From the Weeds to the Horizon: The Altitude Shift That Sharpens Every Decision and Protects You from Burnout, EP 247

Tracy Cherpeski 3/27/26 Tracy Cherpeski 3/27/26

Is Independent Practice Worth Protecting? Tracy's Unfiltered Take on Staying Independent in 2026 – A Special Snack Episode, EP 246

With acquisition offers arriving, reimbursement cuts looming, and colleagues selling, a lot of practice owners are quietly asking: is staying independent even worth it? In this SNACK episode, host Miranda Dorta sits down with Tracy Cherpeski to get her unfiltered take on that question.

With policy pressure mounting, acquisition offers landing in inboxes, and reimbursement uncertainty reshaping the landscape in 2026, a lot of independent practice owners are quietly asking a question they don't say out loud: is staying independent actually worth it? In this SNACK episode of The Thriving Practice Podcast, Miranda Dorta turns the mic around and puts Tracy Cherpeski in the hot seat to answer exactly that.

Tracy doesn't offer a tidy pep talk. Instead, she does what she does with her clients: she validates the feeling first, then walks through the questions every practice owner should be asking before they make one of the biggest decisions of their professional lives. Whether you're fielding an offer, feeling the weight of burnout, or simply wondering if the juice is still worth the squeeze, this episode is a grounding conversation about what independent practice ownership actually gives you—and what it costs you not to protect it.

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Tracy also shares the personal story behind her mission—a deeply human moment involving her own child's health journey that quietly explains why fighting for independent practices is more than a professional stance for her. It's personal.

Key Takeaways

Validate before you strategize. The impulse to give up or sell doesn't mean it's the right move—it means you're human. Acknowledging that feeling is the first, most important step.

Burnout is not a business decision. If you're in an advanced stage of burnout, that's the worst possible time to make an irreversible decision about your practice.

Know your numbers before you act. Financial clarity is power. Understanding your historical data—and potentially bringing in a CFO—ensures your decisions are driven by reality, not fear.

Cash reserves and a 12-month plan are non-negotiable right now. With so much uncertainty in the US healthcare landscape, building a financial cushion and staying nimble is your best protection.

Independent practice gives you what employment can't: time autonomy and the freedom to treat patients the way your training and values guide you.

Q&A

What should a practice owner do if they're seriously considering selling?

Start by slowing down. Tracy's framework is always "slow down before you speed up." Get clear on whether this is what you truly want, whether the timing aligns with your goals, and whether this is a values-based decision or a burnout-based one. Then—and only then—engage the right professionals (legal, financial, and advisory) to make sure the sale happens on your terms.

How does a practice owner know if they should sell or just take a step back?

Tracy distinguishes between being tired of the business model and being tired of practicing altogether. Some practitioners are genuinely ready to transition—maybe to consulting, locum work, or an entirely different use of their expertise. Others are burned out and confusing exhaustion with readiness. The key question is: are you choosing this from a sound mind, or from a place of pain?

What's the one thing independent practice owners should be building right now?

Cash reserves—three to six months' worth. With Medicare, Medicaid, and insurance reimbursement in flux, financial cushion is your most important asset. Pair that with a clear, flexible 12-month plan that keeps your longer-term vision in view while giving you room to adapt as the landscape shifts.

Why is Tracy personally invested in independent practice survival?

Tracy shares that the mission became clear when her child was seriously ill and conventional channels failed them. An independent, out-of-network provider—one not beholden to insurance structures—was able to go deeper, find root causes, and collaborate openly with the family's pediatric practice. Her daughter, now 22 and thriving, is the reason Tracy fights for the kind of care that only independent providers can truly offer.

Episode Highlights

Why Tracy validates the "maybe I should just quit" feeling—and what she says next

The Shrek quote that actually applies to healthcare burnout

How to tell if you're making a values-based decision vs. a fear-based one

What to look for—and look out for—when evaluating a private equity buyer

Tracy's framework: slow down before you speed up

Why you need a 12-month plan AND a three-to-five-year vision right now

The Gumby principle: why agility is your most valuable asset in 2026

Tracy's personal story and how her daughter's health journey became the foundation of her mission

Memorable Quotes

"We always slow down before we speed up." — Tracy Cherpeski

"Make sure that it's not a burnout decision. Make sure it's not just being in fear, having pain that you're not addressing." — Tracy Cherpeski

"Be prepared to be a little bit like Gumby. You're going to need to be flexible and agile—especially this year." — Tracy Cherpeski

"Every practice owner I know started their practice because they wanted to do things differently and have the autonomy to treat their patients the way they saw fit." — Tracy Cherpeski

"That practice saved my child's life. I owe them a debt of gratitude I could never repay with words." — Tracy Cherpeski

Independent practice ownership isn't just a business model—for Tracy, and for the providers she works with, it's a commitment to doing medicine on your own terms. This episode is a reminder that when the path gets hard, the answer isn't always to sell. Sometimes it's to slow down, get clear, shore up your finances, and recommit to why you started in the first place. If this conversation landed for you, share it with a colleague who needs to hear it. And if you're ready to get serious about protecting your practice, visit thrivingpracticecommunity.com to connect with Tracy and her team.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Miranda’s Bio:

Miranda Dorta, B.F.A. (she/her/hers) is the Manager of Operations and PR at Tracy Cherpeski International. A graduate of Savannah College of Art and Design with expertise in writing and creative storytelling, Miranda brings her skills in operations, public relations, and communication strategies to the Thriving Practice community. Based in the City of Oaks, she joined the team in 2021 and has been instrumental in streamlining operations while managing the company's public presence since 2022.

Tracy’s Bio:

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Instagram @drhannah.healthcoach

Tracy Cherpeski 3/25/26 Tracy Cherpeski 3/25/26

You've Done Nothing Wrong: A DPT's Practical Guide to Fitness and Nutrition for Busy Healthcare Providers Featuring Dr. Hannah Brandt, EP 245

What if the biggest obstacle to your health isn't time or willpower—but the fact that nobody ever taught you how to take care of yourself? In this episode, Tracy Cherpeski sits down with Dr. Hannah Brandt, a doctor of physical therapy and founder of Physique Triage, who helps women in healthcare build sustainable fitness and nutrition habits without turning their lives upside down.

What if the biggest obstacle to your health isn't time, willpower, or motivation—but the fact that nobody ever taught you how to take care of yourself? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Dr. Hannah Brandt, a doctor of physical therapy turned health coach who has spent years helping women in healthcare build sustainable fitness and nutrition habits that actually stick. For independent practice owners who give everything to their patients and have nothing left for themselves, this conversation is both a reality check and a permission slip.

Dr. Hannah is the founder of Physique Triage, a virtual coaching practice specializing in fitness, nutrition, lifestyle, and weight loss coaching for women in healthcare. Her approach is rooted in something refreshingly practical: before you change anything, find your gaps. No extreme overhauls, no dramatic restrictions—just honest assessment followed by small, sustainable shifts that build real momentum over time. She knows this works because she has lived it. After earning her doctorate, she found herself at her heaviest and realized that even with all her clinical training, she had no idea how to take care of her own health. She went on to lose over 60 pounds by doing exactly what she now teaches her clients.

Whether you're a practice owner struggling to prioritize your own health, a clinician feeling the limits of a system that trains you to care for everyone but yourself, or someone who just needs permission to start—this episode offers exactly that.

Key Takeaways

Self-care is not selfish—it's essential. Healthcare providers are trained to put patients first, but running on empty doesn't serve anyone. Taking care of yourself makes you a more present, effective, and fulfilled provider.

Find your gaps before making changes. Rather than jumping to restrict and overhaul, Dr. Hannah recommends spending a few days honestly assessing your hydration, movement, sleep, and eating patterns—then addressing what's actually missing.

Small, sustainable changes beat dramatic ones every time. Adding protein to a lunch you already eat, bumping your daily steps by 1,500, or trading one Diet Coke for a glass of water—these are the kinds of shifts that stick.

Healthcare providers often don't know how to take care of themselves—and that's okay. Clinical training focuses on patient care, not personal health. Asking for help isn't a failure; it's the smart move.

You don't have to feel terrible to start. If you feel 'okay' or 'fine,' you're actually much closer to feeling genuinely well than you might think. Starting before things get worse makes the journey shorter.

Q&A

Why do women in healthcare struggle so much with their own health?

Dr. Hannah points to conditioning that starts in training: clinical education centers entirely on patient care, not provider wellness. Add in the culture of self-sacrifice and the pressure to project confidence at all times, and you get a population of highly educated, deeply caring providers who have essentially been taught that their own needs come last. As she observed at one of the largest physical therapy conferences in the country, not a single exhibitor was there to support the clinician—only patient care outcomes and productivity standards.

What's a realistic first step for a healthcare provider who wants to get healthier?

Dr. Hannah recommends starting with honest curiosity: track your water intake, daily movement, and eating patterns for two to three days. Then identify one gap—maybe you're barely hitting 2,000 steps, skipping lunch entirely, or going all day without water—and set one small, attainable goal in that area. Don't try to fix everything at once. Find the gap. Start there.

How does Physique Triage work differently from traditional diet and fitness programs?

Physique Triage approaches health coaching the way healthcare providers approach patient care: with an intake assessment, individualized planning, and realistic goals built around the client's actual life. The goal isn't to hand someone a meal plan or a rigid workout schedule—it's to figure out what will realistically work given their schedule, their family, their practice, and what they already enjoy.

Is weight loss the only focus at Physique Triage?

Not at all. While weight loss often brings clients through the door, the work is really about sustainable health—strength, energy, mental clarity, better sleep. Dr. Hannah notes that many clients don't realize how poorly they feel until they start feeling better. When a client says, 'I didn't know I was waking up achy every morning until I wasn't anymore'—that's the real win.

Episode Highlights

Dr. Hannah's origin story: from doctoral graduate at her heaviest to losing 60+ pounds and discovering her calling

Why she built Physique Triage specifically for women in healthcare—the population she knew best

The evaluation-first approach: why she starts every client with questions, not a plan

Adding vs. subtracting: why Dr. Hannah focuses on what clients can bring in rather than what to cut out

The 'find your gaps' framework: assessing hydration, movement, sleep, and nutrition before changing anything

Why healthcare providers are conditioned to put themselves last—and what it costs them

The pediatric hepatologist who didn't know salmon had fat—and what it reveals about clinical training and self-knowledge

Why sustainable beats dramatic: how Dr. Hannah has maintained her 60+ pound loss for over a decade

The piano lesson revelation: choosing hobbies you'll never be great at—and why high achievers need them

Dr. Hannah's parting message: you've done nothing wrong, you're not broken, and it's not too late

Memorable Quotes

"We are only taught how to take care of others. And we somehow feel like we should know what to do, when in reality, it's not our area of expertise." — Dr. Hannah Brandt

"We wait until the alarms are ringing. None of our pants fit. We're desperate. And when we're desperate, we make questionable choices." — Dr. Hannah Brandt

"Sometimes we don't even know that we don't feel good until we start feeling good." — Dr. Hannah Brandt

"Self-care is not selfish. It's essential to be the most effective version of yourself in all the areas that you want to be." — Dr. Hannah Brandt

"I chose some strategic hobbies that no matter how hard I try, I'll never be great at—so I didn't have this incessant need to be the best and overachieve in that area as well." — Dr. Hannah Brandt

Dr. Hannah Brandt has a gift for meeting people exactly where they are—no guilt, no dramatic overhauls, just an honest look at where you are and one small step in the right direction. For practice owners who have poured everything into their patients, their staff, and their businesses, her message is a reminder that you cannot sustain that generosity if you're running on empty. If today's episode gave you the permission slip you needed to start prioritizing yourself, we'd love to hear about it. Find Dr. Hannah and Physique Triage at [physiquetriage.com — please verify URL], and explore thrivingpracticecommunity.com for resources to help you build a practice—and a life—that truly thrives.

Guest Bio:

Dr. Hannah Brandt, PT, DPT, CPT, IFNCP is a Doctor of Physical Therapy, Certified Personal Trainer, and Integrative and Functional Nutrition Therapy Practitioner. After losing over 60 pounds herself, she left clinical practice to become a health, fitness, and weight loss coach dedicated to helping other women break free from the same struggles she once faced. She knows firsthand the unique challenges women, especially healthcare providers balancing family, work, and health, navigate every day. As the founder of Physique Triage, Hannah blends medical expertise with real-world practicality to cut through the noise of fad diets and quick fixes. With humor, empathy, and evidence-based strategies, she empowers women to feel confident in their bodies and strong in their daily lives through practical fitness, nutrition, lifestyle, and weight loss coaching.

Find Hannah:

Website PhysiqueTriage

TikTok

YouTube

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Tracy Cherpeski 3/18/26 Tracy Cherpeski 3/18/26

Stop Being an Operator for the Insurance Company: Paul Vigario on Branding, Awareness, and Practice Growth Featuring Paul Vigario, EP 244

What separates a thriving private practice from one that's perpetually stuck? According to Paul Vigario, founder of SurfCT and strategist to over 12,000 healthcare practices worldwide, it comes down to two things: attention and compliance. Getting the right patients in the door, and building systems that keep them—without the owner burning out in the process.

What does it really take to build a healthcare practice that works for you—not just a high-paying job with overhead? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Paul Vigario, founder of SurfCT and a strategist who has partnered with over 12,000 practices worldwide. For independent practice owners wondering why growth feels stuck despite doing everything right, this conversation cuts straight to the heart of why—and what to do about it.

Paul's premise is simple: business is attention and compliance. Getting the right patients in the door, and having the systems to serve them consistently and profitably. But what makes his approach different is the emphasis on awareness—helping doctors see the game that's being played in their industry, and making deliberate choices about how to play it differently. Whether you're a solo practitioner, a growing group practice, or somewhere in between, the principles Paul shares apply to any practice owner ready to stop being an operator for someone else's system.

From branding and patient experience to financial clarity and freedom from insurance-driven constraints, this episode is packed with practical perspective for healthcare practice owners who want to build something that truly thrives—on their terms.

Key Takeaways

Awareness is the foundation of success. Paul defines success as awareness—the ability to see what's possible, understand the game being played, and make informed choices. The areas where you're thriving are where you have the most awareness.

Business is attention and compliance. Every practice needs a way to attract the right patients (attention) and deliver a consistent, trustworthy experience (compliance). When both work together, the practice grows independently of the owner.

Your brand is your narrative. If you take insurance without a strong brand, your brand becomes the insurance company's brand. Building your own creates the ability to attract the right patients, tell your own story, and charge what you're worth.

Flat revenue means you're losing ground. If your practice has been stuck at the same revenue for years, you're actually losing money—because costs keep rising. Growth isn't optional if you want sustainability.

The vineyard principle: don't judge year one. Paul's experience co-owning a wine vineyard is a perfect metaphor for practice building—early seasons look slow, but if you surround yourself with the right people and stay clear on the vision, explosive growth follows.

Q&A

Why do so many smart doctors struggle with the business side of their practice?

Paul points out that medical training produces exceptional clinicians—but almost no business training. Doctors enter practice ownership without the awareness of what's actually possible or how the industry is structured. Add in an insurance system that, in Paul's view, positions doctors as operators rather than owners, and you have the conditions for burnout and stagnation even in a successful-looking practice.

What does branding actually mean for a healthcare practice?

According to Paul, branding is a feeling—the culture, trust, and identity that a practice projects. More importantly, branding is how a practice controls its narrative. Without a strong brand, patients often identify more with their insurance carrier than with the practice. Building a distinctive brand means attracting the right patients, reducing friction, and creating a loyal base that isn't dependent on what any insurer decides to pay.

How can a practice grow without just seeing more patients?

Paul's framework of attention and compliance offers an answer: build systems that attract the right patients and deliver a consistently excellent experience—then make those systems work independent of the owner's daily involvement. This is the difference between building a business and building a job. When the attention and compliance elements function together, the practice becomes scalable and sellable, not just sustainable.

Episode Highlights

Paul's founding story: building SurfCT from a college dorm room to 12,000+ practices worldwide

The dental and medical school projects at High Point University—and what they revealed about doctor needs

Why awareness, not intelligence, is the real driver of business success

The brain surgeon and the 11-year-old: why experience isn't the same as game-day awareness

Branding as feeling, culture, and narrative control—not logos and color palettes

The attention and compliance framework: the two levers every practice must master

Why taking insurance without a brand means your brand is the insurance company

Tracy's 10-5 rule for patient experience and the importance of online/in-person alignment

How Paul's vineyard partnership mirrors the patience and vision required in practice building

The stalled-out stick shift: Tracy's metaphor for building momentum in a new or acquired practice

Memorable Quotes

"Business in its simplest denominator is just two things: attention and compliance. If you can create that dance, you can really build something that can scale and grow quickly." — Paul Vigario

"Success in one word is awareness. The areas of your life where you're having a lot of success, you have a high level of awareness." — Paul Vigario

"If you can control the narrative, then you can create the life that you want—versus the life that the insurance carrier wants you to have." — Paul Vigario

"Vision plus control equals success." — Paul Vigario

"You don't want to get stuck in that first year. Surround yourself with great people, stay clear on the vision, and give it a little time." — Paul Vigario

Paul Vigario's message is clear: the most powerful thing a practice owner can build is awareness—of what's possible, of how the game is played, and of the specific levers that move a practice from stagnant to extraordinary. For the independent practice owners who feel the tension between a system that wasn't designed for their success and the vision they had when they opened their doors, this episode is both permission and a playbook. Connect with Paul and the SurfCT team at surfct.com or on Instagram at @surfct.

And if you're ready to build a practice that thrives on your terms, explore thrivingpracticecommunity.com for resources, coaching, and a community of practice owners doing exactly that.

Guest Bio:

Paul Vigario is the founder and CEO of SurfCT, a leading authority in healthcare practice strategy, design, and technology for private healthcare practices, known for its integrated approach to improving and modernizing operations. Over the past 25 years, he has helped more than 12,000 practices worldwide generate more than$36 billion in healthcare revenue, redefining how providers automate, scale, and grow. Widely recognized as a visionary leader and pioneer in healthcare innovation, Mr. Vigario has spent his career advancing the integration of technology, brand, and patient experience in modern healthcare through clarity of vision, purposeful design, and systems that create freedom for providers.

Find Paul:

Website – SurfCT.com

Instagram

Paul’s Personal Website – PaulVigario.com

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Miranda Dorta 3/13/26 Miranda Dorta 3/13/26

Good Revenue, No Money: The Financial Clarity Gap in Healthcare Practices – A Special Snack Episode, EP 243

If you make good revenue but still feel like there's never enough money in the practice, you're not broken—you're probably just missing financial clarity. In this SNACK episode, Tracy Cherpeski and Miranda Dorta get into one of the most common and least-discussed gaps in independent healthcare: the difference between having a great accountant and having a real financial strategy.

If you make good revenue but still feel like there's never enough money, you're not alone—and you're probably not doing anything wrong. In this SNACK episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Miranda Dorta to talk about one of the most common and least discussed gaps in independent healthcare practices: financial clarity. It's a topic that touches nearly every practice owner Tracy works with, regardless of how long they've been in business or how successful they appear from the outside.

Tracy gets candid about why even accomplished practice owners stay in the dark about their numbers—and it's not because they're bad at business. It's a combination of money being culturally taboo, the discomfort that comes with putting dollar signs anywhere near patient care, and the sheer overwhelm of running a practice. The result? A lot of very smart clinicians who are outsourcing their financial awareness entirely, waiting until tax season and hoping for the best.

This episode also introduces a newer offering Tracy has added to her consulting work: fractional CFO support for practice owners who have solid accounting handled but are missing the forward-looking, strategic piece. If you've ever thought about profitability, sustainable growth, or eventually having a practice worth selling, this conversation has something for you.

Key Takeaways

Money discomfort is nearly universal — and doubly loaded for healthcare providers.

Not knowing your numbers is the most common financial mistake practice owners make. Knowledge creates the ability to act.

There's a difference between an accountant (backward-looking, tax-focused) and a financial strategist (forward-looking, growth-focused). Most practice owners only have the former.

Money is a tool. How you deploy it determines whether it works for or against your goals.

Financial health looks like predictable revenue, clean margins, and the ability to spot trends before they become problems.

Q&A

Why do financially savvy practice owners still avoid looking at their numbers?

According to Tracy, it's a three-part problem: money is culturally taboo, healthcare providers are wired to resist putting a price on patient care, and most practice owners are already stretched thin. Together, those forces make it very easy to defer financial awareness indefinitely.

What's the most common financial mistake practice owners make?

Tracy points to two: being hands-off with their numbers altogether, and not being strategic about the money they do have. Knowing your revenue isn't enough—you also need to understand what to do with it and how to use it to move the practice forward.

What's the difference between a good accountant and a fractional CFO?

A good accountant manages historical data, ensures compliance, and handles taxes. A fractional CFO brings strategic, forward-looking financial planning—looking at growth trajectories, margins, and long-term goals like generational wealth or a future practice sale. Tracy notes that in her years of consulting, she's rarely seen practice owners have both.

What does a financially healthy practice actually look like day to day?

Tracy describes it as having relatively predictable revenue, the ability to spot trends in your data before they become crises, and consistent margins even as top-line numbers grow. She also recommends approaching financial data the same way a clinician approaches a lab result—with curiosity and a plan, not avoidance.

Episode Highlights

Why money is a taboo subject for most humans—and even more loaded for healthcare providers

The three-layered reason practice owners avoid their finances (and why it makes total sense)

The difference between "I have a great accountant" and "I have a financial strategy"

How Tracy's one client with a strategically-minded accountant sparked the idea for fractional CFO services

What to look for when revenue looks fine but money always feels tight (hint: check for leaks)

A real client example: thousands of dollars in double-subscribed text messaging fees flying under the radar

Why money is a tool—and how practice owners can start treating it like one

Where to learn more: practicesuccess.co/finance

Memorable Quotes

"There's a real discomfort with that — a double whammy — that there's just a real discomfort putting dollar signs over people's heads." — Tracy Cherpeski

"Knowledge is power. Understanding your numbers means when you have a conversation with a professional who's supporting you, it's more empowering." — Tracy Cherpeski

"Money is a tool. It is simply a tool, and you can use it as a lever to move things you want to move through the business." — Tracy Cherpeski

"We don't get wealthy by saving, but we certainly save ourselves a lot of time, energy, and lost resources by checking for leaks." — Tracy Cherpeski

"As a business owner, it would be unwise and foolish not to put your hands on the money and treat it as another part of the business." — Tracy Cherpeski

Financial clarity isn't a luxury for practice owners who want to grow—it's the foundation everything else is built on. Tracy and Miranda's conversation cuts through the shame and overwhelm that so often keep practice owners in the dark, and makes a compelling case that knowing your numbers isn't about being mercenary; it's about having the freedom to make intentional decisions. If you're ready to stop waiting for tax season to tell you how you're doing, visit practicesuccess.co/finance to learn more about the new fractional CFO offering. And for more resources on building a practice that truly thrives, head to thrivingpracticecommunity.com.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Miranda’s Bio:

Tracy’s Bio:

Connect With Us:

Website – BidViewMarketing.com

Miranda Dorta 3/11/26 Miranda Dorta 3/11/26

Data Over Guesswork: What a Marketing Engineer Knows About Growing Your Practice Featuring Cameron LiButti, EP 242

Most practice owners know they need to market their practice—but far fewer know how to evaluate whether it's actually working. In this episode, Tracy Cherpeski sits down with Cameron LiButti, founder of Bidview Marketing, who brings an engineer's precision to healthcare practice marketing strategy.

Most healthcare practice owners know they need to market their practice. But ask them whether their current spend is actually working—or how to evaluate it—and you'll often get a blank stare. That gap between intention and information is exactly what Cameron LiButti, founder of Bidview Marketing, built his firm to close.

Cameron came to marketing from an unexpected direction: a mechanical engineering degree and a few years designing HVAC systems in Chicago high-rises. When he made the pivot into marketing, he brought his analytical instincts with him. The result is a data-first approach to private practice marketing that treats your competitive landscape the same way an engineer treats a load-bearing structure—with specificity, not guesswork.

In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Cameron to talk through how independent practice owners can market smarter, set realistic expectations for results, and sidestep the most common and costly mistakes that keep practices stuck. Whether you're just starting to think about a marketing strategy or wondering why your current spend isn't producing, this conversation gives you a clear framework for moving forward.

Key Takeaways

Start with data, not a package. Cameron's firm always begins with local SEO data to understand your actual competitive landscape—because what's true for a practice in Manhattan is the opposite of what's true in rural Nebraska.

Marketing results take time. Depending on your location and how long you've been in business, expect 6–12 months for SEO results to mature. Low-competition markets can move faster; highly competitive ones take longer.

Your operations team is part of your marketing. If your front desk isn't equipped to handle increased call volume—or doesn't know what to say—your marketing campaign can't succeed, no matter how well it performs.

Consistency is everything. Starting and stopping campaigns is one of the most common and costly mistakes Cameron sees. The data needed to optimize your strategy takes time to accumulate.

Professional photography before anything else. Cameron won't build a website without it. The single highest-impact change practices can make before launching any campaign is professional photos.

Q&A

How do I know if my current marketing is actually working?

Cameron recommends focusing on what he calls "bottom of funnel" traffic—meaning, are the people finding your practice actually searching for your specific services? He also suggests asking how new patients heard about you, tracking whether calls are converting to appointments, and benchmarking your online presence against local competitors. More traffic doesn't automatically mean better marketing.

How long before I can expect results from marketing?

It depends on your competitive landscape and how established your online presence already is. Practices in low-competition markets can see movement in as few as 3–4 months. In more competitive areas, 8–12 months is a realistic timeline for SEO. Paid advertising moves faster, but Cameron recommends not touching ad budgets for the first 90 days—that time is about buying the data needed to optimize.

Does my location really change my marketing strategy that much?

Dramatically. Cameron has turned off marketing budgets for practices in rural areas where there's simply no competition—because spending on SEO when you're the only provider for an hour in every direction is money that could be better used on branding, positioning, or photography. The inverse is equally true: in Manhattan, he tells clients that taking their foot off the gas means competitors will close the gap immediately.

What does "operational readiness" mean in the context of marketing?

It means your systems need to be able to handle the inquiries that good marketing generates. Cameron shares several examples: an ophthalmology practice with no plan for incoming calls, a scheduling system that got turned off mid-campaign, and a front desk hire who was telling callers "nope" and hanging up when they asked about insurance. Great marketing gets people to the door—operations determines whether they come in.

Episode Highlights

How Cameron went from designing mechanical systems in Chicago high-rises to running a healthcare marketing firm

The engineering mindset applied: calculating "share of local voice" before recommending any budget

Why rural practices should focus on branding and positioning—not necessarily SEO spend

The scheduler that got quietly turned off mid-campaign—and nearly ended a practice's best quarter in 30 years

Why newsletters consistently hit 50%+ open rates when only 20% of the content is about your specialty

How AI and LLMs are beginning to shift how urgent-need patients find providers—and why that matters for healthcare in 2026

The "death by a thousand dollars" pattern: why starting and stopping kills marketing momentum

Why professional photography is the one investment Cameron recommends before anything else

Memorable Quotes

"Death by a thousand dollars. Everybody wants to spend a thousand dollars and then shut it off. Didn't work." — Cameron LiButti

"Who answers the phone? That's my first question." — Cameron LiButti

"I would feel pretty awful taking your money because we're not beating anybody." — Cameron LiButti

"In healthcare, we're not just there to sell a device. We're there for healthcare reasons. We're there to help people." — Cameron LiButti

"If you can get that flywheel to spin, life gets really good." — Cameron LiButti

Cameron LiButti brings a perspective to private practice marketing that most owners have never encountered: one that starts with data, respects your actual competitive reality, and holds both marketing strategy and operations equally accountable for outcomes. If you've been spending on marketing without a clear sense of whether it's working—or if you've been hesitant to start—this conversation is a practical, grounded place to begin. Find Cameron at bidviewmarketing.com and connect with him on LinkedIn. And if you're ready to build the kind of practice that doesn't leave patients or revenue on the table, explore the resources waiting for you at thrivingpracticecommunity.com.

Guest Bio:

Cameron LiButti is the Founder of Bidview Marketing. Before he was helping private practices compete and win online, he was designing mechanical systems for Chicago high-rises—and that engineering mindset never left. He launched Bidview in 2017 and has since worked with more than 100 clients across healthcare, law, and professional services, with a 95%+ retention rate and over $10M generated for his clients. You can find him at bidviewmarketing.com.

Find Cameron:

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Tracy Cherpeski 3/4/26 Tracy Cherpeski 3/4/26

Leading From Last Place: Why Self-Neglect Is a Practice Problem, Not a Personal Failing, EP 241

In this solo episode of The Thriving Practice Podcast, Tracy Cherpeski names what too few people in medicine are willing to say out loud: the training that made you an extraordinary clinician may also be the very thing driving your burnout. She breaks down the paradox of selflessness—how the self-less provider actually delivers less sustainable care—and what it looks like to lead your practice from a place of genuine capacity rather than chronic depletion.

Nobody hands you a brochure in medical school that says: here is how we will systematically teach you to ignore your own needs. It happens quietly—through culture, through what gets rewarded, through the attending who runs on four hours of sleep and treats it like a badge of honor. By the time most healthcare providers open their own practices, the programming is so deep that they don't even recognize it as programming. They just call it dedication.

If you're a practice owner who has ever felt like the harder you work, the further you fall behind—or if you've been quietly white-knuckling it and wondering whether there's another way—this episode is for you. It's not about working less. It's about leading smarter, protecting what makes you effective, and building a practice that doesn't require you to sacrifice yourself to sustain it.

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Key Takeaways

Burnout is a design flaw, not a personal failing. The medical training system deliberately installs self-neglect—not through malice, but through culture, modeling, and what gets silently rewarded.

The warning signs are disguised as success. Early burnout stages (1–4) look nearly identical to what the system defines as excellence: driven, committed, staying late, saying yes. Most providers don't recognize depletion until they're deep in it.

A depleted leader builds a depleted practice. Decision-making, boundaries, and team culture all degrade when the leader is running on empty—and they often can't see it because operating depleted has become their baseline.

Sustainability isn't selfish. Asking for help, building sustainable structures, and finding genuine community aren't luxuries for healthcare practice owners—they are clinical-grade necessities.

Your recovery is part of the larger mission. The practitioners best positioned to repair medicine from the inside are the ones who've gotten well enough to have capacity left over. You cannot advocate for change from a place of depletion.

Q&A

Why do so many healthcare practice owners burn out even when they love their work?

Because the training itself installs burnout. Medical and clinical education systematically conditions providers to deprioritize their own needs through culture and modeling—not a syllabus. By the time they open a practice, they run themselves exactly the way they were trained to: without adequate regard for their own sustainability. The mission is real, the drive is real, and they keep going until something stops them.

What does it mean to lead a practice "from last place"?

Tracy uses this phrase to describe what happens when a practice owner has genuinely internalized the belief that their needs come last—after patients, staff, the practice, and the paperwork. From that position, decision-making becomes foggy, boundaries erode slowly rather than dramatically, and the whole practice culture tilts toward overextension because the leader is modeling it. The practice always follows the leader.

How is this different from just telling providers to "practice self-care"?

Tracy is explicit that this isn't about bubble baths or days off. It's a structural and strategic argument: when you treat your own capacity as a variable that counts—not the most important variable, but a real one—your patients get a more grounded, effective version of you. Sustainable excellence requires honesty about what it takes to maintain it. That's not selfishness. It's stewardship.

What does the Thriving Practice Community offer that other professional networks don't?

TPC is built specifically for independent practice owners—not employed physicians in large health systems, not generic business owners. It offers the rare combination of genuine peer connection with people who understand the specific weight of practice ownership, plus the strategic frameworks and thinking partners to build something sustainable. Tracy describes watching physicians who were mostly strangers connect quickly and go deep fast—because the hunger for that kind of real community is that strong.

Episode Highlights

The unspoken rules of medical training: don't show weakness, sleep is a luxury, the patient comes first—always

Why early-stage burnout is nearly indistinguishable from what the system calls excellence

The paradox of selflessness: what it actually means to be self-less and why it's unsustainable

How operating from depletion impairs decision-making, erodes boundaries, and shapes the whole practice culture

The loneliness underneath the stoicism—and why the "I'm fine" posture cuts providers off from what would actually help

What it looks like practically when a provider starts treating themselves as a variable in the equation

Tracy's account of facilitating a CME-accredited wellness retreat in San Jose—and what she witnessed in that room

Why getting well is one of the most strategic things a practice owner can do for the profession

Memorable Quotes

"You were trained deliberately, systematically, over years of education and clinical formation, to put yourself at the bottom of every list." — Tracy Cherpeski

"Not only were you trained to deplete yourself, you were trained to read the depletion as success. That's not a personal failing. That is a design flaw in the system." — Tracy Cherpeski

"How do you make decisions without a self? How do you set boundaries, hold a vision, lead a team, build something that lasts without a self to anchor to?" — Tracy Cherpeski

"You cannot dismantle an inhumane system while you're being consumed by it. The most radical thing a physician can do right now might be to get well." — Tracy Cherpeski

"Your humanity is what makes you an extraordinary provider. Protecting it is not selfish. It's stewardship." — Tracy Cherpeski

The story that says a great provider puts themselves last isn't a virtue—it's a vulnerability. And it may be the single most important thing to unlearn if you want to build a practice that lasts, a team that thrives, and a career you can sustain. Tracy Cherpeski has spent over 15 years helping highly credentialed practice owners rewrite that story, and this episode is one of her most direct invitations to start. If something clicked for you today, explore what it looks like to work together at practicesuccess.co, or join a community of practice owners doing this work together at thrivingpracticecommunity.com. Links are in the show notes.

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Miranda Dorta 2/27/26 Miranda Dorta 2/27/26

The 80% Rule: How Practice Owner CEOs Stop Perfecting and Start Scaling – a Special Snack Episode, EP 240

Perfectionism can feel like a strength—until it starts quietly costing you time, momentum, and peace of mind. In this SNACK episode, Tracy Cherpeski sits down with Miranda Dorta to talk about one of the most persistent challenges for practice owner CEOs: knowing when good enough actually is good enough.

Perfectionism and high standards are not the same thing—and confusing the two might be one of the most expensive mistakes a healthcare practice owner can make. In this SNACK episode of The Thriving Practice Podcast, Miranda Dorta turns the mic on Tracy Cherpeski for an unscripted conversation about what perfectionism actually looks like at the CEO level, how to define "good enough" without lowering the bar, and why progress—not perfection—is what keeps a thriving practice growing.

For practice owners who've spent years earning clinical excellence, the pressure to get everything right in the business seat can feel just as intense as it did in training. But the skill set required to run a profitable, sustainable practice is different. It asks for a tolerance for imperfection, a willingness to delegate, and the ability to make decisions with incomplete information—often under the same time and bandwidth pressures that already define a full patient schedule.

Whether you're just starting to build your leadership identity, working through analysis paralysis, or trying to help your team embrace a "progress over perfection" mindset, this episode offers practical frameworks and a grounding reminder: the standard doesn't disappear when you let go. It just finally has room to be met by someone other than you.

Key Takeaways

The 80% rule is your move-forward threshold. For recovering perfectionists, 80% complete is often more refined than most people's 100%—and it's ready to go. Getting it out of your head and into the world is part of the process.

Decision-making is the first place perfectionism shows up. Analysis paralysis, constant back-and-forth, or decisions that feel heavier than they should—these are signals. Building your decision-making muscle is part of growing into the CEO role.

High standards and perfectionism are not the same thing. High standards are clear, consistent, and leave room for flexibility. Perfectionism is rigid, moves the goalposts, and is often more about control than quality.

Delegation is a leadership skill, not a loss of control. Using the Time Leadership Quadrant to evaluate what actually belongs on your plate—and then handing the rest off to capable team members—is how you recapture time for the clinical work that needs you most.

Progress deserves to be celebrated. In business, outcomes often surprise and delight when leaders focus on incremental movement rather than waiting for everything to be perfect before calling it a win.

Q&A

How do I know when something is "good enough" to move forward?

Tracy's benchmark is 80%—or 70% for the very detail-oriented. If it's close enough to monitor and adjust, it's close enough to launch. She also recommends pairing that gut check with a data-backed decision framework, especially for business moves where intuition and evidence can work together rather than compete.

What's the difference between high standards and perfectionism in a practice setting?

High standards are consistent, clearly communicated, and built in from the start. They hold firm on what matters most while allowing for flexibility when the unexpected happens. Perfectionism, on the other hand, is about rigidity—moving the goalposts, holding on too tightly, and often rooted in a fear of losing control rather than a genuine commitment to excellence.

How do I help my team embrace progress without feeling like I'm lowering expectations?

Tracy recommends starting with a shared vision of what "perfect" would look like—and then defining 80% of that together. From there, it's about celebrating incremental wins and trusting that when people are given clear standards and real autonomy, they rise to meet them. Often, the outcome exceeds expectations precisely because it was theirs to own.

How does perfectionism show up differently as a practice owner CEO than it did earlier in your career?

Early on, Tracy's perfectionism was largely driven by insecurity and fear of putting things into the world. As the company has matured—now in its 16th year—the shift has been toward releasing control and watching her team shine. The reward isn't just operational: it's the deep satisfaction of seeing people step into their best work when given the space to do so.

Episode Highlights

The decision-making test: how to spot analysis paralysis before it stalls your practice growth

Why 80% is the magic number (and why Tracy's 80% is still more refined than most people's 100%)

Using the Time Leadership Quadrant to stop perfecting tasks that don't belong on your plate

High standards vs. perfectionism—and why the distinction changes how you lead your team

How perfectionism is rooted in control, and what it takes to genuinely let go

A real client story: opening a second practice location by standing next to your team instead of in front of them

Why course-correcting in business often looks like a millimeter shift, not a full pivot

The deep satisfaction of watching your team rise when you give them room to lead

Memorable Quotes

"My 80% as a recovering perfectionist is multiple times more thought out, more detailed, more agonized over than sort of the average person's 100%." — Tracy Cherpeski

"High standards are very clear from the beginning. You do not waver. Perfectionism is being rigid, sometimes moving the goalposts with that rigidity and not being willing to let go of control." — Tracy Cherpeski

"Usually, what happens is the outcomes surprise and delight us." — Tracy Cherpeski

"When I let go and watch you do your thing, I'm just so proud. It's very liberating, actually, when you know you have a team you can trust and they're going to shine." — Tracy Cherpeski

"The standard is set. The expectation of excellence is already there. It's already built in. So now it's just time to rise." — Tracy Cherpeski

Letting go of perfectionism doesn't mean lowering the bar—it means trusting that the bar is already set, and giving your team, and yourself, the room to clear it. Tracy's conversation with Miranda is a reminder that sustainable practice growth doesn't come from holding everything tightly; it comes from making clear decisions, delegating with confidence, and celebrating the progress that gets you there. If this episode resonated with you, share it with a practice owner colleague who might need the permission slip. And if you're ready to build the systems and leadership skills that make letting go feel good rather than scary, visit thrivingpracticecommunity.com to learn more.

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Tracy Cherpeski 2/25/26 Tracy Cherpeski 2/25/26

The Undoctor: Why a Psychiatrist Says Human Connection Heals More Than Any Prescription, Featuring Dr. Fred Moss, EP 239

What if the most healing thing a healthcare provider can do has nothing to do with a diagnosis or a prescription? In this episode, Tracy Cherpeski sits down with Dr. Fred Moss—a psychiatrist with 46 years in the mental health system who believes that human connection, not medication, is at the heart of all healing.

What if the path to better mental health has less to do with a diagnosis and more to do with being truly heard? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Dr. Fred Moss—a psychiatrist with 46 years in the mental health system who believes that human connection, not medication, is at the heart of all healing. For healthcare practice owners wrestling with how to serve patients in a system built around illness rather than wellness, this conversation is a must-listen.

Dr. Fred is the founder of Welcome To Humanity, a coaching practice that helps people undiagnose, unmedicate, and what he calls “undoctrinate” themselves from a mental health model that too often treats discomfort as pathology. His approach asks a question that every healthcare provider should consider: what if there’s nothing wrong with your patients—and what if the most healing thing you can do is simply connect with them as human beings?

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Whether you’re a practice owner rethinking your care model, a clinician feeling the limits of conventional approaches, or someone exploring how to build a more meaningful healthcare business, this episode offers a perspective that’s both challenging and deeply affirming.

Key Takeaways

Human connection is the foundation of healing. Dr. Fred argues that no pill, diagnosis, or treatment plan can replicate the healing power of genuine human connection—and that this applies in every care setting.

Diagnoses can become limitations. When patients define themselves by a diagnosis, it can create an identity that actually keeps them stuck rather than supporting their growth and recovery.

Discomfort is a feature of being human, not a sign of pathology. The expectation that life should be comfortable has created a culture where normal human struggles are treated as medical problems.

There’s a business reality worth examining. The conventional treatment model can perpetuate the need for ongoing treatment, creating a cycle that serves the system more than the patient.

The “undoctor” concept is accessible to everyone. You don’t need decades of training to practice genuine curiosity and human connection—Dr. Fred believes anyone can be an “undoctor.”

Q&A

What does Dr. Fred mean by “undoctor”?

Dr. Fred uses the term “undoctor” to describe his approach to care: rather than diagnosing and medicating, he focuses on genuine human connection, helping people undiagnose, unmedicate, and step away from a system that may not be serving them. He believes the capacity to heal through connection doesn’t require medical training—just deep curiosity and authentic presence.

Why does Dr. Fred challenge traditional psychiatric diagnoses?

After 46 years in mental health, Dr. Fred has observed that diagnoses often give people an external label to explain their struggles, which can become a limitation rather than a path forward. He points out that many diagnoses didn’t exist a century ago and that the discomfort they describe is often just part of the human experience, not evidence of pathology.

How does this perspective apply to healthcare practice owners?

For practice owners navigating burnout prevention and sustainable care models, Dr. Fred’s approach raises important questions about how we structure patient interactions. His emphasis on connection over convention suggests that the most impactful practices may be those that prioritize genuine human engagement over rapid throughput and checklist-driven care.

Episode Highlights

Dr. Fred’s origin story: from childhood communicator to psychiatric “undoctor”

Why he dropped out of college twice—and what brought him back

Working in prisons, orphanages, and homeless shelters: what he learned about real healing

The log in the fire metaphor: why we can’t blame ourselves for getting burned

How diagnosis can become an identity trap for patients

The business model critique: when treatment perpetuates the need for more treatment

Why “there’s nothing wrong with you” is the most radical thing a provider can say

Tracy’s personal aha moment about her daughter’s health journey

Memorable Quotes

“At the heart of all healing is a human connection. And inside of that human connection, that’s where the power actually explodes.” — Dr. Fred Moss

“We don’t blame a log for burning in a fire. We’re all living in a fire. It’s very hard to be a human.” — Dr. Fred Moss

“Your diagnosis, dare I say, is you are Tracy Cherpeski.” — Dr. Fred Moss

“One of the most hilarious parts of this viewpoint is that it’s seen as revolutionary.” — Dr. Fred Moss

“Each and every one of us has the capacity to be an undoctor. You do not have to have 26 years of schooling. All you have to do is be a curious human being.” — Dr. Fred Moss

Dr. Fred Moss reminds us that the most powerful tool in healthcare isn’t a prescription pad—it’s our willingness to show up, be curious, and connect with another human being. For practice owners who feel the tension between what the system demands and what patients actually need, this episode offers both permission and a path forward. If this conversation moved you the way it moved Tracy, share it with a colleague who needs to hear it. Visit drfred360.com or welcometohumanity.net to learn more about Dr. Fred’s work, and explore thrivingpracticecommunity.com for resources to help you build a practice that truly thrives.

Guest Bio:

Dr. Fred Moss is a board-certified psychiatrist, author, and founder of Welcome To Humanity. He holds an MD from Northwestern University and completed his psychiatry residency and child & adolescent psychiatry fellowship at the University of Cincinnati. Over 46 years in mental health, he has treated more than 40,000 patients across settings ranging from prisons and homeless shelters to private practice. Now working as a holistic coach, Dr. Fred helps people undiagnose, unmedicate, and reclaim their identity through his Undoctor Reset™ program. He is the author of Find Your True Voice and Creative 8: Healing Through Creativity and Self-Expression, and has been featured on more than 100 podcasts. He lives in Grass Valley, California.

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Tracy Cherpeski 2/18/26 Tracy Cherpeski 2/18/26

You Don’t Have a Team Problem – You Have a Leadership Identity Problem, EP 238

If you opened your practice to help people heal but find yourself spending most of your day checking, correcting, and redoing your team’s work, you’re not alone—and you don’t have a team problem. In this episode of the Thriving Practice Podcast, Tracy Cherpeski digs into a challenge that almost every healthcare practice owner faces: the gap between clinical excellence and effective leadership. The very instincts that make you an incredible clinician—precision, thoroughness, catching every error before it becomes a problem—can quietly undermine your effectiveness as a leader of people.

Tracy shares why this pattern is actually a leadership identity problem, not a performance issue on your team, and walks through three practical shifts that will change how your team experiences you—starting as early as Monday morning. Whether you’re a solo practitioner building your first team or an established practice owner preparing to scale, this episode offers a clear and compassionate roadmap for leading without hovering.

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If you’ve been searching for help with time management for healthcare practice owners, strategies for reducing burnout while growing your practice, or simply a better way to lead your team, this conversation will meet you right where you are.

Key Takeaways

Clinical training creates a leadership blind spot. The precision and vigilance that saves lives in patient care can suffocate your team’s confidence and initiative when applied to every management decision.

Micromanagement isn’t always the enemy. Compliance, patient safety protocols, credentialing, and financial controls genuinely require close oversight. The problem starts when that same scrutiny extends to how your front desk greets patients or how your office manager drafts an email.

Three Monday-morning shifts can change everything. Replace “let me check that” with “walk me through your thinking,” define outcomes instead of dictating steps, and create structured leadership rhythms with daily huddles and weekly check-ins.

Growing into leadership isn’t a demotion—it’s evolution. The version of you that opens a second location, builds a self-sufficient team, and reclaims strategic thinking time is a leader first and a clinician second.

Curiosity beats control every time. Tracy shares a client story where pausing to ask deeper questions—rather than pushing or rescuing—turned a hesitant team member into a genuinely invested leader for a new location.

Common Questions Answered in This Episode

Why do healthcare practice owners tend to micromanage?

It’s rarely about being a control freak. Clinical training literally wires providers to catch problems before they happen. That instinct is life-saving in patient care but can erode your team’s confidence and autonomy when applied to everyday management tasks.

How do I know if I’m micromanaging my team or just being thorough?

Ask yourself two questions: Am I managing a detail that genuinely needs my eyes (like compliance or patient safety)? Or am I managing a person who I need to trust? If it’s the latter, you’ve crossed from necessary oversight into micromanagement.

What’s the difference between daily team huddles and leadership check-ins?

Daily huddles are brief, team-run standing meetings at the start and end of each day to align on the schedule and debrief. Leadership check-ins are a weekly 15-minute meeting between you and your team lead to address what’s working, what’s stuck, and what specifically needs the owner’s input.

How can I delegate more effectively without losing quality?

Define the outcome and the standard, then give your team ownership of the method. If the result meets your standard but the process looks different from how you’d do it, that’s not a problem to fix—that’s your team member’s talent showing up.

Episode Highlights

Why the clinical precision that makes you a great provider can make you a difficult leader

The important distinction between micro-detailed management and micromanaging people

A real client story: coaching a hesitant provider to lead a second location

The band leader metaphor: setting the key, tempo, and feel—then letting your team play

Shift 1: Replace “Let me check that” with “Walk me through your thinking”

Shift 2: Define the outcome, not the steps—and why “different” isn’t “wrong”

Shift 3: Schedule your leadership with daily huddles and weekly check-ins

Why growing from clinician to CEO is evolution, not demotion

Memorable Quotes

“The best-run practices are not led by the smartest clinician in the room. They’re led by the owner who learned to trust the room.”

“The skills that made you an incredible clinician are not the same skills that make you an effective leader of people.”

“Micromanagement is not a dirty word. There are micro details in your practice that absolutely need to be managed.”

“If the outcome is met and they just did it differently than you would have, that’s not a problem to fix. That’s a team member to celebrate.”

“What got you here isn’t what gets you there. The version of you that builds a team that can run without you in the room… that version of you is a leader first and a clinician second. That’s not a demotion. That’s evolution.”

The shift from clinician to practice leader doesn’t require a leadership course or an overhaul of your operations. It starts with recognizing that the instincts that made you exceptional in the treatment room need to be channeled differently when you’re leading people. Replace inspection with curiosity, define what success looks like and let your team own the how, and create intentional rhythms so your oversight doesn’t scatter into surveillance. These small, practical shifts build trust, develop your team’s confidence, and free up the strategic thinking time your practice needs from its CEO. If this episode resonated, share it with a fellow practice owner who’s carrying too much—and explore how the Thriving Practice Community can support your next season of growth.

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Tracy Cherpeski 2/16/26 Tracy Cherpeski 2/16/26

Relationship Over Cold Calls: Smarter Patient Growth for Practice Owner A Special Snack Episode, EP 237

If you’re a healthcare practice owner who’s ever been told to “just pick up the phone and start calling,” this episode is for you. Cold calling has been a go-to tactic for decades, but for independent practice owners trying to build trust-based patient relationships, it can do more harm than good.

If you’re a healthcare practice owner who’s ever been told to “just pick up the phone and start calling,” this episode is for you. Cold calling has been a go-to sales tactic for decades, but for independent practice owners trying to build trust-based patient relationships, it can do more harm than good. In this SNACK episode of The Thriving Practice Podcast, Miranda Dorta interviews Tracy Cherpeski about why cold calling falls flat in healthcare—and what practice growth strategies actually move the needle.

With research showing that 82–86% of potential patients begin their healthcare journey online, putting your energy into cold outreach by phone may be one of the least effective ways to grow your practice. Tracy breaks down the difference between cold calling and cold outreach, explains why relationship-first marketing wins in healthcare, and shares practical ways to attract patients and build referral partnerships without the hard sell.

Whether you’re opening a new practice, expanding your services, or looking for smarter ways to build your patient base, this conversation will help you rethink how you approach practice growth and patient acquisition.

Key Takeaways

Cold calling creates defensiveness, not trust. In healthcare, the first impression sets the tone for the entire patient relationship. A cold call often triggers resistance, which is the opposite of the trust you need to build.

Cold calling and cold outreach are not the same thing. Digital marketing, social media presence, and email outreach let potential patients experience you on their terms—a critical distinction Tracy highlights.

The instinct to connect is good—redirect it. That urge to get out there and actively pursue patients comes from a solid place. The key is slowing down to clarify who you serve and how to reach them intentionally.

Referral partnerships are built on relationships, not pitches. Whether through networking groups, community involvement, or reciprocal arrangements with nearby practices, the best referral sources come from genuine connection.

Clarity comes before strategy. Before investing in any marketing approach, get clear on your ideal patient, the problem you solve, and how you want to show up in service to them.

Q&A

Why doesn’t cold calling work for healthcare practices?

Healthcare is deeply personal, and patients need to feel trust before they commit. Cold calling creates an immediate sense of intrusion and defensiveness—the opposite of what builds a strong patient-provider relationship. With the vast majority of patients starting their search online, phone-based cold outreach misses where your potential patients are already looking.

What’s the difference between cold calling and cold outreach?

Cold calling means directly phoning someone who hasn’t asked to hear from you. Cold outreach is broader—it includes digital ads, social media, and email campaigns that introduce potential patients to your practice in a less invasive way. Cold outreach gives people the space to engage on their own terms and warm up to the idea of working with you.

How can a new or expanding practice attract patients without cold calling?

Start by getting clear on your ideal patient and the specific problem you solve. From there, consider community-based approaches like having a booth at a local farmers’ market, joining networking groups like BNI or your local chamber of commerce, building reciprocal referral relationships with nearby practices, and investing in intentional digital marketing that reflects your area of expertise.

How do you build referral partnerships with other healthcare practices?

Focus on relationship first. Get to know providers in your building or community, join local networking groups, and create reciprocal arrangements where you’re genuinely looking out for each other’s patients. Tracy emphasizes treating each referral partnership as the gift it is—healthcare is personal, and so should the professional relationships that support it.

Episode Highlights

Why cold calling creates barriers to trust in healthcare settings

The critical distinction between cold calling and cold outreach

How 82–86% of patients start their healthcare journey online

Why the instinct to actively pursue patients is valid—but needs redirecting

Practical alternatives: farmers’ markets, BNI groups, chamber memberships, and community involvement

How to build referral partnerships between practices

The importance of getting clear on your ideal patient before choosing any marketing strategy

Why clarity and service-minded energy matter even if you decide to stick with cold calling

Memorable Quotes

“People are busy. A cold call can feel very intrusive, and it does something to interfere with the potential of a relationship.” — Tracy Cherpeski

“Healthcare is so incredibly personal that it’s important to treat it like it’s personal and treat each relationship like the gift that it is.” — Tracy Cherpeski

“The instinct to make the connection is there, and that’s a really good instinct. The question is, who are you trying to attract to your practice?” — Tracy Cherpeski

“You’ll probably get faster and more measurable results if you choose something that you can kind of track and really work with intentionally.” — Tracy Cherpeski

“Pause for a minute and just make sure that you’ve gotten incredibly clear about who it is that you serve, who’s your ideal patient, and what problem are you solving for them.” — Tracy Cherpeski

Growing a healthcare practice doesn’t have to mean picking up the phone and hoping for the best. The most effective path to sustainable patient growth starts with clarity—knowing who you serve, what problem you solve, and how you want to show up for your community. When you lead with relationship and intention, the right patients find you. If you’re ready to build a growth strategy that feels aligned with how you actually want to practice, visit thrivingpracticecommunity.com to schedule a consultation with Tracy.

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Tracy Cherpeski 2/11/26 Tracy Cherpeski 2/11/26

Consistent Marketing Over Perfect Campaigns: Growing Your Practice Without Overwhelm Featuring Kurt Hoffmann, EP 236

Marketing your healthcare practice doesn't require expensive campaigns or overwhelming social media strategies. In this episode, Kurt Hoffmann, founder of Abra Marketing, explains why consistent, authentic marketing is part of your mission as a healthcare provider—and how to make it manageable when you're already stretched thin.

Marketing your healthcare practice doesn't have to mean expensive campaigns or overwhelming social media strategies. In this episode, Kurt Hoffmann, founder of Abra Marketing, shares why consistent, authentic marketing is actually part of your mission as a healthcare provider—and how to make it manageable even when you're already stretched thin.

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If you've been struggling with time management for healthcare practice owners while trying to grow your patient base, this conversation offers a refreshing perspective. Kurt explains why running a profitable medical practice starts with understanding that your patient experience is your marketing, and why the practices that thrive are the ones that show up consistently in their communities, not the ones that launch big campaigns and disappear.

Whether you're wondering how to run a successful medical practice without burning out or looking for practical strategies to grow your practice in a sustainable way, Kurt's insights on storytelling, community connection, and realistic marketing programs will help you move forward with confidence.

Key Takeaways

Marketing is mission-driven work: Healthcare providers have a responsibility to close the gap between people suffering and the solutions that can help them

Consistency beats perfection: Showing up monthly with something simple outperforms sporadic big campaigns

Your patient experience IS your brand: Marketing doesn't start with ads—it starts the moment a patient tries to contact your practice

Focus creates opportunity: Marketing one specific service doesn't limit your other offerings; it creates a gateway for patient relationships

Human connection is your competitive advantage: In an AI-driven world, practices that prioritize real human interaction stand out

Q&A

Why do healthcare practices need marketing? Because we live in a world of imperfect information. People in your community may be suffering not because solutions don't exist, but because they don't know about them or don't know where to find help. Marketing closes that gap between patient needs and provider solutions.

What's the biggest mistake practice owners make with marketing? Feeling overwhelmed and doing nothing, or launching big campaigns that aren't sustainable. The most successful marketing programs are consistent, modest efforts every single month—not occasional big splashes followed by months of silence.

How much should patient experience factor into marketing strategy? Patient experience IS marketing. Your brand isn't your logo—it's what everyone thinks and feels about your practice. If you're getting negative reviews about front desk interactions, no amount of advertising will overcome that. Start by looking at the complete patient journey from first contact through follow-up care.

Can I market a specific service without losing patients for other services? Absolutely. Focusing your marketing on one signature service or procedure creates a gateway for patient relationships. Once someone has a great experience with you for one service, they become both repeat clients for other needs and referral sources for friends and family.

Episode Highlights

Kurt's origin story: from healthcare marketing to the music industry and back again, with fresh perspective

The question that shaped his career: "Why do we need marketing?" from a chief of staff in his first weeks on the job

How Abra Marketing turned a martial arts school's story into a 30-minute documentary that changed their reputation in the Bay Area fight community

Why lighting a bridge pink for breast cancer awareness drew thousands and became a game-changing community event

The tracking study that revealed huge volumes of appointments come from repeat business and referrals—proving that every new patient opens a pipeline of future business

Practical advice on responding to negative reviews in ways that actually improve your reputation

Why practice owners should look for 2-3 marketing channels that feel natural rather than trying to be everywhere

The shift toward human connection as a differentiator in an increasingly automated world

Memorable Quotes

"We live in a world of imperfect information. You can't assume that people know about all the cures that are out there for the things they're suffering from. That is why I love marketing—we close that gap."

"Your brand is not your logo and your name. Your brand is what everybody thinks about your practice. So start with taking a hard look at why do people love your practice and what could be some things working against you that you could fix."

"The best marketing programs are just consistent—being out there every month doing something—versus a huge project where you do this big splash and then you don't do anything for months."

"You have a mission to market. A lot of people are suffering not because there's not a solution to what's ailing them, but they don't have the information of who can help them or that there is a new solution that can quickly help them."

"Someone's life is better because of you. That's our tagline, and it honors the important work that providers do. Our role is to close that gap and help you tell your story to the people who need to hear it."

Internal Linking Opportunities

When discussing time management and feeling overwhelmed: "Just as we teach practice owners about time leadership strategies for managing admin work, effective marketing requires the same principle—doing fewer things consistently rather than everything sporadically."
In the section about patient experience: "This connects directly to what we discussed in Episode on practice operations and patient satisfaction about how every touchpoint matters in building your practice reputation."

Healthcare marketing doesn't have to be complicated or overwhelming. Start with what Kurt calls the mission to market—remembering that consistent, authentic connection with your community helps patients find the care they need. Pick one or two channels that feel natural, show up every month, and tell your story. Your patient experience is your brand, and your willingness to connect on a human level is becoming your biggest competitive advantage.

Ready to build a marketing strategy that aligns with your practice values and actually fits into your schedule? Visit PracticeSuccess.co/resources for tools and frameworks designed specifically for independent practice owners.

Guest Bio:

Kurt Hoﬀmann has worked in healthcare marketing since the 1990s.

Kurt founded Abra Marketing in 1999 and has since competed hundreds of healthcare

marketing projects for global healthcare companies such as Medtronic and Smith+Nephew as well as local practices/hospitals and clinics.

Abra’s strength is digital marketing programs that help local practices and providers connect with the patients they can help.

Find Kurt:

Website

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Tracy Cherpeski 2/4/26 Tracy Cherpeski 2/4/26

Three Healthcare Experts, One Solution: How to Future-Proof Your Practice When Everything Feels Urgent, EP 235

In this episode, Tracy breaks down her recent "Future-Proofing Healthcare Leadership in 2026" roundtable featuring Marc Chow (CEO of Santa Clara County Medical Association), Aaron Gold (strategic CFO), and Stephen Fogg (healthcare marketing strategist and AI innovation specialist). Despite approaching practice management from completely different angles - policy, finance, and innovation - all three experts confirmed the same fundamental truth about how to actually move forward when the ground keeps shifting.

What happens when a Silicon Valley policy leader, a strategic CFO, and an AI innovation specialist walk into a roundtable about healthcare leadership? They all arrive at the exact same conclusion - independently. And it's the framework Tracy has been teaching practice owners for years.

See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

If you're feeling overwhelmed by everything coming at you in 2026, this episode gives you permission to simplify. Because complexity isn't your problem - trying to solve everything at once very likely is.

Key Takeaways

The expert consensus: Three heavyweight experts from different domains independently confirmed the same approach - choose what needs the most work, break it down to a simple implementable task, build from there

Policy reality check: Track your baseline on pain points like Medicaid patient volume, uncompensated care, and prior authorization hours before trying to solve the entire system

Financial clarity: Start with one metric - revenue per patient - then segment by patient type to understand which segments are actually sustainable

Innovation without overwhelm: Use Stephen Fogg's four-quadrant framework (great, good, could improve, bad) to identify your worst pain point, then implement ONE tool to address it

The methodology works: Whether you're navigating policy chaos, financial pressure, or innovation overwhelm, the solution is the same - start with one thing, make it implementable, build momentum

Q&A Section

How do you choose what to prioritize when everything feels urgent in your practice? Use Stephen Fogg's four-quadrant assessment: categorize what's great, good, could improve, and bad in your practice. Then focus on fixing your biggest "bad" first - not trying to improve everything simultaneously.

What's the one financial metric practice owners should track closely right now? Revenue per patient. Start broad, then break it down by patient type (Medicare, Medicaid, commercial, cash pay) to understand which segments are profitable. If policy shifts your patient mix, you need to know if that mix is sustainable.

How does the Time Leadership Framework connect to managing policy, finance, and innovation pressures? Both approaches solve for the same problem: how to choose what matters when everything feels urgent. The framework helps you decide what needs your clinical expertise, what can be delegated, what can be systematized, and what can be eliminated - so you're not trying to do everything at once.

What's the first step to take when prior authorizations are burning out your staff? Document your baseline first. Track exactly how many hours per week your staff spends on prior authorizations. That documentation becomes your advocacy ammunition and helps you make the business case for solutions.

Episode Highlights

Why three healthcare experts from different domains all arrived at the same fundamental conclusion about managing overwhelm

The forces reshaping healthcare in 2026: Medicaid cuts affecting 20% of enrollees, prior authorization consuming 10-12 staff hours weekly, and trust erosion in public health institutions

Marc Chow's policy perspective: Start by documenting one pain point this week - not solving the entire system

Aaron Gold's financial strategy: Understanding which patient segments are actually profitable before policy shifts your mix

Stephen Fogg's innovation framework: The four-quadrant assessment for identifying where your practice is hurting most

The AI implementation trap: Why teams get Copilot licenses, nobody gets trained, nobody uses it, and money gets wasted

How Stephen's quadrant framework maps directly onto the Time Leadership Delegation Quadrant

Why complexity is the enemy of implementation - and what to do about it

The validation piece: When independent experts confirm the same methodology from different angles

Memorable Quotes

"Complexity isn't your problem. Trying to solve everything at once very likely is."

"Most practice owners I work with aren't failing because they don't know what needs to be done. They're failing because they're trying to do ALL of it at once."

"You don't need more information. You need clarity on what to prioritize and a simple next step you can actually take."

"Whether the ground is shifting beneath you because of policy changes, financial pressure, or innovation demands - the solution is the same: Start with one thing. Make it simple. Make it implementable. Build momentum."

"Complexity is the enemy of implementation."

Resources Mentioned in This Episode

Future-Proofing Healthcare Leadership in 2026 Roundtable Replay - Full 90-minute recording with Marc Chow, Aaron Gold, and Stephen Fogg. Request the replay and highlights document.

Time Leadership Delegation Quadrant - Tracy's framework for deciding what needs your expertise, what to delegate, systematize, or eliminate. Click to request.

Future-proofing your practice in 2026 doesn't mean mastering policy, finance, and innovation simultaneously. It means choosing the one thing causing the most pain right now, taking the simplest first step this week, and building momentum from there. When three experts from completely different domains independently confirm the same approach, that's not coincidence - that's validation of what actually works when you're navigating uncertainty.

Ready to apply this framework to your specific situation? Book a strategy call with Tracy at TracyCherpeski.com to talk through your priorities and build your implementation plan.

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Tracy’s Bio:

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Website Accounted4LLC.com

Tracy Cherpeski 1/28/26 Tracy Cherpeski 1/28/26

"Am I Actually Making Money?" Understanding the Numbers That Matter Most in Private Practice Featuring Sean Healy and Keith Campagna, EP 234

Running a profitable medical practice requires more than clinical excellence—it demands financial clarity that most healthcare providers were never trained to achieve. Many practice owners find themselves caught in a frustrating paradox: their accountant tells them they're profitable, yet their bank account tells a different story. Cash flow problems persist, credit card debt grows, and the question "am I actually making money?" remains unanswered.

In this episode, Tracy sits down with Sean Healy and Keith Campagna from Accounted For LLC to explore the critical difference between cash flow and profitability, and why understanding both is essential for building a thriving practice without burnout. Sean and Keith have spent seven years developing a comprehensive approach that goes far beyond traditional bookkeeping to include insight extraction and strategic coaching specifically designed for private practice owners.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Whether you're struggling with time management for healthcare practice owners, trying to build a profitable medical practice, or simply want to run a successful medical practice without the constant financial stress, this conversation offers practical frameworks and strategic guidance you can implement immediately.

Key Takeaways

The cash flow vs. profitability gap is real: Most accountants focus on profitability for tax purposes, but practice owners operate in cash flow reality—understanding the difference is crucial for making sound business decisions.

Hope is not a strategy: While gut instincts are often correct, running "napkin math" before major decisions helps validate or challenge assumptions and prevents costly mistakes.

Three-part approach to financial clarity: Effective financial management requires data management, insight extraction from that data, and coaching to take action on those insights.

You're not alone in this struggle: The challenges you face as a practice owner are systemic across the industry—asking for help is a strategic advantage, not a weakness.

Goals must be quantified: Knowing you need 20% profit isn't enough—you need to know exactly what profit level gets you to your specific retirement and lifestyle goals, then work backward from there.

Q&A

Why do practice owners struggle to understand if they're actually making money? Most accountants present profitability (which drives tax liability), while business owners operate in cash flow reality. This creates a significant disconnect where someone can be "profitable" on paper while struggling to make payroll or watching credit card debt increase. The two metrics tell different but equally important stories about practice health.

What makes Accounted For LLC different from traditional bookkeeping services? While traditional accounting firms manage data to file tax returns, Accounted For LLC manages data to extract insights, then provides coaching to help practice owners take action on those insights. Their approach combines financial analysis with accountability and strategic guidance specifically tailored to private practice ownership challenges.

How much profit does a practice actually need to be successful? The answer isn't a generic percentage—it's however much profit you need to achieve your specific goals. Most practice owners say 20%, but the real question is: have you quantified your retirement goals, lifestyle needs, and legacy objectives? Once you know those numbers, you can determine if your current business model will get you there or if significant changes are needed.

What's the first step practice owners should take to gain financial clarity? Start with a complimentary financial analysis to understand what story your numbers are telling. Getting a second set of eyes on your financials—and slowing down to truly understand cash flow versus profitability—can reveal opportunities you're missing and help you make more informed strategic decisions.

Episode Highlights

The origin story of Accounted For LLC and the simple question that started everything: "Am I making money?"

Understanding why healthcare training creates a psychological barrier to asking for help with business challenges

The bow and arrow analogy: how financial clarity acts like a laser sight for hitting your business targets

Why "slowing down to speed up" is essential before making major business decisions

The three components of effective financial management: data, insights, and coaching

How capacity and goal-setting can transform practice performance without additional hiring costs

The importance of weekly strategic partnerships and peer networks for business owners

Why most practice owners' gut instincts are correct—they just need validation through the numbers

Memorable Quotes

"Hope's not a strategy." - Sean Healy

"You're not alone. The same trend is there. They feel like they're alone, but they're not... Ask for help and you'll feel better sooner." - Keith Campagna

"All change starts with self awareness." - Sean Healy

"Does this mean I'm going to sleep better? That was all she needed to ask." - Keith Campagna (sharing a client's response after their financial assessment)

"Prescription before diagnosis is malpractice. That applies to business too." - Sean Healy

The journey from wondering "am I making money?" to confidently leading a profitable practice starts with asking for help and gaining clarity on what your numbers are actually telling you. Sean and Keith remind us that the struggles practice owners face aren't unique—they're systemic across the industry—but the solutions become clearer when you have the right partners and tools in place. Whether you need a comprehensive financial partnership or simply want a second set of eyes on your current situation, taking that first step toward financial clarity can transform not just your business outcomes, but your sleep quality and overall wellbeing.

Guest Bios:

Sean Healy and Keith Campagna are the driving forces behind Accounted For LLC, a financial services company built specifically for private practice owners who need more than traditional bookkeeping. Founded seven years ago from a single client question—"Am I actually making money?"—Accounted For bridges the gap between profitability and cash flow with CFO-level insights at a fraction of the typical cost.

Their approach combines three essential elements: data management, insight extraction, and strategic coaching. Whether you're struggling with cash flow, planning to scale and grow your practice, or simply want to make informed decisions with your money, Accounted For uses your accounting data as a platform to provide actionable perspective. Their proactive, outcomes-driven methodology helps practice owners focus on what matters most while gaining the financial clarity needed to sleep better at night.

Accounted For offers a complimentary financial analysis to any practice owner who wants to understand what story their numbers are telling. This no-obligation assessment often reveals money being left on the table and provides insights you can keep regardless of whether you choose to work together.

Find Sean & Keith:

Keith on LinkedIn

Sean on LinkedIn

Inquire: email Keith kcampagna@accounted4llc.com

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Tracy Cherpeski 1/23/26 Tracy Cherpeski 1/23/26

The Multiplier Mindset: Why Subtracting Is the Key to Practice Growth – A Special Snack Episode, EP 233

More than half of healthcare practice owners report burnout, and the traditional response—working harder, seeing more patients, adding more services—keeps them trapped in a cycle that never delivers the freedom they imagined. In this SNACK episode, Miranda Dorta interviews Tracy about the 10x practice owner mindset and why sustainable practice growth requires subtraction, not addition.

If you're a healthcare practice owner working harder than ever but still feeling stuck, you're not alone. More than half of practice owners report burnout, and most respond the same way: seeing more patients, adding services, extending hours. But what if the path to practice growth and freedom isn't about doing more—it's about doing less?

In this SNACK episode, Miranda Dorta turns the microphone on Tracy to explore the 10x practice owner mindset framework. This isn't about working 10 times harder or even necessarily earning 10 times more revenue. It's about asking fundamentally different questions that shift you from operator to owner.

Tracy shares why the biggest obstacle to sustainable practice growth is often a single belief: that you're responsible for doing everything. Even practice owners with capable teams and solid delegation systems hit invisible ceilings because of this mindset. The solution? Learning to subtract in order to multiply.

Key Takeaways

The core problem: Practice owners stay stuck when they believe they must personally handle everything, even with capable teams in place

10x thinking means subtraction: Ask "What would I need to subtract in order to multiply?" rather than automatically adding more

The multiplier mindset test: If you could only work 2-3 days a week, would your practice continue to grow? If not, you're still in operator mode

Focus on what only you can do: The highest-value use of your time is activities that require your specific expertise, credentials, or unique skills

The smallest shift creates the biggest ripple: Getting curious about how things could be different if you didn't have your hands on everything is the starting point for real change

Questions Answered in This Episode

What keeps practice owners stuck on the hamster wheel? The biggest driver is believing you're responsible for doing everything in your practice. Even when you have a strong team and have delegated well, there's often still a mindset block that prevents real progress and keeps you in the day-to-day operations rather than leading strategically.

What does 10x thinking actually mean for practice owners? It's not about 10x-ing your effort or necessarily your revenue. It's about asking: "What would it take for this to multiply?" and "What would I need to subtract in order to multiply?" Most practice owners think they need to add more to grow, but sustainable growth often requires removing things that no longer serve your trajectory.

How do I know if I have a multiplier mindset? Ask yourself: "If I could only show up two or three days a week, would the practice continue to grow?" If the answer isn't yes, you're not yet thinking like a multiplier. This question makes every practice owner nervous—even those who intellectually know they should reduce clinical time—but it reveals exactly where the mindset shift needs to happen.

What should I eliminate first when trying to reduce my time in the practice? Start with your clinical load. Look at what's on your clinical calendar that could be handled by someone else on your team. Ask: "What are the activities that only I, the owner, can do?" Tracy shares an example of a board-certified psychologist who eliminated routine ADHD screenings to focus exclusively on high-level DOJ and Department of Corrections cases that required her specific certification. She reduced clinical time while maintaining billable hours by focusing on what only she could do.

Episode Highlights

The "do everything" belief that keeps practice owners trapped in operator mode

Why sustainable growth requires subtraction, not addition—and what that looks like in practice

The multiplier mindset test: Could your practice grow if you only worked 2-3 days a week?

Real example: How a psychologist maintained revenue while working less by focusing on high-level cases

Constraint-based thinking: Using time limitations as a strategic tool for growth

Why every practice owner feels fear around letting go (and why you should do it anyway)

The physical responses you might experience when doing this mindset work

How to identify which systems need attention and which activities require your unique expertise

The importance of backup systems so you're never hamstrung by a single point of failure

The smallest mindset shift that creates the biggest ripple effect in your practice

Memorable Quotes

"What would I need to subtract in order to multiply? A lot of times we think we need to add in order to multiply."

"If I could only show up two or three days a week, would the practice continue to grow? And if the answer is not yes to that, then they're not in a multiplying mindset."

"What are the activities that only I, the owner, can do? That's where your time should go."

"You don't have to let go of the fear—I think you just do it scared. But you have to trust the process."

"Just start to get a little bit more comfortable with the idea of your hands not touching every single process. Just imagine it. You don't have to do anything about it yet."

The path to a thriving practice isn't paved with longer hours and more hustle. It's built on strategic thinking, intentional subtraction, and the willingness to let go of control—even when it feels uncomfortable. If you're ready to shift from working in your practice to leading it, start by getting curious about how things could be different if you weren't touching every single process.

Ready to develop your multiplier mindset? Visit thrivingpracticecommunity.com to schedule a consultation with Tracy and learn how to build a practice that grows without burning you out.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Miranda’s Bio:

Tracy’s Bio:

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Tracy Cherpeski 1/21/26 Tracy Cherpeski 1/21/26

Bridging the Specialist Gap: How Virtual Consultations Transform Veterinary Practice Management Featuring Dr. Kenneth Pierce, EP 232

Dr. Kenneth Pierce shares how virtual specialist consultations improve veterinary practice management, patient outcomes, and prevent burnout for practice owners.

When Dr. Kenneth Pierce opened Veterinary Vision Center in Shreveport, Louisiana, he became the first permanent veterinary ophthalmologist in a region where pet owners had been driving three to four hours for specialty eye care. But addressing that local gap led him to recognize a much larger systemic problem: the nationwide shortage of veterinary specialists creates accessibility challenges that affect patient outcomes, strain general practitioners, and burden pet owners financially.

His solution, Vespecon, offers a scalable model for bridging the specialist gap through virtual consultations that empower general practitioners while improving care. For practice owners in any healthcare specialty looking at how to run a successful medical practice without burning out, Dr. Pierce's approach demonstrates how strategic delegation and access to expert support can transform both clinical outcomes and practice sustainability.

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Key Takeaways

The specialist shortage is real and growing: There's a significant gap between the number of general practitioners produced annually and the number of specialists across veterinary medicine—a disparity that will never catch up and leaves large regions underserved

Virtual consultation models work: Unlimited access to face-to-face specialist consultations empowers general practitioners to deliver elevated care locally, improving patient outcomes while reducing costs for pet owners

Trust is the foundation: When veterinarians can confidently say "I've consulted with a specialist, and here's the plan" instead of "I don't know," it strengthens the veterinarian-client relationship and leads to better compliance with treatment recommendations

Asking for support strengthens leadership: Whether it's clinical knowledge or business operations, seeking expert guidance isn't an abdication of responsibility—it's strategic leadership that prevents burnout and improves outcomes

Business support is clinical support: Addressing HR needs, financial planning, and leadership coaching helps practice owners focus on clinical excellence while building sustainable, profitable practices

Q&A

Why do veterinarians need access to specialist consultations? Most veterinary specialists concentrate in metropolitan areas, leaving vast regions of the country without local specialty care. This means pet owners face long drives, high costs, and delays in treatment. General practitioners often lack specialist guidance for complex cases, creating stress and potentially suboptimal outcomes.

How does Vespecon's virtual consultation model work? Veterinary practices can access unlimited face-to-face virtual consultations with specialists across all fields through a membership model. The personal, conversational approach allows specialists to educate and empower general practitioners, confirm they're on the right track, and provide specific guidance—all without the client needing to travel or pay specialist fees directly.

What's the business case for unlimited specialist access? When veterinarians have confidence and specialist backing, they can handle more cases locally, deliver better outcomes, and build stronger client trust. This leads to increased revenue, higher client loyalty, and better practice profitability—while simultaneously improving patient care and reducing costs for pet owners.

How does business advisory support help prevent veterinary practice burnout? Practice owners wear multiple hats—clinician, business owner, strategist, team leader, and more. Having access to HR support, financial advisors, and leadership coaching means they can focus on clinical excellence while experts handle business operations, team culture issues, and crisis management when needed.

Episode Highlights

Dr. Pierce's journey from wanting to be a doctor who didn't work on people to becoming a veterinary ophthalmologist

Why ophthalmology specifically appealed: the eye as a unique organ, microsurgery, and the variety of species

The reality of veterinary specialist shortages and geographic concentration in metropolitan areas

How Vespecon removes the barrier of saying "I don't know" for general practitioners

The uncomfortable reality of financial discussions in veterinary care and how specialist guidance eases that stress

Why asking for business support isn't abdication—it's strategic leadership

The importance of "hat switching" between clinician and business owner roles

Business advisory services including HR, financial guidance, and leadership coaching for veterinary practices

How treating a goldfish's eye problem demonstrates the breadth of veterinary ophthalmology

The ripple effects of better access: improved outcomes, cost savings, reduced stress, and stronger trust

Memorable Quotes

"There's got to be a better way and a more personal approach—specialists you're talking to should be fully invested, not just someone on the other line who may not answer your questions appropriately."

"With the membership, veterinarians have unlimited consultations. We recommend they don't even charge the client for that. Get the knowledge, deliver that elevated level of pet care, and clients will spend more money, be more loyal, and you'll have better patient outcomes."

"The vulnerability of saying 'I don't know' is taken away. That barrier is gone. Veterinarians have access, they can do more, and they prove themselves as stellar veterinarians—they just need a little guidance, not being a specialist."

"Asking for support and accepting support is not an abdication of your responsibility as a business owner and as a leader. It's actually a sign of strength that supports your leadership."

"You gotta lighten your load. You got enough stuff on your plate already. Life doesn't stop happening when we go to work, and if we own a business, it doesn't stop happening when we leave the building either."

Whether you're a veterinarian, physician, dentist, or any other healthcare practice owner, Dr. Pierce's model offers valuable lessons about identifying systemic gaps and creating solutions that serve everyone in the care continuum. The principle applies universally: when you remove barriers to knowledge, empower practitioners with expert support, and address both clinical and business needs holistically, you create sustainable practices that prevent burnout while improving patient outcomes. If you're ready to explore how strategic support can transform your practice, join the Thriving Practice Community where we help independent practice owners build profitable, sustainable businesses without sacrificing their wellbeing.

Guest Bio:

Dr. Kenneth Pierce is a native New Orleanian. He received his undergraduate degree from Tuskegee University and his Doctorate of Veterinary Medicine from Louisiana State University’s School of Veterinary Medicine. He completed a small animal medicine and surgery internship at the University of Tennessee’s College of Veterinary Medicine and then traveled to Southern California to complete a specialty ophthalmology internship with Eye Care for Animals and B. Braun, Inc. He then completed a four-year comparative ophthalmology residency with a master’s degree at Michigan State University. Dr. Pierce started as an Associate Professor at LSU’s School of Veterinary Medicine and then transitioned to private practice at Garden State Veterinary Specialists in Tinton Falls, NJ, Veterinary Eye Institute, in Plano, TX, and then started his own business, Veterinary Vision Center, in Shreveport, LA. After experiencing and working in an underserved area with limited access to veterinary specialty care, Dr. Pierce started VESPECON, a veterinary specialist to primary veterinarian advisory support, concierge referral service, and more! As you can see, Dr. Pierce has lived in every region of the United States and has gained valuable experience to educate and empower the veterinary community.

Find Dr. Pierce:

Website

Facebook

Instagram

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Tracy Cherpeski 1/14/26 Tracy Cherpeski 1/14/26

The Three-Year Journey: How One Physician's Burnout Led to Helping Others Reconnect Featuring Dr. Shelina Jaffer, EP 231

Dr. Shelina Jaffer's burnout didn't announce itself with fanfare. Like so many physicians managing demanding practices, she normalized the warning signs—gastritis, reflux, exhaustion—until her body forced a reckoning with late-onset asthma and a moment of emotional darkness she couldn't explain away. Her story is textbook physician burnout, yet her response was anything but typical. Instead of simply stepping away from a toxic role, Shelina embarked on a three-year journey of self-discovery that led to the creation of Haven Within, a program helping healthcare professionals reconnect with their inner wisdom before burnout takes hold.

In this episode, Shelina shares how she moved from acute medicine and general practice in the UK through the classic progression of burnout—taking work to weddings in Canada, explaining away physical symptoms, operating on autopilot until her body said enough. But the real story begins with her recovery: how immediately her symptoms improved when she changed roles, and how that shift opened space for deeper questions about identity, purpose, and what it means to thrive rather than simply survive in healthcare.

Today, Shelina works with organizations, universities, and individuals through Haven Within, facilitating experiential sessions focused on four key stages: discovering who you are through others' eyes, exploring your values, identifying limiting beliefs, and connecting with your deeper purpose. Her work addresses something fundamental that traditional wellness programs miss—respect, trust, and the simple act of slowing down to reconnect with yourself.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Key Takeaways

Classic burnout progression often looks like being a "good, hard worker" until physical symptoms force recognition

Changing work environments can produce immediate physical relief, but full recovery takes time (Shelina's took three years)

Organizational culture built on respect and trust increases innovation, creativity, and productivity—not just employee wellbeing

Experiential learning that challenges participants to examine blind spots and limiting beliefs creates lasting shifts that 90-minute workshops cannot achieve

The shift toward human-centered approaches in healthcare is happening universally, driven by collective recognition that current systems are unsustainable

Q&A Section

What are the early warning signs of physician burnout that get normalized? Taking work home regularly (even to vacations), dismissing new physical symptoms as "just stress" or aging, and experiencing emotional flatness or darkness during patient interactions. These behaviors often look like dedication and professionalism, which is why burnout progression can be so insidious in healthcare.

How long does recovery from advanced burnout actually take? While symptoms may improve immediately upon changing work environments, full recovery takes considerably longer. Dr. Jaffer's experience shows that genuine healing and rebuilding capacity took three years—a timeline that challenges the quick-fix mentality often applied to burnout solutions.

Why do organizations resist investing in team wellbeing programs? Many leaders operate under the false assumption that prioritizing respect, trust, and work-life balance conflicts with financial success. However, when teams feel valued and trusted, they contribute more innovation and creativity, ultimately improving organizational outcomes and profitability.

What makes experiential learning more effective than traditional wellness workshops? Experiential programs challenge participants to actively explore their blind spots, limiting beliefs, and values through interactive exercises with peers. This creates personal accountability and insight that passive learning cannot achieve. The work continues beyond the session as participants integrate new awareness into their lives.

Episode Highlights

The textbook progression of physician burnout: from normalizing stress to physical symptoms (gastritis, reflux, late-onset asthma) to emotional darkness

The immediate physical relief Shelina experienced simply by changing to a role without management pressures—highlighting how occupational factors directly impact health

Haven Within's four-stage experiential process: discovering yourself through others' perspectives, exploring values, confronting limiting beliefs, and connecting with purpose

The university student who became bold after one session—demonstrating how early intervention can change career trajectories

Why organizations that prioritize respect and trust see better outcomes: valued teams contribute 200% and bring more innovation

The fundamental simplicity of what's needed: slowing down, connecting with yourself, and creating space to hear your own wisdom

The broader shift happening in humanity toward reconnection with ourselves and each other, away from the edges of our functional capacity

Memorable Quotes

"Everything that looks like being a good hard worker and a contributor and being a great physician is early stage burnout. It's what contributes to the pretty quick acceleration into advanced stages." - Tracy Cherpeski

"I literally walked in, saw my patients, went home, and I was like, wow, okay, I feel okay. It took a while for me to get back to where I am. It's been three years since that happened, and it's only now that I feel like I'm starting to want to do more." - Dr. Shelina Jaffer

"One of the students who was the quietest in the class, his feedback at the end was, 'You have taught me to be bold.' For me, that one statement was enough." - Dr. Shelina Jaffer

"If you respect your team, you trust your team, and they feel valued, they will give 200%. What's more is that they will be more innovative, more creative, and you'll get more out of your organization." - Dr. Shelina Jaffer

"We spend most of our lives in our workplace. Why do we need to be in a space that is weekend mentality? Monday is another beautiful day. If you love your job, why don't you love your job?" - Dr. Shelina Jaffer

If you've been feeling the early whispers of burnout—or if you're already deep in recovery—Shelina's story offers both validation and a path forward. Haven Within reminds us that reconnection with ourselves isn't a luxury; it's essential to sustainable practice and genuine wellbeing. The shift Shelina describes isn't just personal—it's happening across healthcare as professionals recognize that systems prioritizing respect, trust, and human connection actually produce better outcomes for everyone. Ready to explore what grounding and reconnection could mean for your practice? Connect with Dr. Shelina Jaffer through the links in the show notes.

Guest Bio:

Dr. Shelina Jaffer is a medical doctor with 20+ years in general and acute medicine, and extensive leadership experience driving system change. She is the founder of HavenWithin, a space that helps high-achieving individuals reconnect with what truly matters. Through guided journeys of conscious evolution, HavenWithin empowers leaders and teams to break limiting patterns, unlock potential, and align with their vision.

Find Dr. Jaffer:

Email: contact@havenwithin.co.uk

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Tracy Cherpeski 1/9/26 Tracy Cherpeski 1/9/26

Behind the Scenes: Generational Divides, Physician Unions, and What Practice Owners Really Want - A Special Snack Episode, EP 230

What happens when you put Tracy in the interview seat? In this SNACK episode, Miranda Dorta interviews Tracy about her recent speaking tour across California, where she taught burnout prevention for healthcare providers and earned CME credits for the first time. Tracy spoke with the Santa Clara County Medical Association and Fresno Madera Medical Society—and what she learned from those 200+ healthcare providers is shaping how she thinks about systemic challenges, workplace power, and what practice owners really need.

If you've ever wondered why some physicians leave large systems to start their own practices, or why generational divides are creating friction in healthcare workplaces, this episode offers eye-opening insights. Tracy shares what surprised her most, including a discovery about physician unions that raises important questions about workplace protections and power dynamics in healthcare.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Key Takeaways

Many practice owners started their practices after burning out in large integrated systems—and they're the ones finding the most work-life harmony

Residents in California can unionize (with protections around work-life balance), but attending physicians cannot

A generational divide is emerging: newer physicians are demanding better work conditions, while seasoned physicians feel both supportive and conflicted

Burnout prevention programs often miss the mark by putting responsibility on individual physicians when burnout is fundamentally a workplace issue

Physicians have more collective power than they realize—if systems can't function without their labor, change becomes possible

Q&A: Your Questions Answered

Why do practice owners seem to handle burnout better than employed physicians? According to Tracy's observations, practice owners who left large systems to start their own practices still work hard, but they have the most ease around creating work-life harmony. The key difference? They're working on their own terms, doing medicine the way they want to do it.

What's the biggest systemic challenge Tracy sees in healthcare burnout? The commodification of healthcare. Tracy explains that large healthcare systems are designed to extract physician labor, and burnout prevention programs that focus on individual resilience miss the point—burnout is a workplace problem that requires workplace solutions, not yoga apps and wellness seminars.

Why can't attending physicians unionize like residents can? In California, residents have unionization protections around work-life balance and fair treatment, much like strong nurse unions. But once physicians transition out of residency, those protections disappear. This creates a power imbalance that contributes to burnout and moral injury.

What did Tracy ask that made a room of employed physicians go silent? She asked: "What would happen if 50% of physicians walked out?" The uncomfortable truth is that without physicians providing the labor, healthcare systems can't function—which means physicians have more collective bargaining power than they realize.

Episode Highlights

Why Tracy said yes to speaking at California medical associations (and what made it meaningful)

The pattern Tracy noticed: practice owners who started practices after burning out in large systems

The generational divide in healthcare: residents demanding better conditions vs. seasoned physicians feeling conflicted

The surprising discovery about physician unions in California

Why burnout prevention puts unfair responsibility on individual physicians

The "moral injury" some physicians feel working within broken systems

Tracy's provocative question about what would happen if physicians walked out

How these speaking experiences are shaping the Thriving Practice Community

The universal truth Tracy keeps learning: humans want dignity, meaningful work, and the ability to care for their families

Memorable Quotes

"These were people who took a break, took a beat and decided, you know what? I want to do things on my terms. I don't want to leave medicine. I want to keep doing what I do. I just want to do it on my terms."

"There's this huge push for physician wellness...but it's still putting the onus on the physician to not get burnt out. But burnout, by definition, is a workplace challenge problem."

"Those systems are designed to extract your labor. And without you there providing the means of extraction, they can't function."

"What would happen if everybody walked out? ...You actually have more power than you believe."

"If you strip back everything else, including politics and the way to get there, and we just talk about what it is that people want, it's the same. ...At the end of the day, there are human beings walking around...having the same kind of experience as the rest of us are."

Tracy's speaking tour revealed something important: the challenges healthcare providers face are systemic, but individual practice owners have more agency than they might realize. Whether you're an employed physician considering your options or a practice owner working to create better conditions for yourself and your team, understanding these broader patterns can help you make strategic decisions about your career and your practice.

Ready to explore what's possible when you work on your own terms? Visit thethrivingpracticecommunity.com to schedule a consultation with Tracy and discover how strategic practice management can help you create the work-life harmony you're seeking.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

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Tracy Cherpeski 1/7/26 Tracy Cherpeski 1/7/26

The 66-Day Truth: Building Sustainable Change in Your Healthcare Practice, EP 229

If you're a healthcare practice owner who made New Year's resolutions this January, only to watch them crumble by February, you're not alone—and more importantly, you're not failing. After nearly 16 years of coaching highly credentialed business owners, Tracy Cherpeski has seen the same pattern play out repeatedly: resolutions fail not because practice owners lack discipline, but because resolutions themselves are fundamentally flawed for creating sustainable change in demanding healthcare practices.

In this solo episode, Tracy breaks down why traditional resolutions set practice owners up for failure and offers a strategic alternative that actually works. You'll discover the real science behind habit formation (spoiler: it's not 21 days), understand how your nervous system responds to change, and learn the three-pillar framework that successful practice owners use to create lasting improvements in both their practices and personal lives. This isn't another productivity hack—it's a completely different approach to building a thriving practice without burning out.

Whether you're struggling with boundaries, delegation, documentation backlogs, or simply feeling exhausted despite working harder than ever, this episode provides the strategic thinking tools you need to make 2026 different. Tracy shares personal examples, client success stories, and practical questions you can ask yourself right now to shift from reactive goal-setting to intentional, sustainable growth.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Key Takeaways

The 66-day reality: Research shows it takes an average of 66 days (not 21) for a new behavior to become automatic, with some habits requiring up to 254 days—meaning most resolutions die before they have a chance to stick.

Three pillars of sustainable change: Discovery (what actually needs to change based on your values and capacity), Analysis (the smallest viable shift that creates the biggest impact), and Action (tactical pathways that work with your current reality, not fantasy schedules).

Systems beat willpower every time: Clinical decision-making depletes your willpower reserves all day, leaving nothing for personal goals. Building systems that run automatically eliminates the need for constant willpower and creates lasting change.

How you change personally mirrors your leadership: Practice owners who make reactive resolutions typically make reactive business decisions—adding services without strategy, implementing systems without training, and burning out their teams in the process.

Self-compassion predicts success: Research shows self-compassion is a stronger predictor of sustainable behavior change than self-discipline because it replenishes your reserves instead of depleting them.

Q&A

Why do New Year's resolutions fail for healthcare practice owners? Most resolutions are born from a place of "not enough" and ask you to add more to an already maxed-out nervous system. They demand sprinting energy when you need sustainable marathon pacing, layering changes onto a capacity that's already overflowing while you're navigating burnout, staffing challenges, and the daily weight of patient care.

How long does it really take to form a new habit? A 2009 study in the European Journal of Social Psychology found it takes an average of 66 days for a new behavior to become automatic—not the mythical 21 days most people believe. For some habits, it took participants up to 254 days. This means sustainable change requires getting through the "messy middle" between initial excitement and actual automation, which is exactly when most resolutions fail.

What's the alternative to traditional resolutions? Choose one thing for Q1 (not 10 things for the year), make it so small it feels almost silly, build the system before you need willpower, and commit to 66 days with built-in grace. Focus on consistency over time rather than perfection in the moment, and work with your natural wiring instead of against it.

How does nervous system regulation connect to sustainable change? Your nervous system's job is to keep you alive, and to your nervous system, familiar feels safe—even if familiar is exhausting or making you miserable. Change registers as a potential threat, which is why you can know intellectually you need better boundaries but still feel anxious setting them. You cannot create sustainable change from a dysregulated nervous system without nervous system support practices built into your change infrastructure.

Episode Highlights

The science behind why the 21-day habit myth sets us up for failure and what the actual research reveals about lasting behavior change

Tracy's three-pillar framework: Discovery, Analysis, and Action for creating strategic change that sticks

Four critical mindset shifts: from "I should" to "I choose," from all-or-nothing to good enough is excellent, from willpower to systems, and from future self to present capacity

Real client examples: the night owl forced into 5 AM workouts, the practice owner who increased revenue 18% without adding hours, and the social media time drain that didn't move the needle

Why "subtract then multiply" beats adding more to your overflowing plate

The "slowdown to speed up" philosophy that creates faster, more lasting results in practice management

How missing one day is data but missing one week is a pattern that needs investigation

Practical questions to ask instead of making traditional resolutions, including "What's working that I want to amplify?" and "What would make this quarter feel spacious rather than cramped?"

Tracy's personal morning routine system with Norman the fuzzy cow, Cletus the baby cow, and Jaime El Rey the llama

The difference between self-compassion and self-indulgence, and why self-compassion is a stronger predictor of success than self-discipline

How your approach to personal change directly mirrors how you lead change in your practice

Memorable Quotes

"You are not failing at resolutions because you lack discipline. You're failing because resolutions themselves are a fundamentally flawed approach to sustainable change."

"The difference between people who successfully create lasting change and those who don't isn't willpower—it's whether they've built a strategic framework that can carry them through those 66 days and beyond."

"We don't want to grab a snow globe, turn it upside down and shake it with our life. That's not going to end well. It's always pretty in the snow globe. It is never pretty in real life."

"You cannot create sustainable change from a dysregulated nervous system. You'll keep reverting to old patterns because those patterns feel safer even when they're harmful."

"What if this year wasn't about becoming a better person, but about becoming more fully yourself? What if the goal wasn't more discipline but better strategy?"

"Research shows that self-compassion is actually a stronger predictor of sustainable behavior change than self-discipline. Because self-compassion doesn't burn through your reserves—it replenishes them."

"Burnout isn't just about the volume of work. It's about the mismatch between your values and your daily reality. It's about chronically operating outside your capacity."

The practices you build in your personal life directly shape how you lead your practice. When you move from reactive resolutions to strategic change—focusing on discovery, analysis, and grounded action—you model sustainable success for your entire team. You didn't go into healthcare to feel exhausted, resentful, and trapped. This year can be different, not because you push harder, but because you build smarter. Start with one small, strategic shift for Q1. Your future self is counting on the decision you make right now.

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Tracy Cherpeski 12/31/25 Tracy Cherpeski 12/31/25

The Iceberg Effect: How Winter Blues Ripple Through Your Healthcare Practice, EP 228

This episode offers a different approach to closing out 2025 and setting up 2026. Instead of bigger resolutions that fail by mid-February, we're exploring sustainable systems that actually work for busy practice owners. Tracy reflects on meaningful wins from 2025, addresses the reality of seasonal stress in healthcare practices, and shares why most January goals fail—along with practical frameworks for building practices that don't require constant heroic effort.

The Iceberg Effect: How Winter Blues Ripple Through Your Healthcare Practice, EP 228

The end of the year brings more than holiday obligations for healthcare practice owners—it often brings exhaustion that ripples through your entire practice. When you're running on empty, your team feels it. When you push through instead of pausing, your staff mirrors it. And suddenly everyone's pretending their way through December while practice culture slowly fractures.

If you're a practice owner struggling with burnout prevention, looking for sustainable practice growth strategies, or wondering how to reclaim your time while building a profitable medical practice, this episode provides actionable insights grounded in what actually works for independent practitioners.

Key Takeaways

Acknowledging difficulty is strategic leadership: When you validate what your team is experiencing, you reduce shame and people ask for help sooner—preventing small problems from becoming crises

Rest is foundation, not reward: Sustainable practice growth requires treating rest as the infrastructure you build on, not something you earn after pushing hard enough

Systems beat resolutions: Practice owners who successfully shift their businesses redesign one decision at a time, not by overhauling everything at once

The iceberg effect: Surface behaviors (missed deadlines, short tempers, mistakes) often signal deeper struggles beneath—seasonal depression, financial anxiety, caregiving exhaustion

Energy audits reveal patterns: Most practice owners don't realize where their energy actually goes until they start tracking what depletes versus restores them

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Q&A Section

Why do most New Year's goals fail for practice owners? Most resolutions focus on behavior change without addressing the systems that drive your decisions. When you run a practice, your daily choices aren'tjust about willpower—they're about infrastructure like what you track, how you schedule, who you trust with critical tasks, and where you spend your attention.

How do winter blues affect practice culture? Your stress doesn't just affect you—it ripples through your entire practice. Every forced smile when you're exhausted, every time you say "I'm fine" when you'redrowning, your team sees it and mirrors it. Eventually everyone's pretending their way through winter while the practice culture slowly fractures.

What's the difference between rest as reward versus rest as foundation? Rest as reward means you only allow yourself to rest after you've pushed hard enough or "earned it." Rest as foundation means acknowledging you're human, letting your nervous system actually settle, and creating space before you fill it back up again. The work will be here when you return, and you'll meet it better when you're rested.

What actually works instead of big January goals? You need smaller, repeatable systems that fit into how you already operate, then build on them—what we call "stacking habits." Successful practice owners shift their businesses by redesigning one decision at a time with practical frameworks that work in real practices with real constraints.

Episode Highlights

Tracy's 2025 wins: CME accreditation for wellness workshops, partnerships with Santa Clara County and Fresno Madera Medical Associations, Community of Practice gatherings launch, podcast reaching 51+ countries, Joy of Medicine Retreat in Yosemite, and the 10x Practice Owner Mindset Workshop

The story of Dr. Cheri's OBGYN practice: how one honest team huddle about seasonal stress revealed that everyone was drowning separately, each convinced they were the only one struggling

Four critical questions for ending the year: What drains my energy most right now? Where have I been expecting myself to be superhuman instead of simply human? How has stress affected the people around me? What am I carrying that could actually wait until January?

The Energy Audit Workbook: a five-day assessment to understand where you're hemorrhaging energy so you can make different choices before you hit empty

Tracy Cherpeski International's philosophy: closing for two full weeks every year (December 22-January 5) because rest is the foundation you build on

Two January 2026 opportunities: Community Open House (January 13) and Future Proofing Healthcare Leadership Leadership Roundtable (January 27)

Why strategic leadership means acknowledging difficulty: when you reduce shame, people ask for help sooner and small problems don't become crises

Memorable Quotes

"Your winter blues don't just affect you. They ripple through your entire practice. Every forced smile when you're exhausted, every 'I'm fine' when you're drowning, every time you push through instead of pausing, your team sees it, your staff mirrors it, and eventually everyone's pretending their way through winter while the practice culture slowly fractures."

"Rest is not a reward you earn after you've pushed hard enough. Rest is the foundation that you build on."

"When you acknowledge difficulty, you reduce shame. When you reduce shame, people ask for help sooner. When people ask for help sooner, small problems don't become crises. This isn't soft leadership. This is strategic leadership."

"Most resolutions focus on behavior change without addressing the systems that drive your decisions. When you run a practice, your daily choices are not just about willpower. They're about infrastructure."

"Practice owners who successfully shift their businesses do it by redesigning one decision at a time, not by overhauling everything at once."

As you close out 2025, remember that you don't have to have it all figured out. You don't have to show up perfect—just honest and willing to build differently. Whether you're feeling the winter blues right now or gearing up for January with fresh energy, the key is building sustainable systems that support your practice without requiring constant heroic effort. Join the Thriving Practice Community to connect with other practice owners who understand exactly what you're going through, and get the expert guidance you need to grow without burnout.

Resources Mentioned:

Energy Audit – Download here

January 13 Community of Practice Gathering (Open House for TPC) - Reserve your spot here

December Blog Post - Read Here

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