Episode 238 | Implementing The Accountability Equation™ with Abby Morgan

Maureen Werrbach (00:00:01) – You’re listening to the Group Practice Exchange podcast, where the business development resource for group practice owners, where we talk candidly about business ownership and leadership. I’m your host, Maureen Werrbach. 

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Hey everyone, welcome to another episode of the Group Practice Exchange podcast. Today is a little different of an episode. I have a group practice owner who came to my in person accountability equation event, and we’re just going to be chatting to see where she’s at in the process.

Maureen Werrbach (00:01:31) – Because for those of you who’ve done the accountability equation, like any accountability measure, it does take a little bit of time to get the whole team on board and to see that change happen across the business. So today I have Abby Morgan. How are you?

Abby Morgan (00:01:45) – Hey, I’m doing good. I’m good.

Maureen Werrbach (00:01:46) – So I know you came in. What was it like? September, August, September, I don’t know, sometime around there.

Abby Morgan (00:01:53) – Beginning of October, I think. October.

Maureen Werrbach (00:01:54) – Oh, jeez. I’m so off. Oh. So we’ve only been, like, two months. Yeah, not too long. Okay, so two months ago, you were at our in-person event on the accountability equation, and I just wanted to chat with you about, well, one, to give the audience a little bit of context, a little bit about your business, its size and where you were at before coming. And then I want to be able to dive into a little bit of just any things that you gleaned through the in-person events and then work through any sort of post event challenges, since this isn’t something that can be implemented in like a week.

Abby Morgan (00:02:28) – Yeah. Okay.

Maureen Werrbach (00:02:29) – Awesome. So tell the audience a little bit about you, your business, where it’s at, how long you’ve been in business and the size.

Abby Morgan (00:02:36) – So I’m Abby Morgan, I’m a social worker consultant. My business is located in Norfolk, Virginia. We are a, I guess, a medium sized group practice. I have 13 employees, including admin staff. We are a trauma informed practice. So our approach is when people come in, we look at how trauma is impacted their life and where it started, how it’s impacting them now, and you know how we can help make their future not continue to involve some of those trauma triggers and reoccurring and negative beliefs. Everybody at my office is trained in eMDR. New people coming in. If you’re not already trained, then I’ll get you trained for my consultation here. Yeah, it’s important to me to have a such a empirically tested, just therapy that works and help people eliminate these patterns and really, you know, help them identify things.

Abby Morgan (00:03:33) – They didn’t realize where trauma is, but it was keeping them stuck in just making them have these really negative beliefs about themselves. So it’s been just a great I don’t want to use the term game changer. I think that’s just kind of a cliche term, but it really for both my staff and our clients, it really has helped them push through a lot of barriers and address things that they never thought they would be able to. So it’s been pretty awesome to watch.

Maureen Werrbach (00:03:57) – What you said. Norfolk, Virginia 13 people I know that you’ve had since the event, some staff changes, and I’m sure we’re going to get into that because of course, nothing ever goes smoothly in business. There are always like things that throw us through loop things out of our control. So I’m sure that’s going to be a part of this conversation, which I actually love, because it really shows how nothing we do in business can go without a hitch. But tell me, where were you before? Like, what made you think about starting to, you know, implement or come to the training to learn about accountability and how to set up accountability measures? Usually the same with how it was for me, but there’s usually some kind of either tipping point or maybe an ah-ha moment or something that says like something’s gotta change.

Abby Morgan (00:04:45) – Yeah. So I think a couple of things, you know, my practice grew to the point where I couldn’t manage everything myself and really give my staff the support they needed, the time to focus on clinical measures while also kind of wanting to be in this visionary role where I wanted to grow the practice and really touch on the other areas of my business model and my business plan, which is community involvement, community engagement, and just looking at other areas on how we can affect change. So I couldn’t do all of that. So I was like, all right, well, my leadership team needs to expand. So I want to start to hire clinical manager. And I think my process is just need to be like, I didn’t know what I didn’t know, I know I needed to do something. And I’ve been a member of the group practice. That changed for quite a while now. So I was excited that when I read what the accountability equation whenever I was like, well, this is exactly what it is.

Abby Morgan (00:05:40) – Thank you universe, you know, for putting this right in my awesome.

Maureen Werrbach (00:05:44) – So, you know, before we get into where this has taken you now and maybe what some of the current obstacles are, what are maybe the biggest takeaways or things that like, stood out for you most that are helpful because obviously there’s a lot in it. Some things I find even for myself, are like in any program, there’s, you know, certain little nuggets or pieces that I like hold on to more than other. Was there anything that stood out to you most that, like, either had an impact in terms of just gaining that information or had an impact when you implemented that piece?

Abby Morgan (00:06:18) – When we went over the first phase, Assess, I believe. Yeah, that was really helpful because it was just a nice breakdown of the really integral roles of a group practice. Who does what? Who’s responsible for what? I’m really kind of looking at the template that you offer that, you know, on the whole most group practices, each role will be doing something like this and then taking it and say, well, I’m not quite there yet, but this is what this means for me.

Abby Morgan (00:06:47) – And kind of having a template that I could form to how my group already was, that was really helpful. And then on the next phase, the leadership questions were. Because right now I use the ideal team player when I interview people.

Maureen Werrbach (00:07:02) – Yeah, those are great questions. We use those to.

Abby Morgan (00:07:05) – Yeah, I tell people I’m like, this is going to allow me to find out a little bit more about you or you to really showcase yourself in a way that’s different than, you know, what’s your strength? What’s your weakness? It really asks you to think about yourself in different ways. Yeah, the leadership questions were great, and my administrative director and I use them when we interviewed and hired our clinical manager. So the timing was really good.

Maureen Werrbach (00:07:28) – I’m glad that you were telling me that. So you hired a clinical manager then after that event and use those questions, was there anything that felt like the responses to any specific questions in there, like better helped you feel comfortable hiring that person? Because one of the things that I have historically struggled with is like, there are some people who a are not great interviewees, right? I think of it like as test takers.

Maureen Werrbach (00:07:56) – I wasn’t always a great test taker. It didn’t mean that I’m not smart. And I try to think about that when people come in for interviews, there are people that are just not great interviewees, but it doesn’t mean they’re not going to be good for the position. There are people who are great interviewees who aren’t actually good for the position. They just know how to interview really well. And then there’s the especially for leadership. We know what questions to ask from the clinical perspective, because that’s what we’re trained in. But a lot of us business owners are still also learning how to be leaders. And so it’s kind of hard to figure out, like, what should I be asking in the leadership realm? Not in the how are you in terms of a clinician, in terms of supervision? Those can be, you know, we know what to ask. Were there any sort of either questions. And you might not know these off the top of your head. Or was there anything specific that really helped, you know that this person was going to be a good fit based off the interview?

Abby Morgan (00:08:47) – Yes, very much so.

Abby Morgan (00:08:48) – So I saw this person out. Actually. I had worked with her in parallel many years ago, and when I developed the job description and stuff like that, I was like, oh, I wonder what she’s up to these days, you know? But the cool part is, when we interviewed her, she answered a lot of these questions already, just in talking about stuff like we were going down the list and I was like, oh, she answered that one. She answered that when she answered that one. So that kind of even further solidified my decision, because the way she was thinking about things was already in line with what I wanted to know more about, and she offered that freely.

Maureen Werrbach (00:09:29) – That’s awesome. And that doesn’t happen very often. I feel like one of the things I learned to not do when putting people into leadership positions specifically, was that I would see people in my practice years ago who I felt like I could see leadership in them, right. But when positions would come open in leadership, I would reach out to them and be like, you should apply.

Maureen Werrbach (00:09:52) – I could release you, you know, being really good for this position. And I learned that for me, specifically by me doing that, that I always think about radical candor and those rock stars superstars. Right. There’s some that might be like that are great at the work that they’re doing. And it doesn’t necessarily mean that they want that upward mobility or movement. But by me kind of bringing it up, there might be some people pleasing or like, oh, maybe these, you know, she sees something in me that I’m not even noticing or like, I want to make her happy. And you know that I changed my thinking to I don’t start conversations with anyone about shifting into leadership because I want to see that coming from them naturally. Which kind of goes to your point is, like this person, the more that someone has really good leadership experience, the more likely it is that they are going to be communicating in an interview through that leadership lens and answering a lot of these questions. And so I actually love that, because a lot of times what we’ll see is people wanting to be in leadership positions before they’re actually ready.

Maureen Werrbach (00:10:55) – And so those questions are good to screen those out, because you’ll then see that they’re not prepared for these kind of questions. They don’t have the right answers to them. Or in your case you have someone who knows to answer these. Questions ahead of time because they probably had some level of experience in it and are meant to lead.

Abby Morgan (00:11:11) – Yeah, it was really awesome. You know, because I like to make my interviews pretty. I don’t want to say informal, but pretty conversational. I think that’s just the culture of my practice as well. I mean, it’s, you know, we all get along well. We all have a very collaborative based approach. So I think the interview kind of should highlight that as well. Yeah. Kind of what you’re signing up for. And just within the conversation, in the interview, she was answering a lot of these questions already. And so how long.

Maureen Werrbach (00:11:37) – Has she been with you now?

Abby Morgan (00:11:39) – Her first day was November 27th.

Maureen Werrbach (00:11:41) – Okay. Have you talked to her yet about anything accountability equation related or the roles and functions matrix or anything I’m trying to gauge? Like how if you have had that discussion, I know we’re only like a week and a half into her being hired at this point, so not very long for listeners.

Maureen Werrbach (00:11:58) – But have you had that conversation yet?

Abby Morgan (00:12:00) – Not yet. We’re still. So we have some shifts staff wise. So we’re trying to focus on hiring and, you know, reorganizing things where they need to be reorganized and really just kind of making decisions on what do we need to focus on right now. When I got back from the accountability equation, I was like, raring to go, like, it’s going to be with my admin director and be like, I want you to do this, and I want to do this, and this is the thing. And probably a few weeks after that, that’s been a pretty significant shift happen where, you know, a couple people decided that they wanted to work somewhere else and, you know, just a couple of other HR related stuff. So I had to kind of pause it and look at what do we need to do right now, how do we need to kind of keep things going, and how do I need to make sure that. The morale in my company is where it needs to be.

Abby Morgan (00:12:53) – So I was meeting with everybody individually, and while I’m trying to interview our clinical manager and bring her on and, you know, just it was so many things happened all at one time. But I’m not back burner but maybe middle burner it.

Maureen Werrbach (00:13:08) – Well, I was going to say I’m not hearing back burner for sure because there’s just a lot to it. Right? There’s a whole big system, but they’re put in pieces. You learned it over the course of two days, but in reality, this is something that can, you know, take six months ish for people to actually fully implement. And so you’ve used it in the past few weeks to hire. Yeah, you’ve used it in the sense of building out your roles in the function. So you at least have a roadmap of like what you need. What do the rules actually look like versus like hiring people for certain tasks that you want to let go of, which is what we tend to naturally do, is like not wanting to do certain tasks and then kind of hodgepodge in a position that like really pulls from clinical and a little bit of administrative and maybe a little bit of onboarding, where now you are making decisions around hiring, right? Because hiring is at the forefront after losing those few people.

Maureen Werrbach (00:14:04) – And at least you’re going to be hiring from a much more intentional aware space, which I think is all part of accountability. Even if you’re not implementing a tracker right now or anything else.

Abby Morgan (00:14:16) – Yeah. It also got me thinking about going forward, you know, looking at what’s working, what’s not working, and making intentional decisions around that. And through my Colby, I learned that I was a fact finder. So really making decisions. And now I can like there’s, you know, some sense of urgency, like when you first start a group practice and hiring people and getting clients in the door and insurance and all this stuff. But once you’ve been I mean, I open sea level in 2019. And so I’ve got, I guess, experience now, and I’ve got some people that the processes are running smoother. So I can take the time to make intentional decisions about things I want to implement going forward. And it’s not just full. We got to do it now because it’s here and we just got to do the best we can and figure it out later.

Abby Morgan (00:15:03) – Like, I can take the time to put things in place. And yeah, so I think the accountability equation really helped me to have it all so that I can break it down bit by bit and make those intentional decisions much more informed.

Maureen Werrbach (00:15:17) – So how can I help you now? Obviously you’ve gone through the whole thing, but life happens and not everything is under our control as business owners, as humans. So I want to make sure that I can help with whatever the current obstacles are that play into accountability, not being able to be fully implemented. Because for me, for this specific thing that feels like the goal is like getting to a place where everyone knows their roles, everyone feels confident in the role that they’re in, the responsibilities they have that takes pressure off of you. It allows you to see, you know, the wheel, which is your business, turning and moving more effortlessly. In what ways can I help? Right now.

Abby Morgan (00:16:05) – The biggest parts that I was able to take away were the leadership questions, and I think that’s where I am right now with The Matrix.

Abby Morgan (00:16:16) – And a lot of it is still has to be outsourced. I asked you a lot like the big questions that I had, and I still am. Kind of there is I don’t have one person to be accountable for all this stuff. Yeah. And you really helped me kind of figure out I got I was very black and white about it.

Maureen Werrbach (00:16:32) – Oh yeah, I remember this, that you can have one person in multiple roles.

Abby Morgan (00:16:36) – Right? Right. So I think where I am right now is just onboarding my clinical manager and my admin director, looking at her role is going to continue to evolve. I’d like to see her in more of that integrator role.

Maureen Werrbach (00:16:50) – The admin director.. Yeah. And right now in terms of the matrix, the admin director is the person who’s in charge of all admin operations. Is that that role. Okay. And then you said clinical manager that would be the person in charge of all the clinical operations. Or are they more supervisory eventually.

Abby Morgan (00:17:07) – Yeah. Right now I am still serving as the clinical director.

Abby Morgan (00:17:12) – And I think over time we can evolve into her taking on all of it. But I told her, I said, you know, I want you to learn the ins and outs and I want you to shadow me and pretty much everything that I do, so that you can get an idea of how I respond to all the things that come my way clinically, and then take that and then take your expertise and kind of morph it together into your own thing.

Maureen Werrbach (00:17:33) – Okay. So the clinical manager, what’s that person’s main role like? What are their responsibilities. The supervision.

Abby Morgan (00:17:40) – So she will be doing consultation supervision. We’re working on some stuff for our provisionally licensed therapist for next year. So she’s helping to kind of take. Out over and being a support for our,, but we have one clinical supervisor for licensure. So being a direct support for her, she’s going to be organizing our case consultation where staff get together and go over cases and things like that, and then be the do the day to day kind of.

Abby Morgan (00:18:09) – Fire putting out and stuff. So that’s kind of the bigger pieces of what her role will be. And since she’s started, she’s just really given and has met with a couple of staff members already, just about cases that have come up that, you know, how do I do this? How should I proceed? We’ve met a few times for our professional licensed therapist, kind of what we want to have going forward next year and just really pulling in the knowledge that she has and the connections with the contacts she has to get our list for our lunch and learns together and stuff. So she’s pretty much go right in. Yeah.

Maureen Werrbach (00:18:40) – Can I give you a suggestion on what I think needs to happen? Yeah, I know, I feel like because you’re a fact finder, I’m going to overwhelm you because, you know, I’m a quick start. Hiring is your primary focus right now. I don’t think that that needs to stop you from having your admin person, your head of admin, and your clinical manager get an understanding of what their accountabilities will be, which is essentially the tracker, right? I get that it’s you mainly doing a lot of things and that you don’t have a whole robust leadership team.

Maureen Werrbach (00:19:20) – But I want to challenge you on at least sharing the portion of the tracker that. Includes the things that they’re responsible for and like what that looks like, I know that. Learning the whole process takes a while for a team to learn, but I’m wondering, I find that accountability is transparency, but it also helps people feel like they’re doing their job well, which I think plays a role in employee morale. So I’m assuming just based off the little that I know you and being with you for a few days, that those two people specifically, and I’m just talking about those two because they’re in kind of leadership positions that you’ve talked with them about what they’re responsible for, and it’s just not formalized. Right. Because I think of like the tracker or some kind of documentation that shares like what the expectations are. But I look at like hiring because this is what you are going back to of kind of why you’re pausing the, you know, the last half of the accountability equation is that the focus since those people leaving is on bringing more people in.

Maureen Werrbach (00:20:32) – But I look at hiring as something that leadership as a whole plays a role in. Right. Like my clinical people, you know, are in charge of knowing like what’s needed. Like, who are we looking for ideal clinician wise? Do we have space for provisional supervision. Right? Or are we maxed out on all the provisional folks and we should be hiring a couple more fully licensed? My admin plays a role in the hiring decision because she knows what the inquiries are coming in. Are we needing someone who’s available for more daytime? So like I look at the accountability piece as something that’s more holistic, that we all sort of in leadership play a role in. And so you’re saying that the focus is on hiring, and I’m wondering if you three in leadership were to outline how each of you plays some part of a responsibility in the hiring, that that wouldn’t create a quicker and more efficient process for getting people back in so that you’re not in this kind of putting out a fire in terms of replacing those that have left.

Maureen Werrbach (00:21:34) – You know, I find that everything is a little bit more holistic in that way that we all, in leadership, at least support every goal in the business in some way, some more than others. Right? Like I have a full on onboarding and hiring person. She’s in charge of it, but still, all of my leaders in some way play a small part in the success of that, whether it’s our head of intake, being able to say who time wise and kind of days of the week, which office location, because we have multiple offices, you know, for us, we’re multi-specialty. Like they are able to say, you know, we actually are getting so many couples calls or so many kid calls, that would be my suggestion for the next hire. That is an accountability on that admin person to help support in successfully bringing on that next person, you know. So that would be my little challenge.

Abby Morgan (00:22:23) – I think, you know, I definitely appreciate that. I have verbally talked with both about the accountability tracker and about roles and things like that, and they both well, prior to our clinical manager coming on, the admin director and I would both sit in on the second interview, the first interview I would typically do just to kind of weed out anything.

Abby Morgan (00:22:43) – And if they moved on to a second interview, I would have usually the admin director just to have another set of eyes and also looking at it from an administrative perspective of scheduling and clients and stuff. But right, I will be scheduling a meeting with them to show them, like my goal was to be in our conference room and have it up on the big screen and show them. So I need to just, you know, stop what I’m doing and actually.

Maureen Werrbach (00:23:06) – Do that, which I get like when something when it feels like there’s a fire of some sort and for, you know, your practice at 13 people, I can understand, you know, having 2 or 3 people leaving, that means that, you know, the focus for the time being might be on replenishing or filling those gaps. Again, I just believe that the use of accountability can help bridge that gap from like, it feeling like a siloed thing that you have to focus on yourself to it being something that can be more shared responsibility among the other two that are leading with you, which can take a weight off of you, but also help move the needle forward more quickly, because now there’s three people that are, you know, sort of obviously someone’s got to be responsible for each thing, but it can move that needle forward a little bit more quickly and give them a taste of like, what other parts of leadership look like.

Maureen Werrbach (00:24:02) – I was recently reading an article, and I’m not going to say it right, but that there was a CEO of some business I don’t know what kind, who every couple of years would shift all of their leaders to different leadership positions, like literally like if we translated this into the group practice world, like the head of admin would become head of clinical, the head of clinical might become the head of onboarding, the onboarding person might become a head of admin. And every few years they would switch. Because one if your leaders are all working together and collaboratively, everyone knows what is going on in all of the other leaders world. But also a lot of times, especially the larger your business gets, the more likely the leader is not as much boots on the ground doing the work of the people that they’re leading, so they don’t necessarily need to have the exact experience of doing right. Like, I have a head of admin who has never done billing before, and she’s in charge of our billing person.

Maureen Werrbach (00:24:59) – She’s learned from the biller the processes that they have, and they work together on fine tuning. But she’s never been a person who does billing and sending claims through her EHR. She can still support that person, right? And so I like this concept. Not that I’m going to do it, but the idea that all leaders have the ability to really support each other because leadership is more about it’s like a state of mind. It’s the way we present more than like all of the knowledge we have. So I would use your two people to help you in that, especially if that’s like kind of at the forefront of your brain.

Abby Morgan (00:25:34) – Yeah.

Abby Morgan (00:25:34) – No, that’s awesome feedback. Thank you. I will talk with them both about it.

Abby Morgan (00:25:38) – Okay.

Maureen Werrbach (00:25:38) – I want to end with an accountability thing. Since I can’t not have accountability to be part of this. What is something because you’re going to be saying this out loud to anyone who’s listening. What do you want to hold yourself accountable to as a next step? And it does not have to be accountability equation related, but the next thing you want to do or think about that will help you get your business into the space that you want it to be in, where people have, you know, their accountability measures.

Maureen Werrbach (00:26:06) – Things are moving forward the way they need to. What’s the next thing that you feel like you need to hold yourself accountable to doing?

Abby Morgan (00:26:12) – So I find myself often saying, oh, I’ll get to that in just a second. I just have to do this first. And it’s not just with work, it’s just in life in general. You know, all of the things I have in my brain. But I think that what I’m going to hold myself accountable to is say, no, I’m going to do this now and then. This can wait until I’m done. Like I’m going to meet with my admin director or my clinical manager about the printed out black and white accountabilities of their role and have a conversation with them instead of just, oh, I went to this accountability equation was amazing. And I’m going to have you do this and this. And, you know, instead of having a conversation, I’m going to have an actual meeting.

Abby Morgan (00:26:49) – Yeah.

Abby Morgan (00:26:51) – Before all of these other things that are in my brain.

Abby Morgan (00:26:54) – Get ahead of.

Abby Morgan (00:26:55) – It. Yeah.

Abby Morgan (00:26:56) – I think that they’ve both been kind of even said in so many words. You know, when I know what your expectations are of me, that helps me do my job better. Yeah. And because, you know, we talk about, well, how where I can improve or whatever. And that was my director’s feedback to me. So, you know, having a meeting and saying, this is what it is in front of you.

Maureen Werrbach (00:27:13) – Well, it’s such a big thing to like shift conversations around accountability to like a real space. And I can see that you’re doing this, and I did this, and it’s probably a pretty common thing, is to want things to be running smoothly before you tackle a beast as big as this, which is like shifting the whole culture to accountability. But I don’t think that ever actually happens. Like as a business owner, I don’t think there’s ever really a place where nothing is going on. Everything is running perfectly smooth, and you’re like, well, I think we have time to fully focus on this one thing.

Maureen Werrbach (00:27:55) – Nobody’s stressed. Everyone’s on track with everything. Like people got open space to, like, think about this. I think this is probably one of the most common issues with anything. Not even just accountability. But like any change in business or thing we have to think about in business is waiting for the right time. I don’t think actually ever happens because there’s always, you know, someone going on the train leave someone leaving, someone that needs supervision or a pip,, hiring new people and onboarding them and getting them used to the ropes, offering new services, putting together new, you know, programs or offering. There’s always something going on that can feel like it needs to take precedence. So I totally get what you’re saying.

Abby Morgan (00:28:38) – Yeah, I think I can count on one hand, in the almost six years that we’ve been open that I was like, I think I finished everything.

Abby Morgan (00:28:48) – Yeah, yeah, this is okay.

Abby Morgan (00:28:50) – I must be missing something. Literally, on one hand, in the whole time I’ve had this practice that I think I everything in my to do list in my brain and my literal to do list had been checked off, and I could just sit and exhale.

Abby Morgan (00:29:00) – Yeah.

Maureen Werrbach (00:29:01) – So okay, well, I like what you put out there, so I will be holding you accountable to that.

Abby Morgan (00:29:08) – I appreciate it I.

Maureen Werrbach (00:29:09) – Do appreciate you coming on and sharing and being vulnerable and talking about something that we all experience, which is the ups and downs of business ownership, the transitional periods. None of us are immune to that at any size in our practice. And you’ll likely have those experiences if you are ever a, you know, 30 person practice. People who have three people have had this experience. And I think it’s just this common humanity of like, I guess, me wanting to validate that that experience is 100% common in all of us and will probably likely happen more in the future as well. And it’s on us to sort of remember that these are not like unique, rare instances that are only happening to you or only happening to me, but a common theme in business ownership, which can sometimes make it feel a little easier when it feels heavy.

Abby Morgan (00:30:02) – Yeah, absolutely.

Abby Morgan (00:30:03) – Thank you so.

Abby Morgan (00:30:04) – Much. I appreciate you having me on and everything that you do for practice owners, it just it makes things so much better, so much easier. So I appreciate all your time.

Maureen Werrbach (00:30:13) – Yeah, I appreciate that. Well thanks for coming on.

Abby Morgan (00:30:15) – Yeah. Have a great day.

Maureen Werrbach (00:30:16) – You too. Thanks for listening. Give us five stars on whatever podcast streaming service you use and I’ll see you next week.