Don’t Wait, But Don’t Rush: A Year-End Order of Operations for Practice Owners, EP 286
Most healthcare practice owners reach October already counting down to the holiday break. Then the break arrives, the energy is gone, and next year’s planning turns into a list in a notes app and a hope that 2027 is easier. In this solo episode of The Thriving Practice Podcast, Tracy Cherpeski offers a better approach to year-end planning for practice owners: don’t wait, but don’t rush.
Tracy walks through a five-step order of operations you can start in November. Know your numbers, diagnose whether you have a people, systems, or tool problem, clean up the process before you automate it, choose your tools and partners with a clear head, and give time back to your team and to yourself. She also draws on three guest conversations coming up this month, with Aaron Westphal, Jeremy Hummer, and Ginger Hilton.
If you run a private practice and want to plan for the year ahead without burning out, this episode shows how to build a small plan that actually happens. You will also hear a client story about what changes when a practice leader makes room for planning first.
Key Takeaways
Waiting and rushing come from the same place. Both are responses to exhaustion. One says you don’t have it in you to decide, and the other says decide just to be done. The useful work lives in the middle.
Year-end planning has an order. Numbers first, then diagnosis, then process cleanup, then the tool or partner, then giving time back to your team and yourself.
Name the real problem before you buy anything. People, systems, and tool problems feel the same from the inside, and most owners jump to the tool because it is the one you can buy.
Space comes first, then rhythm. A client who once held a single planning meeting a year now runs weekly touch-bases and quarterly planning sessions, after she cleared real time and brain space.
Make the plan smaller than you think it should be. Protect two or three short blocks in November, decide what can wait until January, and put a date on it.
Q&A
How can a practice owner plan for next year when they are exhausted?
Tracy says planning slips at year-end because a depleted brain reaches for relief, not strategy, so the fix is to design around that. Schedule two or three short, protected blocks in November or early December and use them only for your numbers and your diagnosis. Then decide what you will not decide until January, put a date on it, and keep the plan smaller than you think it should be.
Which numbers should a healthcare practice owner review before the end of the year?
Pick three to five numbers and look at them in November, not January. Tracy’s examples include denial rate, days of cash on hand, turnover, and whether credentialing delays are costing the practice money. At this stage the goal is to turn the lights on, not to fix anything yet.
Should I buy new software or make a hire before year-end?
Not until you know whether you have a people, systems, or tool problem. Tracy explains that automating a broken process makes it faster and bigger, and adding staff to an undocumented workflow multiplies the problem. Her test: can you describe the process on one page? If not, that is the work. Once the picture is clear, waiting has a cost too, so look for a partner who asks what you want to accomplish before pitching anything.
What is the Bottleneck Diagnostic?
It is a tool Tracy generally reserves for intensive clients and Thriving Practice Community members, and she introduces it at the Community of Practice Gathering on Tuesday, November 10. It lines up with the numbers and diagnosis steps from this episode and helps an owner see where they, as a primary clinician, may be the bottleneck to practice growth.
Episode Highlights
Why end-of-year exhaustion derails next year’s planning, and why it is structural rather than a character flaw
The two Q4 temptations: waiting and rushing
Step one: pick three to five numbers and look at them in November
Step two: sort out people, systems, and tool problems
Step three: clean up the process before you automate or hire
Step four: choose a tool or partner once you can act on a clear picture
Step five: give time back to your team and to yourself
A client story: from one annual team meeting to weekly touch-bases and quarterly planning
Three small moves for owners who have nothing left
A look at the November Community of Practice and MasterMind gatherings
What is coming this month: Aaron Westphal (EP 288), Jeremy Hummer (EP 289), Ginger Hilton (EP 291), and two SNACK episodes
November Gatherings
Community of Practice Gathering: Tuesday, November 10, 2026, 7:00 to 8:30 p.m. Eastern. A structured 90 minutes with questions submitted in advance (or asked in the moment), hot seat coaching, and conversation with fellow practice owners. The Bottleneck Diagnostic is introduced at this gathering. Click to register.
MasterMind Gathering: Friday, November 20, 2026, 9:00 to 10:00 a.m. Eastern. A popcorn-style conversation with no presentation and no advance questions, led by Tracy. It is a good place to ask about Thriving Practice Community programming and get a feel for how the community works. Click to register.
Memorable Quotes
“That isn’t a plan. That’s hope wearing a planner.” — Tracy Cherpeski
“Rushing feels like action, and when you’re tired, action feels like relief.” — Tracy Cherpeski
“When you’re depleted, your brain reaches for relief, not strategy.” — Tracy Cherpeski
“If the real problem is people or systems, a tool just becomes an expensive way to avoid it.” — Tracy Cherpeski
“A small plan that happens beats a big one that never gets started.” — Tracy Cherpeski
Tracy’s message comes back to a simple idea. You do not need a perfect plan for 2027. You need a smaller one that actually happens. Look at your numbers, name the real problem, clean up what is messy, choose your tools and partners with a clear head, and give the time back. If you know a practice owner who is already running on fumes, share this episode with them, and watch for Aaron Westphal, Jeremy Hummer, and Ginger Hilton in the weeks ahead. Find the November gathering details above and explore more resources for building a practice that thrives at thrivingpracticecommunity.com.
Tracy’s Bio:
Tracy Cherpeski, MBA, MA, CPSC (she/her/hers) is the Founder of Tracy Cherpeski International and Thriving Practice Community. As a Business Consultant and Executive Coach, Tracy helps healthcare practice owners scale their businesses without sacrificing wellbeing. Through strategic planning, leadership development, and mindset mastery, she empowers clients to reclaim their time and reach their potential. Tracy designs and delivers CME-accredited wellness retreats and workshops in partnership with medical associations, bringing burnout prevention and sustainable practice management to physicians nationwide. Based in Chapel Hill, NC, Tracy serves clients worldwide and is the Executive Producer and Host of the Thriving Practice podcast. Her guiding philosophy: Survival is not enough; life is meant to be celebrated.
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