0:00:02 - Intro/OutroWelcome to Practice Freedom. What if you could hang out with owners and founders from all sorts of healthcare private practices, having rich conversations about their successes and their failures, and then take an insight or two to inspire your own growth? Each week on Practice Freedom, we take an in-depth look at how to get the most out of both the clinical side and the business side of the practice, get the most out of your people and, most of all, how to live the healthy life that you deserve. I'm Mark Henderson Leary. I'm a business coach and an entrepreneurial operating system implementer. I have a passion that everyone should feel in control of their life, and so what I do is I help you get control of your business. Part of how I do that is by letting you listen in on these conversations in order to make the biggest impact in your practice and, ultimately, live your best life. Let's get started. 0:00:55 - Mark Henderson LearyWelcome back. Practice leaders Got another one for you. Today I want to talk about infinite opportunity cost. This is the concept of you have a job, and I guess this is. If you've not had a job in a long time or ever and you've always been an entrepreneur, this could be a useful model for you. But if you are coming out of or getting ready to leave a role, that is arguably a job, working for somebody else in some capacity. This is an important mindset. So before we dive into that, though, don't forget if you like this episode, share it. If you don't like this episode, give some feedback Like subscribe, share it, move it all around, get it in the hands of people who can use it. And if you're stuck anywhere in the process, if you are envisioning an amazing organization with a clear vision, on the path to someplace important, to do something important and managing an organization, a special leadership team is accountable and disciplined to making it happen, and you got a healthy, functional leadership team and a healthy, functional organization. If you're imagining that, but stuck, not quite knowing how to get there, please don't stay stuck. Reach out, get some time with me. Practicefreedomcom slash schedule. We could talk about a first step, what that would look like for you, anyway into this concept of infinite opportunity cost. When you have a job and you think you know what I want to go home today. And by a job I mean you work for somebody else, you've got a role as a surgeon, you've got your doctor in an organization, your patient load is done for the day. There's a pile of documentation, paperwork you need to get caught up on. You go home early, you go home early and if there's a pile, you got to work on it and you're done, and if there's consequences of that delay, you'll hear about it. You get a little nasty gram, whatever. Don't take that for granted, because that is the freedom. When you're done, you might have a lot of work to do when you're not done with doing it what's not in your lane is someone else's problem to some extent, when you move into accountability for the whole ball of wax, I mean having a lane. I mean, if it's a big lane and it's a high speed lane and lots of traffic, it might be high pressure and it might be high volume, but it's a high speed lane and lots of traffic it's. It might be high pressure and it might be high volume, but it's a lane and I'm not saying it's not big, I'm not saying it's not plenty of weight, because I've had that. I've been in that situation, not as a doctor, but I had it where the lane was big and it wasn't going great. I didn't like it and I like what people ours were sending me. They said I'm at a lane and I didn't talk. I had a voice like what people? I'm out of lane. I didn't feel like I had a voice in that. And so when I said I want to make the lanes, I want to decide what traffic gets on that freeway and hopefully this metaphor keeps working because so far it feels good I decided to make a switch and I did and I said I'm going to build the roads, I'm going to send the traffic on there. And man, what a difference. And I did, and I said I'm going to build the roads, I'm going to send the traffic on there. And man, what a difference. And here's the difference I was so much more stressed out because now I didn't have to worry about the lane, I had to worry about the roads, I had to worry about the cars and everything. And what if there's more lanes? And what if people don't go on my lane? They got to go. There's not my lane, it's all the lanes are mine, all the traffic is mine and anything. If things don't go right, if traffic goes wrong and somebody gets stuck and there's a traffic accident, you know, that's all on me now. And so there became really no limit to what I could worry about, because now the whole business is me. Is it going to survive if we have employees? When we get to employees like, oh, that's me now. And my thinking has expanded, now I will say I felt way better because the stress and the agency, I could decide. If it didn't go great, I didn't. I couldn't blame somebody else, like, ah, you put this on me, it was no question. Like I didn't go great, yeah, that was me, I'm going to learn, forced me to learn, got a whole other episode on the learning mindset, as opposed to the knowing and answer mindset Forces you into the learning mindset because right away I don't know what the hell is going on here, because there's so many things. Now I can know the lane, I can own the lane. I can't own all the roads, all the city, all the everything. And that mindset is just like we have to admit that I don't know what's all going on and have to learn a lot. So it's very gratifying to be in the entrepreneurial world, to be the visionary leader of an organization whether even I didn't even really think of it in those terms, I was actually an individual contributor running a business, trying to do the work and lead the organization and run the business Just like you are or were. So one of the things that I think is so important is that mindset. How different does it feel? It feels like every hour that you're not spending solving real problems in the business is a massive opportunity cost Every hour, like I could go home early now and I could watch TV, except that that would that'd be an hour where I'm not solving critical problems, and what could that problem solve, be worth who knows? Infinite opportunity costs. I could say the right thing that could get us a lot more patients, a lot more clients, a lot more business, sell more product. Sign that deal. I could you know if, in terms of like a partnership or get that surgical center open, I could raise some money? Whatever those opportunities are, because you start looking at the things to do. You started this practice and if you're starting a practice, it's just. This is hard to explain how you go from a lot of tasks to an infinite amount of tasks and not by tasks I mean things need to be fixed, little things, big things, getting you know the submission, a tax ID. You know incorporating the organization, picking a piece of software, things you have to do To like good ideas. Oh, you know what we should do. We should do some more posting on Instagram. Oh, we should get a partnership with a primary care organization because they're going to, they could feed us a ton of leads and we know what. What can we do? All these good ideas, great ideas that list goes well beyond the horizon and I remember. I remember the feeling of like I thought I was going to be picking like the good ideas out of the bad ideas. It's like oh, I got nothing but good ideas and great ideas so many. What do I do? I don't feel like I'm doing any of these because I'm just sort of stuck and so, choosing that that the most important thing, we start to try to work our way out of it in terms of more hours, more time. 0:07:18 - Intro/OutroAnd I won't lie. 0:07:21 - Mark Henderson LearyThere is no way through the entrepreneurial journey that doesn't involve moreness. There is no way through the entrepreneurial journey that doesn't involve moreness. And so let's be real. The idea of the critical diminishing point of return on an employee productivity being 40 hours or whatever, 50, 45 hours, I don't want to say that's total bullshit because it's not in mass. Say that's total bullshit because it's not in mass. Because if you think about the average half engaged employee, you know how long have they been half engaged? How long have they been overworked? What is their productivity? How many habits do they have built around being underdirected and underprioritized? Lots their productivity is terrible. But the entrepreneur who is in the fire for the first time has a different tolerance and a different way of thinking. And so there is no like I'm just going to work so brilliantly at 40 hours a week that it's going to work great. That's fictitious. That's not real. Because if nothing else, a lot of things you do's going to work great. That's just that's fictitious. That's not real, because if nothing else, a lot of things you do are going to be wasted anyway. You're going to make a whole lot of mistakes and you're going to spend a lot of cycles on things that don't end up being valuable, and that's unfortunately part of the recipe as well. So you're going to have to work hard, you're going to have to overhorse for a while, but it doesn't. It doesn't, it's a sprint pace. You have some time for any, some direction, and there's some. There's some organization to building a practice by looking at peers and it tends to make you more effective than the typical average employee beyond capacity. So you're working here somewhere between 50 and 80 hours, whatever. Your number is Probably beyond 80,. You're not super productive, but there's some people that are there. I was never, so I was more 55 hours. That was kind of like I could. I really just could never and maybe that was a limitation on me at some point. But that was 50 hour, 55 hour guy. That was kind of my beyond that I just was hitting family obligations and other things and kind of where I drew the line and that worked for me and and kind of where I drew the line and that worked for me and I felt relatively productive. But what I found is that when I had 60 hours worth of work on my plate 65 hours of work, man, that did not feel good. Balls were hitting the floor and so I had to prioritize. So what's the point of this conversation? The point is that you are going to have to have a way of prioritizing and taking a step back and assessing the relative value, in probably emotional terms more than anything else. If you can quantify the value of these things sometimes that's helpful, especially early on, and if you're doing, if you're working at a good collaborative team and you're having good say, if you're running on EOS, like the system I'm talking about and that's where this conversation is going what is the pulse for looking at this and how do you get tactical? There might be some real intellectual cognizance of we got five opportunities we're working on, which ones are profitable, which ones are not. That's a great way to prioritize, but when you're looking at time, and if you're the visionary leader or really in any role in your organization where you're looking at I mean, I think you know the trigger for this conversation being useful is you're feeling like you could spend more time on all of it, like if you had more days in the week you could spend them all. That mindset is not practical, not useful. It's not useful. It just doesn't work. And the only recognition that does work is saying we are going to run out of time. We got 24 hours in the day, seven days in the week. That's all we got, and we're going to have to make a recipe for what works for now. And so part of this is vision work, and in the EOS world we're definitely setting things like our three-year picture when is this going, making sure we're checking in on that, and we find sometimes in this vision work, which we do, hopefully doing this vision work at the practice level. Hopefully we're doing this work at the family level and at the personal level. So this is sort of the three levels you should be saying what am I trying to work towards? And, as I put in effort, am I progressing towards that? And there's a whole other concept about moving the goalposts, and so let's just assume that you've got the discipline not to move the goalpost, because we get the things, and if you are moving there's another. I'll just leave that little trigger. Let's have a conversation. If you're moving the goalposts a lot, that means we're not really getting what we need, what we want. So we got to go back to the well and say, like, what is it that I want? And I keep moving the goalposts. So that's your signal that you're not actually. You don't actually want that, you want something else. That's a great topic, but that's not for this. I want you thinking about assuming we have a sense of life balance. It's like a belief in it. And I don't mean life balance of like equal parts, I mean healthy recipe Tastes good, like when somebody you have a beer, you have a, you know eat a piece of steak and there's sauce on there. Is it balanced? You know it's spicy. I'm not saying don't have a spicy life. You know like that's not the balance I'm talking about. I'm saying, like you know, if it's spicy and sweet, is that what you want? Is it too sweet? Oh yuck, that's out of balance. So this prioritization has to happen periodically and it's so normal that you've started your, your business. Your practice, with a commitment to sacrifice because we know we're all in this is this is high stakes stuff, gonna take some sacrifice from everybody and everybody around the family if you've got one at that stage is like, yeah, we understand, this is going to be great, mom or dad's a superhero and we're going to be on the journey with them and that's great. But six months in a year, in, what's the cost? You know one more little league game missed, perhaps? Perhaps you know one more little league game missed, perhaps perhaps not. Or and we can talk about it in a second you have to go back and assess are we, are we, is this the recipe for the season? A guy named Rory Vaden wrote a couple of great books, runs a bunch of great organizations, talks about the seasons of balance. I mean, he actually kind of rails against the concept of balance and I think this is all compatible thinking. But what he's talking about? What's your season? What you know? What are you trying to do right now? Are you early in the development of the business? We've got to have a recipe that creates the development, that sacrifices certain things. We get a little further down the road. We've developed a lot of these skills? Do we so heroically work to grow the business, grow the organization in the ways we did in the first one, two or three years, or do we try to figure out how to delegate that, how to outsource that, how to use some of the money we're making to pay for ways to do that and get some of that energy back so we can put it elsewhere in our organization or into our life? And I guess I'll talk about it now that sometimes our life regresses. Right, so we get really excited about being able to be at every school event. Right, so we get really excited about being able to be at every school event. And then, as a business leader, you have to ask and say, ok, you know, things were going great until that thing switched and that government regulation came out, or that things happening with immigration or whatever that is, and, like man, we really got to hustle. Have we take every adjust to the recipe back to where it needs to be? Now my hope is that you've done the right kind of planning and you're not making, you're not forcing your family to sacrifice. The whole point of this is go back and look at the recipe. What is the cost and, 100% of the time, what we're talking about here is an emotional cost. Am I getting what I want? Am I giving the right people what I want, and this has to be very personal and intuitive. If you're feeling pressure at home, understand that. I'd really rather you take that as feedback. And then you also have to go internal and say you know, I'm in charge of this. I got to make some calls. I'm probably going to disappoint somebody for a period. And what does this look like? Do I have to disappoint the family a little bit more? Like they wanted to go on that vacation, but we really are out of money and we're going to have to deal with that. Or is this the other way around? The business wants me to be there more at the office because of whatever value, but they're going to have to be disappointed because the family deserves it. We've earned it as a family. We've earned the money. We've earned the time we put the dues in. And this is and I'm consciously rebalancing my life and making those changes. And so you want to be in control of your business, right? So if you're not in control of your business, that's a problem. We should talk about EOS, for sure. You need to be in control of the practice and you need to be, as a leader, aware of what those control levers are pulling for you. So quarterly quarterly is the pulse quarterly is the time, nine times out of 10, really high growth, really high trauma, those sometimes the pulse needs to be more frequent. We need to check back in with how much we're progressing and what's going on. In rapid change situations it's different but it turns out that nine times out of 10, the pulse that makes sense is this very predictable quarterly pulse. Checking back in, how did the quarter go? Do we have the right people in the right seats? Are we on track for the division? And just ask yourself, you know, hopefully you're setting goals, hopefully you're setting goals for the year rocks for the quarter. Hopefully you're running on the EOS. If not, check it out and certainly get some time with me, but hopefully you're checking progress on that. But one of the questions you should ask yourself is how would we give ourself as a grade, as a company, as an organization? Do the same pulse individually? Give yourself a grade individually. How am I feeling about my life, how am I feeling about the family, a through F, pluses and minuses? And be honest, how does it feel and be thinking about what's wrong, what's right? And this is the Rebalance, the Recipe concept. So we do the vision work? No-transcript, those are not what we want in life. Those are close proxies, hopefully, and they're always going to be a little imprecise and what only matters is are we feeling fulfilled? Are we making the mark we want? And this is only ever an emotional check-in. And so one of the things I'm guiding clients through constantly is the wording. We want to nail the wording, but even when we nail the wording, it evolves, it's never quite there. The emotional aspect, the purpose of life, is really always nonverbal as humans, and so if you're thinking super logically and I'm not a hyper rational individual, I love logic and precision and all that Unfortunately, if you look at the brain science, the emotions, the emotional part of the brain is fundamentally nonlingual, doesn't have words. So when we're using our intellectual brain to interface with our purpose and the feelings, which is really what drives us with our passions and our purpose, you got to accept that there's imperfection. So asking that question, a through F how do you feel? Why? And are we off track? And do we need to rebalance the recipe? And do we need to get some feedback and check back in? And it's been one year into the business? Do I need to rebalance the recipe? It's been 15 years into the business. Should I have rebalanced the recipe 14 years ago? Very possibly. And looking at this infinite capacity, infinite opportunity cost of every hour, there's no way that you can rationally I say no way just go with it for a second, see if it works. You can't rationally say that there's a dollar amount of earnings that are going to overcome the infinite opportunity cost of spending an hour on some yet to be solved problem that could possibly change everything in a new, bigger, better way. You're not going to get there At least, and if you do, you probably went way too far. Oh look, we're making $1 million in a minute. This is great. So no point in thinking more because I've already optimized my thinking time because of what you're going to think is like well, look at all this horsepower I've got. I got a million dollars a minute. If I think a little bit better, what the horsepower, what the impact, the positive things I could be doing with a million dollars a minute? And suddenly you've got exponential value on your million dollars a minute of thinking because of what you can do with it. So you're long before you run out of opportunity to change the world and change your life. With every minute you're going to have to say this is the limit, this is the end, this is what I'm going to do and this is the. This is where I'm at my best and I, after I, spend more time than this. It doesn't make sense. I'm going to spend this much time with patients directly. I'm spending this much time, much time as an expert solving problems specifically. I'm going to spend this much time solving these kinds of things as a visionary leader, and I'm going to spend this much time with my family. I'm going to spend this much time working out in the gym, this much energy or however you measure. I was using time, but then I realized it could be energy and it could be, you know, organizing your schedule in a way to manage that energy. But you got seven days, 24 hours. That recipe changes constantly. Has to do with what world are you trying to create? What outcome are you trying to create? And you know I've talked about this before, but you know a lot of this has to do with setting those routines, and I think that's probably the theme here, because we get into repetitive thinking based on a set of priorities when we start and then we don't go back and check it, and we get into these habits and we're not even aware we're in these habits. It doesn't feel routine, but it is terribly routine and we don't go back and rejigger the system and tear down the structure where it needs to be torn down and delegate to other people and change the structure of our life and the time of our lives and move ourselves out of the individual contribution work that's fixed production. You know, every surgery makes this amount of money. Every patient we see makes this amount of money. And take that back into thinking time and creative time and learning time and innovation time that doesn't make any money in the moment but brings back ideas and innovation and inspiration to turn an organization around or move it into the future or spur some ideas for new services, new products and new ways of taking care of people. That's exponentially more valuable. And then also, you know it's really important that this concept is probably a whole other. Well, maybe not I mean, maybe it's relevant here we lead our family through our business very often, as opposed to leading the business through the family. When I say family, maybe you're not a family person yet, or maybe that's not exactly where your purpose comes from. Maybe it's spiritual, maybe it's something else that feeds into the family. But whatever you think, the lead domino is on your personal impact on the world. It's so striking how common. We go right to work. I have a purpose, I'm going to plan. I'm going to plan, I'm going to make a. You know, do hard things and then we challenge ourselves pretty quickly into running a marathon, which I've done. That comes pretty quickly, but nine times out of ten, what would it be? Four out of five, eight out of ten, I don't know, it's not nine times out of ten, but it's certainly a lot of the time. We have the mindset, predisposition to apply the science to the business, to the work. We go there first, we built it out, we know all the tools, all the techniques, we've got all the books and all the networking and there's so much horsepower. It's like imagining, you know, like the weightlifter, who's just got this right arm, who's just this huge and it's the left hand, left arm is all weak. Like I'm right-handed, got this right arm, who's just this huge and it's the left hand, left arm is all weak. Like right handed. You know, I just left lift all the weights with my right hand, you know, and we do that and it's not crazy, it's not totally random. You know, all good things in our life tend to come from our ability to provide, and so having that abundance is really liberating and it makes a lot of other things possible. But we end up getting into your 30s, 40s, 50s in life and you got this massively strong right arm and it's like, okay, cool. The idea was to be able to do things with two arms, but I haven't given any attention to my left arm and that is, of course, my apologies to all the left-handed people, but you get my point. So if we want to be balanced in our life, we want to have two strong arms and to be able to lift things holistically. Do a farmer's carry, not just with one arm. Make a significant impact with our whole body. And we were saying, well, the lead domino. There was our purpose. This led into teaching my kids and having a family that's cohesive in doing what we do. It has to flow through that. Going back to you know what's the formula behind all this is at what cost everything you do, every benefit, has a cost, every cost has a benefit. Hopefully you got to put your mind to that and rebalancing that recipe around. What are the costs. Did the costs go up for the first year? Everybody was running around doing their thing, you know, and everybody was supportive. But now the kids are at a different age. They need more or less or whatever, and less is a thing. You get older, sometimes with less and you can pour yourself back into the business but rebalancing that recipe to say what's the cost. So I hope this is a useful mindset to go back at least on a quarterly basis and I certainly encourage you in the business. It's fundamental Reviewing your quarterly objectives and asking yourself is it working? Are we moving towards the vision? Does it feel good? Does it feel right If not, put the issues? on the list and have a hard conversation. What do we need to change to get this to the point where it feels good, we're going the right direction? But certainly do this work quarterly. Personally, what do you want out of your life? Is your work fitting into your life the way it needs to? To take care of you, to take care of your family? And we've been doing this two, three, four years, five years, 15 years, 30 years. Did I adjust? Do I need to adjust now? How far off am I? When was the last time I asked myself what I really wanted? Does that question feel foreign? Does that question feel inappropriate? Well, let me assure you it's not just appropriate, it's essential, it's fundamental, because what you want is what you can do the best with and do the most with, and you're driven, and what you want is probably bigger than you, but it is in you and it is not from outside of you. It's not should, it's not what people should tell you should do. It's what you feel inside and it's obviously a journey to unpack that and get clear on what that is. I hope that was useful. That went longer than I expected, but it's not the first time I've said that either. I hope that's useful. Give us some feedback. Like I said, though, if you're stuck, please reach out. Practicefreedomcom slash schedule. Get some time and talk that through and share this with your friends Like subscribe. Give us the feedback and we will see you next time on Practice Freedom with me, mark Henderson Leary.