Culture Focused Practice

So what happens when your practice grows into something that feels bigger than you? That is the question for the day.

My name is Dr. Tara Vossenkemper, and you, my dear friend, are listening to the Culture Focused Practice podcast. Thank you for being here with me.

Today's episode is my favorite style of episode. It's the owner's room, and so the space here is just really free flowing and ideally emotional, and it's honest and it's accurate about where things are right now.

So an owner's room today might not be the same as one in three months or six months with the exact same questions. That's kind of the cool thing about doing them. The other piece is that the, we're not focusing on content here. It's really just about the experience of being a leader at a practice and the messiness and fallibility of being a human and trying to run a business that is culture oriented and people centric.

And if this feels like something that is of interest to you and you want more unfiltered reflections, make sure you subscribe. Then you'll get notifications whenever new episodes drop, and it makes it easier to listen in bulk.

Let's do this. Owner's room is always a setup of five questions that I'll ask myself, and then one or two scenarios. We will do two today. And I just riff some answers and share some thoughts, and then we move on with our lives.

Okay, so every leader eventually hits this moment where your business basically is growing and has continued to grow, but you start to question if you're still the person that it needs.

You have evolved, but so has the system, and so you're on this precipice of I don't even know if this fits anymore. Like I'm not sure the role that I play or how I fit into what this is in this owner's room. I wanna sit in the space between maybe pride or ego or identity, and then also panic and questioning like what is actually gonna happen? What does this mean about me? What does it mean about the business? In essence, a space where growth and identity go toe to toe.

We'll start with the five questions. I do not prep in advance, like I don't think about these in advance of literally right now. I just choose them and then save reflection for doing it live.

So let's start with question one. When did I first start feeling like my role was shifting? Oh my gosh. I honestly feel like my role is constantly shifting and so I have two answers.

One is that I do feel like my role has kind of constantly been shifting since the inception of the practice. I knew early on I didn't want to continue doing all of the things that I was doing at the practice, and then as that has continued to get more clear as time has gone on, like what I want to be doing versus what I am doing versus what I will be doing next or where we will be going.

As all of that has just continued to get more clear , there was like a more specific to visionary role shift. So when we first started using EOS, which has been years at this point, this is years ago, I remember reading about visionary and I could not own that language. Like I did not take on that title. I did not feel comfortable using it.

I maybe felt like I was moving in that direction, but I did not feel. I was a visionary, and so it felt disingenuous to use the title

A couple of years into using EOS is when I formally adopted the title Visionary. It felt more reflective of the role that I was seeking to create and the role that the leadership team and I had clarified.

But I will say that probably nine months ago or something, I mean, it's been less than a year , my understanding of the visionary role and the interplay between visionary and integrator leveled up.

I sort of felt like I was Mario, like going from the little Mario to now I've eaten this mushroom and like, oh shit, I also have this tail. And like, holy hell, there's Yoshi. Like And I've got a star.

That's how it felt. I feel like now I'm operating with a consistent either fireball or tail and Yoshi by my side.

And that shift, like I said, it was like less than a year ago. I don't exactly know what it was. I don't know how it took place. I do know that it happened after my husband and I sold our house and our 30 acres and we decided to full-time RV with our kids.

So maybe there was something about. Movement, like changing up what we're doing and going to new places and something like energetic that shifted, that allowed a lot of log jams to just like clear up entirely.

And in that process, it sort of dawned on me that I needed something different from my integrator. And then as a result of passing things over to her and being more clear about, this is what I need her to do, it allowed me to more clearly see what the visionary role can and should look like.

And in all of the shifts, like all of my role shifts with the practice, this has been the one that has felt the most grounding, validating and energizing. I don't feel like I am shifting to do something that has to be done for the next stage of the practice.

I feel like we have found our stride and I finally get to fully be in the visionary role in the way that it was intended and with the level of understanding that I had yet to achieve.

So what feels funny about thinking back to when I first started feeling like my role was shifting, which again. Immediately like it's been going on the entire time. And then comparing those shifts to this most recent one, they all feel like shifts, but this feels like the penultimate shift.

Like I needed all of these other things to get to this point to really understand what it was that I was moving into and shifting into. Like I said, this has been the most grounding and energizing and honestly fucking awesome shift that I've experienced at the practice.

Okay, question two. Where am I resisting growth because it threatens my identity? Ooh. Where am I resisting growth because it threatens my identity ? Hmm.

I don't mean to cop out or like avoid an answer, but I really don't know if I am resisting growth because of a threat to my identity. For me, it always comes back to one or two key things, and so any resistance I have to growth or like the evolution in my role or how things have changed for me at the practice .

The resistance is perpetually about attachment stuff. It's consistently about if I'm not connected to my people and instead my leadership team is the main point of connection for all of my people, how do I stay up on them? Are they gonna be invested? Are they still interested in being here? Why would they wanna stay? Is my vision still clear?

I know that this is ridiculous to say because they're not just here for me. Duh. You know? And it's like the threat of disconnection is the thing that's scary. So this really is like old stuff coming up. Like if we're not connected, then we're disconnected. Like if I'm not here, I don't exist.

Regardless of how wild that sounds. I know we're not talking about lucid, cognitively aware prefrontal cortex running the show. Tara, we're talking about an old limbic system experience and honestly, probably hind brain experience if we're talking about attachment, you know, so it's old stuff that comes up.

When I do level up or evolve as a leader, this absolutely is still a feeling that comes up as a result. Honestly, it's almost used as like an indicator of the direction that I need to go, but it still isn't necessarily comfortable when it happens.

For example, when my DCO or my Integrator point out that there's something happening with a clinician, my first indication, the first thing I want to do is reach out directly to them and talk to them and figure out, okay, how are you? What's going on? What do you need? What can we do? I'm immediately like, okay, I wanna, I wanna reach out, I wanna connect with them.

Which is really great. Maybe it's like, oh, that's nice. I would love that if I was an employee. Sure. And it's really invasive for people who have roles that include staying in connection with clinicians.

My DCO is the one , ideally who is staying connected and reaching out and making sure people have what they want and need or feel supported at the very least. Or she might say, Hey, let me have a CTL, a clinical team lead connect with that person. Or, oh, I know that they have supervision tomorrow with so and so, i'm gonna reach out to ask them to just check in on that topic.

Totally makes way more sense to do that. Like absolutely, that's the route that we should go because we have the structure in place that there are multiple and varying levels of support. And basically none of them include me.

And still, again, I'm thinking like hind brain tendencies. My initial response is a desire to do something. I I'm a move into pressure animal. My desire is gonna be something like connect. Are they okay? Check in. Typically coupled with a sense of urgency. Or a desire to fix something really fast

I don't feel self-critical about this. It just happens still. What's nice is that with the right people in place, and also knowing this about myself, it doesn't really go anywhere. And so if I were to listen to that and ride that out every time, like follow through on those sort of initial urges or initial, I need to make sure they're good.

The result would be that my DCO and my integrator would feel probably trodden on and then also shut down.

And then also I would be keeping myself in a position where I couldn't move into a different role because I would constantly be tending to the people around me.

So the more I like evolve as a visionary, the more that I shift and have my feet firmly planted in the Visionary camp. Over time, I have felt those urges less, but the reality is that with every time I level up even slightly or tweak something about my role, I end up having one of those responses. There's something that happens that brings shit up for me.

So it's weird to say like, I'm resisting growth. I think instead I would say that I am experiencing growing pains throughout this process. Necessary. Sure. Pleasant, not always.

Okay. Question three. Do I want to keep leading this version of the business or the one I built before? Fuck no. I don't wanna lead the one I built before. Absolutely. I wanna keep leading this version of the business.

Why would I wanna put myself back in a position where I was in every role or in every problem, or deciding all the things or not having externalized processes, not having shit outta my head and onto paper or in a Google sheet. You know?

Hell no, I don't wanna go back there. It was exhausting. It was exhausting, period. And it was a lot of stuff that I don't want to do. Initially, yeah, I wanted to do all these things as time went on things got cleaned up and people got in place, and systems were clear and ownership was delegated, and an accountability chart was not only created but also really, really clearly defined. I realized more and more that I don't want what I was doing.

I want less and less of those things, and I want more and more of the creative ideas, big picture, problem solving, and the future visions and the, honestly, almost like a visionary consultant role, like I'm a consultant to my leadership team rather than somebody who's responsible for executing key things at the practice.

So no, I do not want the one I built before. I am grateful for the thing I built before, but I don't want it back. No, thank you.

Okay, question four. Am I afraid of being replaced or relieved at the idea of letting go? Ooh. I don't think I'm afraid of being replaced, although I think there's a cost to other people doing something that I maybe used to do or could do, but there's also a cost to me doing it.

And I don't mean a personal cost, I mean a cost to the people who are engaged with that role or with that system or with that process. If I'm good at something like sparking excitement in people, great. I might be exceptional at that thing, but I'm not good at maintaining execution over time, and so that's the cost.

On the flip side, if my integrator is really good at maintaining execution over time, that's incredible for long-term safety and consistency, but she might not be as good at abstract problems or creative problem solving or breathing energy into an idea and bringing it to life for people. So then that's the cost.

So I don't feel afraid of being replaced, but I recognize that with any direction that we move and with any, even if it's a right person in the right seat, there's always a cost. There's always a pro to that person being in that seat and a cost to the other person not being in that seat.

And so maybe what feels most important is that for me, the seat has to be clarified and I have to know what's most important about this role.

So if what's most important about a role is consistency in execution, the cost absolutely has to be that energy into new ideas is gone. Like this might not take place because what's more important is consistency in execution.

So, no, I don't feel afraid of being replaced, although I do recognize the cost to any given person in any given role.

The second part of the question is, or do you feel relieved at the idea of letting go?

My answer is primarily the same, except also it's, yes, I feel relieved at letting go, but I only got to that answer as a result of going through the role shifts and the process of evolving as a human, I think, but also as a leader over the past however many fucking years, you know.

I would not have felt relieved at letting go five years ago, three years ago, two years ago, a year and a half ago, up until I really started to grasp this visionary integrator dynamic.

That's when this concept of letting go, like for real, letting go of key things , felt attainable, like truly attainable. Sort of like the home stretch of, holy shit, I'm doing this thing. Like this is what it will look like, and I see the outcome right there.

That is relieving. And still, I think there are pros and cons to the process, to me, letting go of certain things to other people stepping in, all of it. I think it's just a matter of figuring out what the balance is for yourself and your practice.

I'm not trying to proselytize at you. Geez. I hope it's not coming across that way.

I'm gonna wrap up questions. Question number five. Can I hold both gratitude and grief for the old version of me? Oh, yes. I think it's always, grief for me is wrapped up in everything. It lives really close to the surface, like it's just sort of a little poke away.

Grief is a constant part of my life, that sounds so dark. I don't mean it in a dark way. I mean it in a truthful way, like it's just close to me. I think about grief often. I feel it very easily.

I don't mean that it overtakes me and I can't function or think, but I mean to say it feels really apparent to me that when something beautiful is happening. My evolution as a leader has been a really fantastic experience. It's also interwoven with grief.

There's a constant process of contending with my own stuff that might come up, with reorienting myself to my role and what that means for my practice and the people who are a part of it, and even I think grief about , honestly, time lost at not doing this well or not knowing what I was doing when I started.

I absolutely feel grateful for my experience and I feel grounded as a result of said experience, and there's grief all throughout it.

Maybe this is actually a cop out question because I think grief is everywhere all the time . So it's silly to ask myself, well, can I hold both gratitude and grief? Fuck yeah, I can. I hold gratitude and grief all the time.

Even positive change entails grief of some sort entails letting go and grieving some part of you or some part of your life, or some life unlived. That is probably a core component of my grief actually, is saying yes to one thing means saying no to a thousand other things.

It's like Sylvia Plath in The Bell Jar. You know the person standing in front of the fig tree and she's watching these figs drop from the tree as she's having trouble deciding which one to pick, and each fig represents a possible future life.

That is it for me, like in in the, the smallest nutshell version. It's that exact image. I think that's why grief is so present. It's what life is not lived.

And whatever decisions I'm making now, even if they are decisions that I like and I want to do this thing, that means I'm also saying no to doing something else, which typically coincides with some level of grief or at least awareness of loss, and all of that exists with a healthy fucking dose of gratitude.

Ooh, okay. We are going to shift entirely to scenarios. We have two today. So scenario number one.

The practice is thriving, systems are smooth, leadership team is humming, but you feel oddly detached. You used to feel essential and now you feel peripheral. You catch yourself wondering, am I even needed anymore? The truth might be that your role is evolving, but that doesn't mean your value disappeared.

Yeah, I mean, I get this. Like, am I even needed anymore? To some extent, the answer is going to be no. At some point the answer will be no. You are not needed in the same way that you were. And so that's about the role evolving.

What can be really hard though, what I think is hard or can be difficult is when. You know that your role needs to change and you are trying to work out whether it's on your own or with your leadership team, what that evolution looks like, and maybe you're actively like passing things over and delegating ownership to the right roles, iE not your own, but you're still not entirely clear how your time is spent in your role.

There's like this limbo period where, okay, well what I'm doing isn't it anymore, so let me disperse what I can. But then you're sort of standing there like twiddling your thumbs and looking around questioning, what the fuck am I supposed to be doing now?

I hate that space. I don't do dormancy very well, and so that's is a hard place to be.

I don't even think that I have something to say about being in that space other than a some shit we just have to wait out.

I constantly also, there's some like visuals that just come to mind consistently. For me, that's a fish tank. There's a fish tank and you have moved something inside the fish tank and the fish tank is filled with sand and water.

And if anybody who has ever had a fish tank knows, when you move something inside, even when you're trying to be careful and you've got sand and water inside of it , what happens? Well, all of a sudden, your fish tank is cloudy as fuck because all of the sediment is now coming up and floating around in the water.

There is no way to really speed that process up. And maybe even like dormancy in the winter. You can't make springtime happen sooner than it's going to.

So I think it's kind of the same idea, and it's funny to say this too, because I said I don't do dormancy well, I don't. I'm like irritable. I have doubt in those moments, I sort of question like, why can't I fucking see when there's sediment floating around me.

Realistically, I'm gonna try to speed the process up and then I'm gonna make it worse and I'm gonna have to sit and let it settle regardless. You know? I put my foot in my mouth basically.

I do really think that the only thing to do during those sorts of moments is to just allow the dormancy to take place, allow it to unfold, allow the sediment to settle, and then when the trees come out of dormancy and they start to bloom again, when the grass turns green, when the flowers start to sprout, when the sediment settles, then we see what things look like.

I think from that point, then we can see how our role has shifted and thus how our value has shifted as well.

And again, this is like attachment stuff for me. I do not like to feel detached. Mm, no, no, no, no, no, no. Thank you. I do not like it one bit. I really fucking hate it, in fact. If you're comfy with detachment, maybe this'll be an easier process for you.

For my preoccupied comrades, or at least a history of preoccupied attachment, shit's fucking hard, man. It's hard.

And that doesn't mean it's gonna last forever, and that might mean that it's a prerequisite in order to see your new role more clearly, as well as see the value that it can bring to the practice.

And that's all I got for scenario one. Let's do the second one, shall we?

Scenario two. You realize the business has grown past your comfort zone. You built it as a clinician who loved people, and now you're managing budgets, policies, and strategy. You find yourself fantasizing about going back to simplicity. Fewer staff and fewer headaches. But deep down, you know this discomfort might be the edge of your next evolution.

True dat. That's all I gotta say. Yep. Agreed.

What's not really clear here, and I think what is nuanced for each person is what the discomfort is. And so is it something about detaching from the current role and evolving up? Is it something about fear around stability? Like, this thing is getting more stable, now shit's gonna go to hell in a hand basket. Like I don't trust stability. Is it something around enoughness? Is there something around self-doubt, like how can I keep this alive for everybody? Is it something about the weight of responsibility? Is it something about trusting others to do their roles effectively and own things entirely?

I think the discomfort that you feel is just going to be reflective of your own stuff.

And so if you do think, okay, this discomfort is probably a result of me feeling just fearful about the next evolution of the practice and slash or my role at the practice.

In my mind, that's possibly a few different conversations. I think one that's great grist for the mill for therapy. If you're seeing a therapist, that's a fantastic conversation to have or at least a fantastic start to a conversation to have.

Second thing is, that's the sort of thing that I'd probably bring to my leadership team.

I think the beauty of having a leadership team, or at least one that is primarily cohesive or there's a lot of trust between the two or three or four of you, you know, whatever, is that you can share with them. Like you can openly share some of the stuff that's going on for you.

For me, in doing so, it it always de intensifies the thing that I'm going through.

I think it helps me feel more connected to my leadership team, and I think vice versa. I think they end up feeling more connected to me and it just feels less scary.

It's not that the problem is just fixed by going to my leadership team, but it is that I'm trying to be open and honest with them about my discomfort and what's coming up for me and why this is difficult.

And maybe we troubleshoot how we do this incrementally moving forward. Maybe we troubleshoot, okay, is there sort of a bridge between where we are and where we're going that would help you feel better about this transition?

And sometimes even just the act of sharing is enough to say, no, actually I, I feel better now. I just wanted to share with you, I wanted you to know what was going on for me and that this is especially difficult to do.

I think a third piece, which is maybe less popular is trying to connect back in with your, oh fuck. I hate saying your why. What's your why? Yeah. But I do think trying to get connected back into the purpose and the vision, and then in doing so, I am totally distracted right now because my daughter is outside of my door. She's two and a half yelling, mommy, mommy. Like trying to get in. It's locked.

But let me get back to my point. If we can connect back into our purpose and the vision, then it's the Nietzsche quote that we can sustain the how we get there. If we know why we're doing what we're doing, how we get to that point is doable, because why we're doing it is bigger than how it feels as we go through the process.

If you do that and you realize this is not the vision I want, that to me is an entirely different conversation. So we're not even having that conversation here. We are assuming, or I am assuming, that the business growing past your comfort zone is still a business growing in the direction that you want it to grow into.

And if it's not, again, that's kind of a separate conversation, not for today, although I do feel for you, we just don't have time to get into it right now.

I think the final piece of scenario two that comes to mind for me is the power in community. Find your people. Find people who are running groups at or around the same size or slightly past where you have been

. And maybe find people who have gone big and downsized. Maybe find people who are leveling up quick and they seem to be doing so with a lot of grace and understanding. Or maybe hire a consultant who, you know, has a bigger practice or you know, has gone through this process and say, this is where I am, this is what I'm questioning, this is how I'm feeling. This is what I need help with.

I don't think you need to do this alone, and I'm not saying that you think you need to do this alone. Maybe what I'm trying to do is actually push for you to connect with either your leadership team or some colleagues slash peers slash friends who are also group practice owners or leaders.

So let me close this out then. I will say that having that sense of community for me is one of the most powerful things. And by community I mean my people who I feel safe with not only opening up. I feel safe opening up to a lot of people. Like there's not much hidden, you know, but also specifically seeking their opinion.

Tell me what you did. Tell me how this went. Give me feedback on me. What am I doing? What am I missing? What can I expect?

if you are in that space, if you're in that identity shift and you're wanting connection with community and you're wanting a space for honest reflection and growth, and feedback and help with your evolution as a leader, I would absolutely recommend you consider joining the membership.

It's inside the Living Practice membership. It's a community oriented space. With a live q and a and a live training with me or a guest expert every month, and with a portal full of requested resources.

So I don't put everything out there because that is horrifying to maintain for me, but I put shit out there that people are specifically wanting and needing help with. That's the whole goal.

You can find more details at www.taravossenkemper.com/the-membership.

Okay, so that said, and as per usual, thank you for spending time with me. I absolutely value time. It is the most precious commodity, and I hardcore appreciate you spending time with me.

Hopefully I will see you in the next one Again, make sure you subscribe, then you get notified as soon as the episode drops.

Alright, that's all. See ya. Bye.