Dr. Jeremy Sharp (01:19)
Hey everyone, welcome back to the podcast. I’m glad to be here with you. Today we got a business episode talking about one of my favorite topics, which is how to run your business deliberately. Many of us fall into this trap that research would call you know an accidental business. In our case, that’s an accidental practice.
So I think a lot of us probably avoided or fled from institutional jobs, either at community mental health or hospitals or universities or wherever it may be, where there’s a lack of autonomy, heavy workload, and very little flexibility. But we go into private practice and somehow end up recreating that exact same situation, except now you are actually the employee who’s overworked and the incompetent boss.
And that is a real thing to get your mind around. So today we’re talking about how to bring joy and alignment back into your business as core metrics that you are that you’re looking at. All right. So a lot of us will, you know, fall into this trap of just doing the work. We keep our heads down, we see the clients, we don’t raise our fees, we don’t do an audit of our time, we don’t check out our software stack. we just kind of like roll along.
On autopilot and then wake up one day and realize that we are burned out. So I’ve talked about this a little bit on the podcast before, a lot on the podcast before, but I’ve never really put any research to it. And that is one of the differences today as I dig into some of the research on organization management and business and so forth over the years to yeah, put some context to this phenomenon of the accidental business and then course talk about what we can do to combat that.
So we’ll talk about a lot of different things. we will discuss the the trap of this accidental grind. So dig into that a bit more. talk about some upgraded ways to look at business development and a little bit of a framework for how to how to think about our business. We’ll talk about the actual drivers of burnout. there’s a big meta-analysis in 2026 about burnout and what causes it, and it’s a little surprising to be honest. We’ll do a practice inventory audit of sorts, and then we will talk about the importance of what you could call an executive day or a retreat, you know, think time, that kind of stuff.
But carving out some kind of deliberate space to actually work on your business to bring some joy and satisfaction back as metrics in your practice. So, if that sounds interesting to you, stick around. I think it’s super important.
Let’s go.
Dr. Jeremy Sharp (04:18)
All right, folks, we are back digging into this idea of the accidental grind and how to turn that around, bring a little more joy and maybe even fun into the work that we do. So like I mentioned, I mean, if you ask most of us why we went into private practice or left agency work or hospital or whatever, the reason that comes up a lot is flexibility and autonomy, something like that.
I mean, this is when I do workshops for emerging professionals, grad students, really anyone, and ask why they would consider private practice. autonomy and flexibility are two of the primary themes that come up a lot, right? So we try to avoid or get out of these high stress environments so that we can chase the freedom that comes with controlling our own calendar and you know, being our own clinical directors and
Architecting our lives the way that we want, right? But if we’re honest, I think a few years, if that, into running a practice, a lot of us realize that we have traded one version of the grind for another. without some kind of intentional, like repeatable strategy to review your business operations, we tend to fall directly into what you might call the accidental grind.
What this means is essentially what happens when you lose track of what actually brings you joy and you start operating out of obligation and fear and scarcity and all of those things that more often than not end up driving a lot of our decisions in private practice. So maybe you start out by answering answering like every single referral call because you’re terrified the phone’s gonna stop ringing. you keep like clunky, disjointed software tools or processes because you aren’t sure how to take.
Time to revise them or move to something new. You let your fee schedule pause or stagnate for years at a time because you feel guilt at raising your rates or you’re scared that people won’t pay them or whatever. And then all of a sudden you might look around and realize that you didn’t actually secure any autonomy. Instead, you have quietly slipped into the role of a highly stressed employee who is working for a deeply disorganized, reactive boss.
And you just happen to be both of those people in this equation, which is quite humbling. So what do we do? We put our head down, we power through the week, we say we just need to work harder, we promise ourselves that we will find time to make these changes, and you end up kind of losing track of the physical and emotional energy that comes with all of this grinding. and then
On the other side of the coin, the lack of joy and fulfillment that that we tend to bring to our practices. So you end up no longer like running a business that is fueled by your energy and you know your passion and your excitement, and you’re just kind of running a business that is fueled by a sense of survival and obligation. So if that is you, that’s okay. This is pretty normal. I think this is what happens. It’s you know built into a business development.
Business development stages, it’s like in the literature, this is a thing that happens. So my question to you today is what if we could flip that script entirely? Okay. What if the primary objective of your business wasn’t just survival and it wasn’t some like arbitrary goal of perpetual scaling or making more money or whatever it might be? it’s what if it was instead focused on like maximizing your joy and fulfillment and satisfaction?
In the work that you do. I think when we talk about business development, we’re culturally conditioned to think about numbers and market share and expansion and that kind of thing. But I don’t know, for me, the ultimate compass for a sustainable practice is your personal joy barometer, so to speak. And we can actually measure this by tracking a simple data point, which is energy generation versus energy drainage. Okay.
So to bring this to life just a little bit here in this prelude, think about your current work week. All right. When you look at your calendar, does the does does the design of your day generate professional energy or does it drain your cognitive reserves before you even step into your appointments? Okay. When we get totally clear on what brings us the most joy and fun in the work that we do, I think that emotional clarity ceases to be a luxury.
It ends up becoming the exact operational filter that we use to drive every practical decision in our business, from fees to daily workflows and other things. So if a choice that you’re making doesn’t protect your joy and fulfillment, my guess is it’s a choice that’s kind of born out of a false sense of obligation or fear or insecurity.
Okay, so when we think about burnout, there are there is some research out there, of course. and I’m gonna tackle it from this particular angle, where you know, when we surrender, so to speak, to this accidental grind where we’re choosing to just put our head down and like work harder out of this sense of obligation, you’re not just sacrificing personal happiness, you are also introducing pretty significant psychological strain into your daily life.
So we often tell ourselves that burnout is just like a logical consequence of working too many hours. But organizational psychology would tell us that the root cause is actually deeper than that. Burnout tends to occur when we lose our strategic direction and fall into role ambiguity. So where’s this coming from? There was a huge meta-analysis that came out in the Journal of Vocational Behavior and analyzed like 60 years of role stressor research.
Across over 500 independent studies. This is a huge meta-analysis. It was almost a million workers. And what they’re trying to do is isolate what actually destroys professional well-being and performance. And here’s what the data revealed: there’s kind of a definitive hierarchy among three primary workplace stressors. the first thing is what they call role overload. So this is simply like having a high volume of work.
And compressed timelines. I think a lot of us deal with this, okay? This is like too many reports to write and too little time, or too much admin work, too little time. Interestingly, the meta-analysis linked role overload primarily to physical health issues and baseline somatic complaints. So this is like your body kind of breaking down from long hours and too much work. The second thing they identified is role conflict.
So this is when you face mismatched competing demands. this a great example of this would be you know trying to balance the administrative tasks with the clinical tasks in your practice. could also be something like you know trying to run the practice, like you know, be like the business owner or the CEO versus doing the day-to-day admin work or clinical work.
So the data here identified role conflict as the single highest driver of clinical burnout and an individual’s explicit intent to leave an organization. Okay. So super relevant for community mental health, hospitals, that kind of thing. But third, and most importantly, I think for our discussion here, there is role ambiguity. So we’ve talked about role overload, role conflict, and now we have role ambiguity. So in role ambiguity,
This is defined as operating without clear goals, missing definitions of success, or working without a mapped-out strategy. This is where I think a lot of us fall in private practice. Unless you’re doing like pretty deliberate business planning, it’s really easy to fall into role ambiguity where we don’t have clear goals and we don’t know what success looks like.
So the most striking conclusion, I think, from this 60-year review is that role ambiguity, like I was just talking about, is by far the most detrimental workplace stressor overall. So the data show that role ambiguity alone is responsible for about a 70% drop in work engagement and an 80% decline in task performance. So when folks, including us, don’t have absolute clarity regarding their strategic direction, task
Commitment vanishes and cognitive fatigue tends to set in. So here’s the direct bridge between research and your daily reality. Role ambiguity is the psychological fuel of the accidental grind. When your strategy is ambiguous, meaning you don’t have a clear, deliberate plan for your own practice, it creates this kind of like internal vacuum.
And because you have no self-defined target for what success looks like, you kind of stop navigating by what brings you joy and you start navigating by these external obligations. Looking outside yourself at what the like capitalist culture would say you should be doing or what other practices are doing or whatever. And you adopt those goals just out of default. So when you’re operating your practice without a clear deliberate plan, you’re kind of forcing severe role ambiguity onto yourself every single day, right? Like you sit down, you come into your office
Constantly chasing a moving, kind of undefined target, trying to figure out what you should be doing next. and that constant second guessing just sort of drains the the energy that you need to do deep clinical work and actually run your business. Now, if you’re a group practice owner, keeping the operational strategy a secret or running on autopilot kind of forces this exact same role ambiguity onto your staff. so it just compounds across people. So they’re left guessing.
Whether they should be pushing for like more intakes or slowing down to focus on quality. Job specificity and strategic clarity are kind of the ultimate structural shields against a culture of obligation and burnout. So that’s specific, you know, for group practices. So, okay, what does this let’s bring this to life even more here? let’s talk about like accidental, like joy-destroying habits in a practice.
Okay. So when role ambiguity takes over and you start operating out of this external obligation rather than internal joy, you can like turn off your ability to spot operational friction, right? You just got your head down, you’re just doing the thing, you’re just getting through day to day, week to week. So the choice to stop actively planning for your own satisfaction, so to speak, manifests as, well, many things, but I’ve picked three specific.
Accidental habits that will you know that’ll take away from the joy and vitality in your practice. And these are things that I’ve seen, you know, personally, but in many practices that I work with as well. the first one is a stagnant fee schedule. So we will often avoid fee evaluations for years just out of fear or like inertia. So this is a habit that’s born entirely, I mean most of the time, out of clinical guilt, some false sense of obligation to the market.
The expense of your own well-being. Most of the time, you know, business consensus would demonstrate that failing to regularly index your fee against local inflation and operational overhead just means you’re essentially taking a compounding pay cut every year while you carry the exact same clinical liability. So when your fees are artificially low, because you feel obligated to carry that financial burden for your community, you’re kind of forced into roll overload.
Right? You’re working significantly harder, seeing more clients just to hit baseline financial needs. So that completely steals the fun out of your clinical work. Okay. So that’s the first thing is a stagnant fee schedule. The second thing is a misaligned caseload. So out of a reactive, oftentimes reactive need to maintain a full calendar or the misplaced obligation to answer every single referral that comes across your desk, we start accepting or assigning cases that fall entirely outside our clinical sweet spot.
You tell yourself that you should be able to help everyone, which is a symptom of operating from scarcity and obligation, rather than a deliberate strategy of alignment. When your schedule is packed with clinical presentations that don’t match your strata strengths or passions, then the work becomes emotionally exhausting. And you find yourself kind of like dragging your feet into your evaluations instead of feeling energized by this clinical process. Okay. So that’s a misaligned caseload.
And then the third thing that I’ve found is what I will call like clunky workflow or lack of consistent standard operating procedures or SOPs. So an SOP, standard operating procedure, is a simple, clear, repeatable recipe for administrative tasks. So when we as practice owners lack consistent SOPs, it’s usually because the owner, us, is trapped in some kind of obligation or like that head-down grind where you’re just
Just working in the business instead of taking the time to design on the business, right? So without these systems, these SOPs, every single administrative action becomes some like clunky, unpredictable, bottleneck-y kind of task. You end up like reinventing the wheel every time you onboard a new client, you process a billing error, you chase down documentation. and this lack of systems just creates a chaotic environment where you’re constantly.
Putting out operational fires instead of enjoying the business that you built. So that last one, clunky workflows and lack of consistent SOPs. So these are just three top-of-mind examples that can work against our desire to have more joy in our work. All right. So what do we do? What do we do? Y’all know with this podcast, there’s always a doing component. So I’m going to talk about the vehicle for helping some of this.
Conquering role ambiguity, putting aside these external obligations, and bringing our practice more into alignment with our own joy and satisfaction.
Dr. Jeremy Sharp (19:19)
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Dr. Jeremy Sharp (20:24)
So we need something like a dedicated process to get out of that daily grind and step into the visionary role. Okay, so that vehicle is what I would call a thinking day, or you could call it an executive day, or a planning day, or a business management day. Whatever you want to do, it’s a protected block of time completely.
Cut off from direct clinical care that’s dedicated solely to auditing your business operations through this lens of joy and fulfillment. All right. So whenever I talk about this with people, I can already hear like the immediate objection is I’m already drowning in work and I have a crazy wait list. My administrative to-do list is a mile long and I’ve got thousands of reports. I do not have time to take a whole day off to just sit around and plan.
Okay, so that’s legit, but I want to challenge that perspective very directly. The belief that you don’t have time to plan is the exact mechanism that keeps you trapped in that accidental grind. It’s a symptom of the scarcity and the obligation that we are actually trying to cure. So you can think of this executive day or thinking day, not as lost clinical revenue, but as a major, like exponential structural time multiplier.
So if you can slow down for two hours, four hours, six hours to build, let’s say, like a clean onboarding workflow, or write a consistent SOP, or strategically adjust your calendar to match what you actually want to do. this can easily alleviate, you know, an hour, two hours of time every single week just on the administrative side and like financial stress.
Whatever the value of that is, you know, over the subsequent year. So you’re spending a minor amount of time up front to buy back a huge quantity of future peace and mental clarity and clinical energy. So you have to stop telling yourself that you don’t have time to build a business that you actually enjoy.
And I recognize, all right. I recognize there are structural limitations in place sometimes, right? Like maybe you’re a single parent. maybe you just have young kids, maybe you care for an older adult, maybe you are the primary breadwinner and you know, feel like you have to continue to bring in this income. Maybe you don’t have, you know, means of getting away. maybe it’s seems financially impossible. There I know there are legitimate concerns that can make this tough. So I don’t want to present it like it’s a super easy thing to do, but I think it is absolutely worth consideration for how you might make this happen.
So when you can clear the space and actually step into this thinking day or planning day, I I’m a fan of having a structured way to actually evaluate your practice. All right. So I’m gonna start with a kind of a foundational standalone exercise to gauge your baseline capacity. Then we I’m gonna dive into, you know, three like targeted prompts that will directly address core practice areas and hopefully let you, you know, change out some of this obligation for intentionality and more joy.
Alright, so what’s the foundational step? So this is just the capacity and joy check. Okay. So this is a literal exercise. Before you look at a single other document or thing in your practice, I want you to either print out, well, yeah, print out. I think printing is good. Print out your calendar from the last 90 to 180 days. Okay, so that’s three to six months. You’re gonna take two highlighters of different colors, and I want you to go through and highlight every clinical hour, or meeting or administrative task that gave you energy and felt genuinely fulfilling in one color.
All right. Go through your calendar, highlight everything on the calendar that gave you energy and felt fulfilling. Then you’re going to use the second color to highlight every hour that left you feeling depleted, frustrated, bored, acting out of obligation, anything along those lines. All right.
Once you have that, you’re gonna have like a pretty clear visual cue of the balance of your energy. And this is kind of your baseline measurement of joy, right? So again, we’re using like energy generation as a proxy for joy. So your goal for the rest of the day is to use these three prompts to kind of systematically reduce the depleting color and expand The fulfilling colour. Okay.
So, prompt number one, this is a fee schedule audit. Look at your current fee schedule, compare it to your actual overhead costs, inflation data, and desired clinical hours. The question to ask yourself is: what baseline rate is required to make sure I’m making a sustainable living while capping my caseload at a level that preserves my personal well-being? Okay. I’ll say that again. What baseline rate
Is required to ensure I am making a sustainable living while capping my caseload at a level that preserves my personal well being. So this is essentially a capacity audit. You know, what do you have the capacity for? And then how much do you have to charge to reach the level of income that you need? I want you to write down a concrete data back plan to implement some kind of fee correction over the next quarter, trying to let go of the guilt that keeps your rates artificially low.
This can be hard for folks, right? I’ve done this exercise many, many times individually and in small groups and at my retreat each year. And people are always very hesitant. But it’s another example of a principle that I love, and that principle for you CBT folks, you know, they’re gonna recognize this is mood follows action. All right. So you can’t wait until you are ready to update your fees.
It’s probably gonna feel uncomfortable for most of us most of the time. So you can’t wait until you feel comfortable to change your fees. Just do it. Just do it. So write down some kind of data back plan to update your fees over the next quarter.
The second prompt that I want to give you is this ideal alignment filter. Okay, so this is kind of addressing that misaligned caseload issue. So with this, I want you to go back again on your calendar and review all the cases that you took on over the past three to six months.
And you want to ask yourself which specific clinical presentations or client demographics consistently matched your highest levels of professional fulfillment and what strict boundaries do I need to put on the intake process to politely decline and refer out it’s a key part the cases that drain my clinical energy?
So here’s that prompt again. Which specific clinical presentations or client demographics consistently match my highest highest levels of professional fulfillment? And what strict boundaries do I need to put on my intake process to politely decline or refer out the cases that drain my clinical energy? Okay. So again, this is just kind of shifting your stance from the obligation to see everyone to being more choosy and giving you
The choice, which you always have, to see the right clients for you.
All right, the last prompt I’m I’m gonna talk with you about is a f a frictionless recipe blueprint. So this is to address those clunky workflows and SOPs. So with this one, I want you to like try to identify the single most frustrating or disorganized administrative task that has occurred in your practice over the last two or three months. Whether that maybe it was like a messy onboarding sequence or like a delayed billing cycle issue. this could come up in lots of different ways.
Getting paperwork to people, sending questionnaires, whatever it may be. And the question you ask yourself is if this specific process had to be completely frictionless, twice as fun, and half as complicated, what step-by-step repeatable recipe needs to be written down today so that it runs on autopilot moving forward? So again, I’ll say the prompt again. If this specific process had to be completely frictionless, twice as fun, half as complicated.
What step by step repeatable recipe needs to be written down today so it runs on autopilot?
And I will say, out of all the three, out of all the prompts that I’m talking about, prompt number three is probably the one that’s best suited to AI. so you can, and this is one of the uses, my original uses for AI was I described our entire intake and client onboarding process by dictating, you know, so just explaining and talking out loud to the AI, and asked it to act as a systems and process expert.
You know, geared toward efficiency and client satisfaction, to analyze that process and, you know, expose any gaps or places that it can be improved. So if you’re struggling with this, you may employ you may use AI to to help work through this process. All right. So again, to recap, a lot of us are struggling with this accidental grind. We fall into business ownership, we don’t have a deliberate plan.
And we end up with just like a head-down approach where we do things out of obligation or fear or scarcity or whatever it may be. That is, in fact, stealing the joy and satisfaction from your work. And what we have found is that role ambiguity or not having a clear direction is the biggest driver of operational burnout for business owners and employees. So I am imploring you to.
Create some space, could be two hours, four hours, six hours, eight hours for a thinking day where you can step back and actually take some action to help with these things. And I give you four exercises. One foundational exercise where you do a capacity and joy check, and then three prompts to evaluate three areas of practice that you know I’ve seen kind of stealing joy. Now you might have other things. You can certainly create your own list of joy stealers in your practice.
But I gave you three. The prompts are right here. If you need to hear them again or look at them again, you can go read the transcript for the episode and get them word for word. But the hope is that by utilizing, you know, this thinking day or planning day to answer some of these questions and be deliberate, you stop treating your practice like an accidental obligation and you break this cycle of role ambiguity. You can reconnect with what brings you professional fulfillment.
And transform your business into a deliberate architecture that’s actually designed to maximize your joy, not just maximize the amount of business or busyness that you’re engaging in. So I hope this has been helpful. thanks as always for listening. And if you really love this kind of stuff, if you listen to this episode and you’re like, my gosh, this is incredible.
This is the kind of stuff that we talk about in my membership community and at my in-person event every summer. These are the things that we’re doing. And the work that people engage in is pretty incredible to see people go through this exercise and others and really improve their practices. So keep an eye out for those. Would love to actually work with you directly if you’re interested. But in the meantime, good luck with this executive planning day.
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