. So why would I wanna create something, a project, or try to change something rather than say, I want you to do this because you have, your hands are all the way in these pots. You're the, you're the fucking chef, man. I'm just trying to serve the food.
We have to empower people. We have to empower people to attempt to. Complete a project or work on a problem or do something and it's not just do this task, it's, you know, here's a project I'm entrusting you with. So delegation is about empowering people.
And again, most practice owners are bad at delegating. We think we're the only ones that can do it. And also there's a key difference between task delegation and true leadership delegation. So we're talking about how to delegate like a CEO, just to recap.
A third piece is that we have to try to create a team that functions without your, my, our micromanagement. So if your practice or your group just tanks, if you're gone on vacation, you are the linchpin. You are the thing holding everything together. That sucks. That's not visionary ownership, CEO, that's not true Leadership. Being the one person that everybody goes to, which is gonna lead to burnout. We're trying to get out of burnout.
Ultimately, we won a business that runs without us. I'm actually am thinking about now, Mike Michalowicz's, uh, Clockwork. His book Clockwork. If you haven't read it, I would say download, read it, or EMyth is another really popular. I didn't love it, but it's really popular. A lot of people really like it. So I'm gonna say EMyth is good. Clockwork is another good one.
But regardless, we want a team that functions without us being involved in the mix and without us micromanaging. So this is where you need to practice being okay with mistakes. They're not fun. It's not fun. You know, I remember once I had a, um, conversation with my director of ops at the time and her, and my, also at the time, clinical director.
Now my director of ops is my integrator, but at the time she's director of ops and it was clinical director and they were doing something. And they were coming to me with like, Hey, this is a project. This is what we decided. This is blah, blah, blah. And I was like, that sounds great. My only feedback is I don't, I don't think that many people should be involved. Like that's a lot of cooks in the kitchen. And they were like, well, we're, we're gonna go this route. And I was like, I am actively stepping out of this. I'm gonna let you do you and I, I don't like it, but it's cool 'cause it's yours. So run with it and see how it goes. And if you're right, then awesome. We'll go that route in the future.
And if you're not, then cool. Now we've learned. And she came back and she was like, yeah, you were right. I was like, yeah, that's okay. Like cool. Now you know, that's what I'm talking about. It wasn't some glaring, massive oversight mistake. It was like a little piece to a puzzle that I knew wasn't gonna work.
But it doesn't matter that I know it's not gonna work because I want them to own this project. And so I'm actively stepping out of involvement because it's theirs to do. So that's the stepping back piece that's trying to trust people. Also, I, I'm neurotic about some things, not all things, but I am neurotic about some things and so for me it is an active practice to have to step out.
And so I will language like I am actively stepping out of this. I have to remove myself because I have thoughts and feedback and questions and so I don't wanna encroach. I want you to own this. I'm removing myself. What's great is they know me well, and so it's a, it's shorthand that works for us is what I, what I will say. If that doesn't work for you, then don't own it that way and you can just practice. I'm not, I need it. I have to say it. I have to say it out loud like, I'm stepping back from this. Do your thing. I don't love it, but I'm gonna trust you to do it. And then I might back up and disappear.
Okay, one more quick thing. Ah, fuck. Quick. I don't know. One more thing. How about that? One more thing.
Something that is very important is this concept of energy management versus time management, and I think so often we think about projects and things and life and work in relation to how much time will it take me.
When you are in a leadership position or a CEO or the visionary or the person at the top who has to strategize and visualize and delegatize, and I'm making up words now, but you understand what I'm saying- when you are that person, energy management is greater than time management.
When you question, why am I so fucking tired, like I only worked a few hours, that's because mental energy is more finite than physical time, than actual time. So you might block your calendar for 90 minutes, but that 90 minutes you spent time like thinking, strategizing, planning, you will be more exhausted.
You will likely be more exhausted than if you were just going through a simple to-do list. I'm not negating the importance or dismissing the importance of a to-do list. I, of course, they, it's important to get shit done and also one thing eats up more brain power than another.
I remember, I'm just thinking about my second semester in my doc program. I think it was my second semester back, so I'd only had one semester on my belt, under my belt, excuse me. Second semester back in, we were taking, I was taking Multicultural, oh, integrating Multicultural. Multicultural counseling. Something like that. Advanced multicultural counseling. That's what it was. And we had a, you know, a bunch of books to read.
They were, some of them especially were just incredible. But I remember one of the first reading assignments, it might have been that first week. I was doing the reading and these are, they were dense books. I mean, my master's program was cake. My doc program was not cake. It was, it was work. And so we're doing this reading assignment.
I put it down, I probably read for, I. 45 minutes an hour or something. I was trying to like stay focused and highlight and make notes and think, you know, and my husband was like, Hey, I'm taking the dogs for a walk. You wanna go with me? This is pre kids for the record. And I was like, um, yeah, yes, I do wanna go.
I had to think about it, but lemme go. I wanna go with you. So I put my stuff down, I get up, I walk out the door, probably, you know, one house down from our house. I had to turn around. I said to him, I don't know what is happening, but I am so exhausted I need to go back. My brain was not used to being used in that way.
I was tired from reading and thinking and doing these notes and intensely trying to focus. I was tired, tired, and it sort of slapped me across the face when I realized that that's what had happened.
So you might be drained even after working for a few hours because your energy management is more important, it's greater than your time management. So this is something to keep in mind as you're shifting into leading like a CEO.
Another thing is that I would want you to start structuring your week for maximum energy and efficiency.
So if we know now that energy management is greater than time management, we need to reorient ourselves to our schedule. So we need to be thinking about how does our schedule, how do we maximize what we're doing and where we're spending our time? This might require you to do a time and energy audit, and so it might be for the next two weeks, or you plan this out for two weeks in advance or something where you are spending time documenting what you're doing and your level of energy before starting and after ending.
And so then you get a really good sense for holy shit that lit me up, like I feel energized or oh my God, I am exhausted. Like I started strong and I, I just waned. I'm, I'm done. I'm tired. This is a great habit to get into, period. But also, I think it's especially important now because you can shift and start to maximize, okay, where and how is my time gonna go?
Where is it most important that I'm really fully engaged and energized versus where are those like low energy tasks that I can work on that I, I don't need to be as, you know, engaged and present for, you know, working through a to-do list, for example. Again, I'm saying a to-do list, but working through a to-do list, for example, is gonna be different than strategizing a whole new system or service or way of a process or something like that.
So, third thing related to energy management, it is imperative that you take real breaks. I'm not talking like, I took five minutes here. That's not a real break. I'm talking like real breaks. Your brain literally needs time to rest and recharge. What's awesome about this, there's a fuck ton of research behind this, so just go look into it if you want to.
But one of the things I love the most is gamma waves and eureka moments. So I like brainwave stuff. So I'm just gonna very quickly say that gamma waves are most associated with eureka moments. Your gamma waves tend to spike in your brain. They tend to spike right before we have these like insights, these aha moments, these eureka moments, which is cool as fuck.
Gamma waves, they're not present in the same way as all your other brainwaves, um, on a regular basis. I don't know how to say that differently, but. When they spike, that's again, shortly after you might have one of those eureka moments, which is a moment where a bunch of kind of related thoughts come together and you have that insight.
You know what I'm talking about. Gamma moments, you cannot get to those gamma wave moments through beta and alpha waves. So beta waves are very hyper-focused attention. Think about a border collie, a working line border collie. They are keyed in, they're fucking locked in on the, that animal that they are, you know, herding, for example. If you don't know what I'm talking about, Google a working line Border Collie herding sheep. Oh my God. I love watching those videos, first of all. Just seeing how fast they run and how they respond to. Their owner. It's just I love watching those videos, but also my point is look at their eyes. Look at how intensely focused they are. That's beta wave. That's like a beta wave in action.
An alpha wave is gonna be a little bit less intense. An alpha wave is more like relaxed attention. So if you ever see a dog, I always think about dogs with regard to waves, but this is where if you see a dog and they're like relaxed, you know, like a dog on a hillside. It's sort of like relaxed. You don't see stressed eyes or whale eyes or anything like heavy panting and slobbery lips. You see a dog that looks like it's fucking chilling, but it's also looking around. It's like surveying the land around it. It's sort of paying attention to what's going on. That's like alpha wave state. That's like relaxed attention.
Your theta wave state is gonna be like your trance-like state, it's gonna be when we kind of zone out in the shower, whenever we are in a light or deep meditative state, people will talk about getting to this when they are deep in prayer, they sort of go into this the theta state might be when you are walking, you're not really sort of thinking, you're taking a walk in nature. You're just. Piddling along, hanging out. Those usually lead to theta wave states.
We get to gamma wave, which again happens right before those eureka moments. We get to gamma wave spikes from theta wave states.
So in other words, we have moments of insight from trance-like states. Not from relaxed attention or even focused attention. We get to them whenever we are zoned out. That's why people have insights in the shower because you're not typically intensely thinking about a problem.
You're just showering and then all of a sudden, I. Oh fuck. Like you have this big insight that hits you. It's 'cause you're sort of zoned out. You're just like doing these little, this little task that you know, you wash your hair, you wash your body, you might shave, you might brush your teeth, and then all of a sudden you've got this big insight that hits you. Again, same with meditation, same with walking in nature.
So your brain literally needs space and time to come down to bring by, come down, I mean like the high frequency waves that needs to come down to some of those lower frequency states in order to have those moments of insight. So incredible. That's just one thing that I especially love.
This is again about energy management being greater than time management.
So this notion of feeling drained when you aren't, I only worked a few hours, it's 'cause you're using your brain more. We have to structure our weeks for that maximum energy and efficiency, which might mean a time and energy audit. Again, where you're logging, what you're doing, your energy level at the beginning and at the end, and we have to take real breaks. We have to actually step away and stop actively thinking about a problem, whatever that problem might be.
And that's it, folks. This is, I'm about to wrap up. I wanna say that again. This is part three in our three-part burnout series. And so episode one, the hidden burnout traps, we really were. I don't wanna say defining burnout, but talking about some of those early warning signs, really talking about some of the false beliefs that keep people stuck in burnout, and then what happens when you reach that final stage.
Episode two is about boundaries. So boundaries, mistakes people make. Cons, common boundary mistakes people make. Why we need boundaries, so boundaries around time, emotionality, decision making, and communication. Having pushback from our team and employees about when we set boundaries and how to deal with those, but also knowing that when we set boundaries, this is how we start to get our energy back and shift into being able to think about leadership more deeply.
And then today, when we're talking about leading like a CEO, we're really talking about that mindset shift. Going from a practitioner mindset to a visionary or CEO mindset, how delegation isn't about being a task master for others, or the one micromanaging the projects.
It's really about empowering your team to take something and create it or fix it or solve it or whatever it might need to be, then having them come to you if they're really stuck potentially or at the very end where they say, this is what I've created, and then we review it together, for example. And also where sustainable leadership is really about, of course, boundaries and also delegation. And also for you to shift into that visionary CEO mindset.
So I hope this is helpful. This has been a fun three part series to do. I don't, I think I said in one of the first episode. In the first episode, actually, I don't love talking about burnout. It's not like it's not my thing. I don't, yeah, burnout.
Let's talk all day about it. But I do like talking about the shift from practitioner to visionary or CEO. That is just an incredible shift to make. It's really hard. Also, it can be really hard for people to do. So powerful, so impactful, so helpful, so necessary if you're trying to grow your group practice, or if you're on leadership, trying to help a group practice grow.
If you need more support, you know where to find me. Go to taravossenkemper.com, click on the membership, and join my membership. It's a steal of a price. You get me twice a month live for a q and a and for a live training and of course for any of the trainings, if you have requests, I will tend to those requests.
I like to do things that people are in need of. There is a portal full of resources, including previous recordings and any documents that I have that you want and anything, I think, hey, I'll upload that for people and a private group, so join me if you need more support, especially with implementing and integrating some of the stuff, it's easy to talk about.
It is much harder to do, especially if you're doing it on your own. So ideally the membership is a place where you feel supported and where you can get access to people who are going through similar processes or access. To me, if the q and a where you're like, I really need to support around this specific thing, fuck yeah, do it.
So hopefully I'll see you there. Otherwise, it's been great seeing you and I will see you next time. Thanks for making this awesome and yeah, it's great seeing you. Bye. See ya.
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