Transcription for

CREATING AND IMPLEMENTING A VISION FOR YOUR PRACTICE

DR. JEFFERY ZIMMERMAN

Continuing Education Programs APA

MAY 2017

PROVIDED BY

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May 18, 2017

CREATING AND IMPLEMENTING A VISION FOR YOUR PRACTICE

DR. JEFFERY ZIMMERMAN

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[MUSIC]

DR. NEIMEYER: Why don't we go ahead and get started?

Welcome to today's presentation on creating and implementing a vision for your practice.

I'm Dr. Greg Neimeyer. I direct the Office of Continuing Education in Psychology and the Center for Learning and Career Development in the Education Directorate at the American Psychological Association. On behalf of the Center for Learning and Career Development, on behalf of the Education Directorate, and on behalf of the American Psychological Association, welcome, welcome, welcome. Delighted to have you all on board today for today's presentation, which will last for 90 minutes.

The presentation this morning is on creating and implementing a vision for your practice. We'll take a two hour break and then we'll come back and Dr. Zimmerman will also lead us in a program on managing staff and organization in the pursuit of practice excellence.

Let me take a second and just introduce you to Dr. Zimmerman. Thrilled to have him on board to present to us today. Dr. Zimmerman received his doctorate in clinical psychology from the University of Mississippi. He interned at the West Virginia University Medical Center Department of Behavioral Medicine and Psychiatry. He also has worked in a mental health center and is the chief psychologist at Mount Sinai Hospital in Hartford, Connecticut. He's a fellow and past president of the Connecticut Psychological Association, where he also is the recipient of its award for Distinguished Contribution to the Practice Of Psychology. I note he's also board-certified by the American Board of Professional Psychology in clinical psychology, and a fellow of the American Psychological Association. In 2015, Dr. Zimmerman received the honor of Distinguished Fellowship in the National Academies of Practice and was admitted into the Psychology Academy as a distinguished practitioner and fellow.

We're delighted to have Dr. Zimmerman on board today and we're going to be talking about creating and implementing a vision for your practice.

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DR. ZIMMERMAN: Thank you.

Thank you, it's great to be here, and thank you to the Education Directorate in APA, and Dr. Neimeyer and his staff, and the Learning and Career Development Center. It's great to be here.

Before we get started, a few disclosures as I understand we need to have. I've co-authored or co-edited three books on practice. I'm also a principal in the Practice Institute. I won't be selling any of those through this program.

And I'm here to try to help educate you and give you some ideas about creating and implementing a vision for your practice.

As we go along, certainly, if you have questions, there's been some information posted about how to submit those questions. And we'll be taking those from our audience, as well as from people out there online in the webinar. So by all means feel free anytime to send in a question, or a comment, and we'll go from there.

And thank you to all of you who are with us today. We understand that this is a sold-out program with I think over 200, maybe 250 people who have registered. So welcome, wherever you are--East Coast, West Coast, Hawaii, Alaska, or other countries. We're glad to have you with us today.

So most people go into practice and they have, actually... Some of my colleagues, one person with 50 years experience said to me, "I just put one foot in front of the other and here I am."

And they make a tremendous investment. You all have made a tremendous investment in your practice. And you put one foot in front of the other and here you are.

Our typical training programs do very, very little in terms of teaching about the organization of a practice and really what's that all about. So we'll be talking a little bit about direction, a lot about direction.

And in these four, we actually have four segments that we're doing together. And we'll be talking about how to really look at, not only implementing a vision, but how to really structure your practice in many different ways going forward.

When I think about going into practice, I think about the investment that you make in time, in energy, in your soul, and, of course, in money. I presented a workshop along these lines to a PsyD program and the students there told me that many of them had spent upwards of $200,000 in terms of the investment in their education. It's not just tuition but it's all of their life expenses as they go through both their undergraduate and graduate training.

With that kind of investment and with the ongoing investment in your practice, it's amazing how few of us actually set a vision for the practice that we're going to have. We don't set a direction, we just do this one foot in front of the other. It would be like investing in a great big sailboat that costs hundreds of thousands of dollars, and not setting a course but just going out there in the ocean. You might do that on a bike ride, not too far from home.

But yet on the important trip of your practice, the journey of being in practice, which can easily be a 30-, 40-, or 50-year journey, to not have a vision, to not have direction may undermine the importance of that investment.

If you were, I often say to people if you're writing a check as a venture capital investor for that practice, would you want a plan back? Would you want a vision back? Would you want a sense of where the practice was going? In actuality, you did write the check. That's your investment in the practice.

So today, we're going to focus on setting that intention, and creating and implementing the vision for the practice. Our focus is going to be rather broad, and we're going to be talking about why a vision statement's important. We're going to be talking about some different types of vision statements, how to create it, how to make it real.

There are a lot of organizations that have a vision statement. I've been in some of them, and the statement is up there on the wall. And if you ask anybody what the vision for the organization is, they don't know it.

There are other organizations where not only do they know it, but they live it and breathe it. And we'll be talking about some of those today.

You know in retail, when you walk into a company and you see on the door, you see on their website, what their vision statement is, and you walk into the retail shop and it's not lived. [LAUGH] And you know that by the very attitude--or it is lived. And you know that for the very attitude of the first person that you come in contact with.

I often see that when I happen to get the manager. I was in a pet supply store just the other day. And I could tell I had the manager by his approach with me and how dedicated he was to customer service.

We are not selling products, generally. But we are in the work of offering our professional services and professional expertise and our time, and often for reimbursement of some sort. So we are interacting with the community, not as a retailer, but certainly as a service provider.

So let's start with a couple of definitions.

There's a lot of confusion out there in terms of mission and vision. And depending on who you talk to and what article you read, you see them get mixed up. And they're used interchangeably. And it's very confusing as to what a mission is and what a vision is.

I'm going to give you a way that I think is fairly easy and simple to keep them apart, to distinguish one from the other.

The mission is essentially what you're about, what you do. (A little technical issue here...) So the mission is what you do, who you are, what your present major goal is.

So, for example, if I am providing services to veterans, my mission might be to provide great service to veterans in our county, or our township, or our city--and to help with PTSD, and reintegration, and other kinds of services.

I happen to provide a lot of divorce services outside of court. And my mission might be to provide alternative dispute resolution services outside of court.

(Just working also on a technical issue here...)

But the vision is not just what you do... But why you do it. And this is quite different.

The vision of why we provide veteran services might be something like...to help pay it back. The tremendous sacrifice that was made by our veterans... I'm in practice if I provide those services to give back to the veterans.

That's very different than saying what I do. Why I'm doing it is to give back. Why I'm doing the divorce services is to give kids a sense of family.

Which is more compelling?

"Hi, I'm Jeff Zimmerman, and I provide mediation, and co-parenting, and parenting coordination in collaborative divorce services..." The what I do...

Or the why I do it... "I'm Jeff Zimmerman, and I provide divorce services [That's the what.]...in order to give kids of divorce a sense of family as they grow up."

One is, I would hope, more compelling than the other. The why, the vision, is what we're going to be talking about today.

If you look at psychology today websites, much of what you'll see there is the mission or the what.

"Hi, I'm so and so, and here's a list of all the things I do..." And no sense of why they're there and doing them.

A vision statement gives you the intention that helps define your culture. And that often can lead to an alignment between the decisions you make...the focus of the practice, and what that vision is. So you wind up having a cultural synergy between the actual work that you're doing, how you're doing it, and why you're doing it. There are countless decisions you're going to be faced with, large and small, and the vision statement gives you a basis for making those decisions.

So, if I'm in divorce services and I want to give kids a sense of family, and I'm asked to testify in court, is that likely to be aligned with giving kids a sense of family? I would suggest often it's not, because that's an adversarial place that puts its caregivers, the child's caregivers at war with one another. What's that have to do with giving them a sense of family?

If I'm working with veterans, and my focus is on the payback and helping them adjust, and I have an opportunity to work at the local university and provide consultation for an eating disorders program... Is that something aligned with my practice's vision?

And many times people will say to me, "Should I do this great opportunity over here that may complement my practice in some way?" Well, why is it a great opportunity if it doesn't fit within your vision? I might argue it's something to let go of. Something to say, that's a great opportunity but no thanks... Because there you don't have that alignment.

The vision helps you let your clients know, and your staff know, what it is you stand for. Crucial to your relationship with the community, and also in terms of your investment with the people that you hired.

If you are paying people on a percentage of what they collect, if you're paying people on fixed salary, whether they be clinical staff who's somebody you pay on a fixed salary, or the clerical staff, or clinical staff, some of whom you may pay on a percentage of what they collect...

A huge portion of your investment in your practice going forward beyond what you've already invested is going to salary and benefits, to compensation and benefits.

What do you stand for? What do you want them to stand for? Your vision speaks to that.

And it guides those decisions, as I was saying, that you make large and small, even minute ones.

Let's look at a couple of corporate, non-mental health visions. So I took these off the web. I think I can give credit to the organizations that they come from.

So this one is from Whole Foods and it's called their Higher Purpose Statement. Remember we talked about, or we're going to be talking about the different types of visions, and...

They have a higher purpose.

"With great courage, integrity and love, we embrace our responsibility to co-create a world where each of us, our communities and our planet can flourish--all the while celebrating the sheer love and joy of food."

I thought they were a grocery store [LAUGH]. But they're not talking about being a grocery store. They're talking about a higher purpose, with courage, integrity, and love.

If you work there, you have a very different sense of what that's about, I'm presuming, than if you worked in perhaps at a different grocery store that had a very different vision of itself.

Amazon, you've heard of them?

"Our vision is to be Earth's most customer-centric company, to build a place where people can come to find and discover anything they may want to buy online."

A customer-centric company... A place where people can come and find anything they want to buy online. They're not talking about shareholders, they're not talking about profits and distributions and dividends, and things like that. They're talking about why they're doing what they're doing.

And what's the scale? Earth. [LAUGH] Big... They didn't just say the US, they didn't just say France, or someplace else--the Earth.

LL Bean has a core values statement:

"Sell goods and merchandise at a reasonable profit, treat your customers like human beings and they will always come back for more."

And that is by, I believe, it was done early, early on in LL Bean's history by the founder: "Treat your customers like human beings and they will always come back for more."

I bought a windbreaker. I fell, I ripped the sleeve. I called up months later to buy a pair of jeans.

They said, "How'd you like the windbreaker?"

I don't go into a stores and they say, "How'd you like the last product you bought from us?"

"How'd you like the windbreaker?" Of course, it came up on the fellow's screen.

I said, "I like it but I fell, I made a little hole in the arm."

He's said, "Doesn't sound like you it's 100% to your liking.

I said, "Well, the windbreaker is." I didn't get it. "The windbreaker is, but I have this little hole in the arm."

He says," It doesn't sound like it's 100% to your liking because it has a hole in the arm."

Finally it dawned on me...

He said, "Our policy is, if it's not 100% to your liking for any reason, send it back.

"Do you I need a receipt?"

[LAUGH] "Send it back. And if you want to change the color, or you don't like the one that zips and you want one that pulls over, that's okay too," he said. "Send it back."

I was treated like a human being. And by the way, they answer on half a ring. [LAUGH] I was treated as a human being. And how many times have I told that story? And will I go to the competition? Not first...

They have customer loyalty. If I'm looking for something that I think LL Bean has, I go there first, because I am treated like a human being.

Bright Horizons Family Solutions, they have the HEART Principle--Honesty, Excellence, Accountability, Respect, and Teamwork. So they did five words, first letters spell out the word "heart." Why? It keeps it easily in your mind as to what it is.

I was going to read Apple's...vision statement, but it is long. And it's just different because it's long. That's not necessarily bad, but it's a lot harder to really keep present in your mind if it's long.

There are different types, as you can see on the screen, of vision statements. You have vision statements that speak about the product, that speak about the values, that speak about the core purpose, and that also speak about the long-term 10- to 30-year goal. We don't often think in 10- to 30-year goals. We

can't see beyond our headlights, but we have vision statements that actually do speak to the 10- to 30-year goals.

So let's look at how we might do that.

In the divorce services, I might say, as a product-based, I might say, "Create innovative alternative dispute resolution services." A values-based vision statement might speak to decreasing the conflict in families and the impact that that has on children. The core purpose would be what I said earlier, giving kids a sense of family. The 10- to 30-year goal might be to change the way families divorce, change the system.

Depending on which vision statement I choose, I'm going to be taking slightly different paths at the start, that may turn into very different destinations at the end.

It's kind of like four ships leaving a harbor. And they all leave kind of in the same path. But by the end of the journey, 10 to 30 years later they may be in very different places.

Same thing with the Veterans Affairs example. "I'm providing needed PTSD services with cutting-edge treatments." That would be the product, if you will, or the service.

"I'm recognizing the great debt and paying back the great debt that was created by the amazing sacrifices that our veterans made for us." That's a values-based...

"My core purpose may be to take care of those that took care of us." So that may be a vision statement crafted around that.

The 10- to 30-year goal may be to change the way veterans come home. And to really change how we treat our veterans when they come home and what we offer them. And how we treat the veterans that are severely disabled, as well as all the way up to the veterans who perhaps aren't disabled at all, and their families. And to really look to changing not only what we as a practice are doing, but what we as a system are doing.

I was speaking to a new graduate not too long ago. And the reason I chose the veterans example here is I don't have her vision statement. But we had a workshop where she actually worked on a vision statement. And it was so touching that I and other people in the workshop actually had tears in our eyes.

She's an early career person. You don't have to be in practice 30 years to figure this stuff out. But she reached into her heart, and she said, "Why do I want to work with vets?" And that became her vision statement.

I reached into my heart after being a kid therapist for many years in divorcing families and said, "Why do I do this difficult, sometimes unpleasant work?" And for me, it was to give kids back a family and not let divorce kill a family.

And I couldn't do that by being a kid therapist. I had to work with the parents. So I gently kicked the kids out and not so gently brought the parents in.

But you don't have to be 30 years in practice to come up with a vision statement. You can even be a graduate student thinking about what practice you might want to go into.

So let's look at some tips for creating your own vision.

Mark Twain said that it takes a lot longer to write less. And I think he was absolutely right. What I often suggest is keeping your vision statement short.

For those of you that are with us, if you'd like to actually experiment, not that I want you to be distracted by doing something during this presentation... But if you want to experiment and then offer a vision statement to us as we're going on this today, by all means feel free to do that. You may already have one, and you can feel free to send that in as well.

Certainly, you need to take your time in creating a vision statement. That is really very important.

What I would first suggest, though, is write it out as long as it is. Just write it out what comes either from your heart, or from how you want to position your practice. What is your vision for your practice? Why are you in practice? And if you say, to do quality work, that--I would hope everybody's in practice to do quality work-- and that that doesn't differentiate you from anybody else in practice. Include those core values and then start to edit it.

What sentences can I take out? What words can I change? How can I make this vision statement work for me in a way that is much more effective and shorter, and can represent what I'm doing? If you can get it down to one sentence as you saw in some of the others, even if it's a relatively long sentence, that might be great.

Do we have a question?

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VOICE FROM AUDIENCE (OFF MIC): Yes, we do.

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ANOTHER VOICE FROM AUDIENCE (OFF MIC) : It's on.

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VOICE FROM AUDIENCE (OFF MIC): Oh, it is?

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ANOTHER VOICE FROM AUDIENCE (OFF MIC): It is.

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VOICE FROM AUDIENCE (OFF MIC): Yes, we have a question. "I recently closed my highly rewarding and successful practice."

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[INAUDIBLE VOICES]

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ANOTHER VOICE FROM AUDIENCE : Test.

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VOICE FROM AUDIENCE : The question: I recently closed my highly rewarding and successful private practice of 25 years. My vision for my later career stage is to do coaching, not therapy, in groups, possibly at retreats, as one way to gain greater life balance.

What advice and cautions can you share? Thank you.

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DR. ZIMMERMAN: Well, in terms of vision, I would...the greater life balance is important to you. But I would also suggest that you think about the "why" that's important to the person or people that you will be coaching or doing the workshops with. What's in it for them?

So your vision should relate, not to just what you're going to get out of it, but to what they're going to get out of it. Why are you doing this for the people you want to connect with?

Sometimes when I see vision statements that are really about just what I'm going to get from it, I see that fall flat. Because there's not an explicit understanding of the relationship between the community and the people or person that's providing the service. So the idea is to really be able to connect your vision statement with what the community is getting and why you're providing that.

So I'm not going to speak to all the pros and cons of starting a coaching business right now. But certainly in terms of your vision, I would encourage you to move to a place where the vision is broadened out to include what the user of your services would be getting. Especially, at this juncture in your own career development where you're starting something brand new.

So I hope that's helpful. Okay, so, if there are other questions, by all means send them on in and we'll take them as they come.

Let's look at some more examples.

Southeast Psych is a private practice that, I think they now have three offices in at least two states. And their mission is to get psychology into the hands of as many people as possible to enhance their lives. And they have, I think, upwards of 30 clinicians in their practice. They are outside of managed care.

You walk into their waiting room and they have Star Wars characters, I believe. They have a coffee barrister, barista, barista--barrister's the lawyer, barista. They have a sound studio.

They see a lot of kids on the spectrum, and families of kids on the spectrum. Their office is fun and inviting.

They write and speak, I guess you write prolifically, and they speak anywhere, and they speak for free a lot. They're out in their communities, just out there.

And they describe themselves, this is not their term, but they describe themselves, they didn't originate the term, as a purple cow. Their goal is to be different and to be recognizable.

When you drive down the highway and you see a black cow or a brown cow, you say, "Oh, there's a cow..." But imagine if you saw a purple cow. You'd say, "Wow, there's a cow!" [LAUGH] They want to be that purple cow. And, as best as I can tell, they are. And we had two of the principals write this book, and it describes how they went about it, not how you should go about it, but how they went about it.

Going back to our veteran's practice, as we're using as a example, let's look at the difference between mission and vision. So when I said our mission is to provide high quality services to veterans, how does that strike you? It's a good cause.

When I speak to our obligation and our dedication to helping the veterans that sacrifice so much, recover, resume, restructure, and their families, restructure their lives... How does that strike you?

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VOICE FROM AUDIENCE (OFF MIC): More impressive.

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DR. ZIMMERMAN: More impressive. It touches you.

The vision, if you were going to have a veterans practice, the vision would impact the programs that you offer, because you might decide to offer more programs for families and perhaps fewer programs on anxiety management [LAUGH].

You might have a support group for vets who've been traumatized, but what about all those vets that maybe haven't been traumatized but are still having difficulty reintegrating? So you might look at having a broader array of programs that touch your clients or patients in a different way.

And sometime even your use of language--are they clients or are they patients? They may be both. Some people may be patients that you're treating for a diagnosable psychiatric disorder and some may be clients that you're providing consultative services to, that you're not treating for a diagnosable disorder. So even your own language can be impacted.

What about office space? If you're treating veterans, especially those that have been traumatized or maybe even been prisoners of war, does that impact what your waiting room looks like? Does that

impact how much light you have coming in to the offices? There are a lot of office suites that have consulting rooms that are inner suite rooms that don't have windows.

How does that work for you, if you're treating people that maybe have been in a box? That maybe have been in very close, cramped quarters? Are you wanting to replicate that, or are you wanting to be thoughtful about how you're designing your office space, if you're working with that clientele? So it can go down even into the way that you design your office.

What about who you connect with in the community? When I speak to a lot of mental health professionals, they say to me, when I talk about who they're going to connect with, they say, well, I've got to talk to physicians. I've got to talk to physicians...

In this practice with veterans, would you be looking primarily to talk to physicians? Or might you be going other places, in terms of trying to offer speaking opportunities or get speaking opportunities to provide information to get psychology into the hands of those users?

This practice, as I said, does a lot of work with kids on the spectrum. Would you be going into pediatric offices? Or might you be looking to connect with the community in a very different way?

So how you structure that vision is going to impact those many other decisions.

So I said earlier this morning that we don't want to have the vision statement just simply sit up on a wall.

I did a consultation years ago with a large organization and we crafted their vision statement. Six months later, they asked me to come back and watch a board meeting, just to observe the board meeting. And it was after lunch, but when I'm working, I don't get sleepy. I get sleepy later, but I don't get sleepy when I'm working. And I'm sitting in this board meeting and I'm getting sleepy, and I'm thinking, what's going on here? How come I'm getting sleepy? It's not that I had this huge lunch, a turkey dinner for lunch... Why am I getting sleepy?

And I saw on the wall the vision statement that they had crafted. And I started listening to the conversation in the board room, which, by the way, could be in your office with your practice partners or your staff. And I realized that the conversation had nothing to do with was hanging on the wall. That was an exercise that was put, instead of in the closet or in the drawer, it was put on the wall, but it was an exercise that was not being implemented.

So the concept that I want to stress to you, is that it's so important to make your vision real both inside and out. Decisions, large and small.

And also the exceptions to decisions, large and small... So you have a decision about a 24-hour cancellation notice... When do you reserve the right and exercise the right not to follow that policy? And how do you make that determination? You make that determination as a function of your vision, and why you're in practice, and what you stand for. It may relate not only to your clients, it may relate to your staff, it may relate to the community.

So I'm doing an interview for a psychologist to join my practice years ago, when I was managing partner of a 20-person practice with seven offices in Connecticut. And a fellow comes in, and he has his own practice. He wants to blend his practice into our practice. And I asked a routine question that almost every interviewer asks: What's your strengths and weaknesses? (I asked another question which we may talk about later today in the second segment.)

But I asked him about his strengths and he said, "I'm really good at keeping people in treatment a long time." And in my head there was a huge noise, sounded kind of like, I don't mean to stress anybody having made all the comments about veterans and programs, but it sounded like an explosion going off in my head. Because you just exploded all over the office. The interview essentially was over at that point, and we went back and forth for a few minutes. And I then thanked him for coming in.

And there was no way that he was going to get any other consideration for the job. That one answer torpedoed the whole possibility with his ever working in our organization as far as I was concerned. He wasn't getting second interviews. He wasn't meeting the other partners. He wasn't meeting other clinicians.

He was done, because of that strength that he mentioned, which was completely out of alignment with our vision about quality and short-term, when appropriate--and not over, not providing more services, of course, than somebody needs. Of course, ethical delivery of care...

So your vision can guide you in your hiring. It can guide you in your staffing.

If your vision is about, how do I make the most money? How are you going to staff for that? You might staff very lightly for that and not have enough staff. You might have your clinicians working excessive amounts of hours.

There's some clinicians who will work 40 or 50 clinical hours a week. I don't want to be the Friday afternoon at 6:30 PM appointment after you've been working since 6 AM on Monday morning for 50 hours a week. I don't know, unless you're exceptional, I don't know that you can provide the same level of care. We get tired. Our brains get tired. [LAUGH] I get tired. I couldn't do it. Let's put it that way, I'll just speak for myself.

So we may decide to staff differently. We may decide if we're staffing a business office or staffing receptionists to staff differently. We may decide if we're creating weekend hours or not, to how we want to do that. How we're going to do on-call... Our vision can help with that.

Our vision can help with discipline. Somebody made a mistake. They were careless, perhaps they intentionally made a mistake. Do we want to look at discipline as a time for correction? Do we want to look at discipline as a time for learning? Do we want to do that harshly? Do we want to do that with humanity? What kind of practice are we? What's our vision?

Are we going to reward creativity? So Southeast Psych, amazingly creative... They're almost in your face creative. Thank you guys [LAUGH] and gals for being in my face, creative...

They did an interview of me and I, what is going on here, right? We were having fun. And it was the very different kind of interview. But they were being creative. And that was actually at an APA convention years ago...

There are a lot of practices that I hear about that people interview at, and they say the practice says, this is what we do... I see ads online, we're a CBT practice, we're a DBT practice, we're LMNOPQRST practice and this is what we do.

Well, what if I have another idea? Are you a practice that's open to either within that framework or outside of that framework, bringing other ideas and being creative?

My own practice has changed many different times over my career. From health psychology to a lot work with kids and families, to organizational work to the divorce work... To now doing a lot more training. It's changed over the years.

And I hope I've got another couple of chapters left, and writing, to see where it changes to in the future. Your vision can help with that change because your vision can span the 10 to 30 years.

And it can also help with the decisions that you make and as you implement those different chapters.

Even down to office design, as we were talking about earlier, to your practice policies...

And to how you connect with your community. Do you say, when a physician's office asks you to come in and do a lunch and learn, do you say, "Well, how much am I going to get paid for that?"

Or do you say, "The community is interested in learning about..." I mentioned spectrum kids, kids on the spectrum before. "The community's interested in learning about kids on the spectrum..."

Or there's doctors' offices interested in learning about veterans or learning about anxiety disorders...

Do I say, "I need to get $200, and you buy the lunch"? Or do I say, "When and where?"

And when they say, "Well, it's Thursday at 12," do I say, "well, Thursday at 12 is really hard because I have patients at 11 and at 1, and I can't really get there at 12. How about 3 o'clock in the afternoon?"

And it's a pediatric practice. Really? [LAUGH] There's no way I'm coming into their office at 3 o'clock in the afternoon.

And maybe if my vision is to connect, part of my vision is connecting with the community, then quite possibly what I'm going to say is yes. And I'm going to do my best to responsibly reschedule those appointments. I would reschedule them if I was ill. I might reschedule them responsibly for other things, too.

So the key is really using the vision to walk the walk, not just talk the talk.

By the way, I got fired from that larger account that had the vision on the wall when they said to me, "Gee, what do you think of the meeting?" The CEO said. And I was honest. Now, I didn't have to be

honest, right? I could have said, "I think that was a great meeting. You guys are doing a wonderful job, thanks for having me back here." But that would of betrayed my core values.

So instead I said,"I have some concerns that what we spent almost a week full-time working on was not...lived in this meeting, and here are the examples..." And the CEO didn't happen to like that. And I serve at the pleasure of the president so to speak, and stopped serving because he didn't like that. And I understood that. And I understood that was the risk I was taking because I wasn't going to give him what he hoped and wanted to hear.

I think we have another question.

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VOICE FROM AUDIENCE: Yes, we have another question.

So this person says: "I've done research on how couples cope with stress. I'm passionate about helping people thrive in their family and social contacts despite difficulties, stressors, trauma, etc. I've struggled to develop a good vision statement that doesn't sound too routine. Everyone helps people cope with stress. Any suggestions?"

>>

DR. ZIMMERMAN: I'd love to hear your vision statement. I don't know if you can send it to us real quickly. But if you have one, I'd love to hear it.

>>

VOICE FROM AUDIENCE (OFF MIC): You go on, what's [INAUDIBLE]...

>>

DR. ZIMMERMAN: Okay, maybe we'll come back to it in just a minute. And if we don't get it back, then please just reread the question for me, because it may not stay here all that long.

So let's talk about some examples of using vision and values. You get a referral. You're in your office, you actually pick up that thing called a phone, as opposed to getting a voice mail. Why did you pick up the phone? Because you have, part of your values of how you run the practice, when you're available you want to answer yourself. You don't want to have somebody else answer for you.

So you pick up the phone, and local doctor says-- you're a generalist--local doctor says, "I have a cocaine addict here in my office right now. I'd like to send them to you for an evaluation so that you can get them placed. When can you see them?"

What do you do with that?

>>

VOICE FROM AUDIENCE (OFF MIC): Refer them to someone who's got that specialty.

>>

DR. ZIMMERMAN: Refer them to someone who's got that specialty. I'm just repeating you because you're not on mic. Refer them to somebody who's got that specialty. Why? Why not schedule an appointment for two weeks out?

>>

VOICE FROM AUDIENCE (OFF MIC): Otherwise, you're working outside your area of expertise.

>>

DR. ZIMMERMAN: So I'm a generalist, I'd be working outside of my area of expertise.

What if I'm not a generalist and I do a lot of work with substance abuse? And this is a cocaine addict who needs treatment? Schedule him for a couple of weeks out?

>>

VOICE FROM AUDIENCE (OFF MIC): No, not a couple weeks out. [INAUDIBLE]

>>

DR. ZIMMERMAN: So don't wait a couple of weeks... Why?

>>

VOICE FROM AUDIENCE (OFF MIC): Because the person is suffering and you had time to answer the phone, you can probably work them in...

>>

DR. ZIMMERMAN: [LAUGH] I had time to answer the phone. I can probably work them in. I have all afternoon, [LAUGH] send the guy over right now. [COUGH] Excuse me. Right... Maybe I had three minutes between appointments, but who knows.

>>

VOICE FROM AUDIENCE (OFF MIC): You're creative.

>>

DR. ZIMMERMAN: I'm creative.

There is another reason to not accept the referral. Three days from now, seven days from now, a week from now, what's the likelihood that I'm going to have a motivated cocaine addict in front of me?

I would suggest to you that motivation is probably going to be low. That right now the patient's in the doctor's office. The motivation is high. I don't expect the motivation is going to get higher. If anything, it's going to get lower. If it stayed the same, that would be a miracle. [LAUGH] It's probably going to get lower.

So regardless of scope of practice, which absolutely is an important issue, and I'm not just saying scope of practice doesn't matter, not at all... It absolutely matters.

But regardless of that point for a moment, one answer, if the vision for your practice is to provide the best quality of care, the best quality of care you could argue would be to say to the physician, "Gee, here are the names of three substance abuse treatment facilities in the area that treat cocaine addiction. And I would suggest that you might want to make sure it's covered by the person's insurance, whatever... But here's three names that I know of and I had good experience with. You might want to try calling one of those."

What does the referring physician think about that in all likelihood? Especially if you say, and I'm concerned if I get the guy in here on Friday or next week or two weeks, we've lost an opportunity. What does the referring physician then think at that point?

>>

VOICE FROM AUDIENCE (OFF MIC): You're someone he can count on.

>>

DR. ZIMMERMAN: I'm someone he can count on. Because my values are to take care of his patient, not to bring income into my practice.

And by taking care of his patient, what happens? I get the next patient, the next patient, the next patient, because I built a relationship that wasn't just about him being a referral source, but really being what's called a referral partner. And that I was invested on taking care of his patient, even though they weren't my patient. I was invested in helping him take care of, and get the treatment for his patient.

If he called a cardiologist and said, "Hey, Jeff, do you think this guy who's having pain on his left side radiating down his arm should go to the ER, or do you want to see him in the office?" I would expect the cardiologist would say, "Go to the ER, don't send him to my office."

And the same with the OBGYN in a similar circumstance.

And why not the same with a mental health professional? So your vision can lead you to actually referring cases away, and can lead you to developing relationships with the community out there as partnerships. Whether it'd be physicians, schools, whomever you're connecting with, VAs, whoever you're connecting with, attorneys, etc.

Your vision can also take you to a place of giving psychology away. We've got so much to offer. Go to the APA website. Look at the public education information that's available out there, from bullying onto many, many other things. Kids and feelings, lots and lots of things...

The idea of your vision can also be related to you deciding to I want to give it away, or I want to get it in as many hands, in the hands of as many people as possible.

Pro bono work... Why do pro bono work? That doesn't help my practice. Of course it helps your practice. And it's not about the money, it's about the vision. So might I volunteer in the courthouse to do full-day mediations that have no income associated with them, they're all pro bono? Of course, I may, because that's in line with my vision, even though it's not necessarily in line with, directly bring the income in. It's not all about the income, it's about why am I doing this work.

I think we either have a new question or that we got the vision statement?

>>

VOICE FROM AUDIENCE: Yeah, no, there's a new question, but it's about a vision statement. And this person's writing it and saying: " I've had a hard time narrowing my vision. In my 27 years of practice, practical help with grief is one focus. In fact, I've written a book on bereavement. I was advised years ago, though, that grief would not be good positioning, so I haven't moved ahead with it. Any thoughts you have?"

>>

DR. ZIMMERMAN: Bewilderment is the first thought. I have no idea why grief would not be good positioning. I think there is so much grief out there in so many different ways, not just in terms of loss due to death but lots of other grief... Grief around loss due to illness, grief around loss to missed opportunity, grief around all other kinds of losses-- I won't enumerate all of the ones that are coming to my mind right now, but there are so many.

And I think, yes, I would move forward with that, would be my advice, but to really refine it. What about grief? How are you going to help? Why are you going to help? Why are you doing this work? What is your vision for it?

You wrote a book on it, terrific... Why'd you write the book? Just to make royalties? Unless that book sold a million copies [LAUGH]... For those of us that have written books... [LAUGH] It will take you out to dinner maybe, maybe more. But it's not because you're selling a million copies and making a king's ransom on the royalties, you wrote the book for some other reason. Why'd you write the book?

And who doesn't go through grief, whether it's what you might call a normal grief reaction or not, but who doesn't go through grief and who doesn't need our help? Or might not benefit from what we as psychologists and mental health professionals have to offer in terms of grief?

So, I'm not sure why that advice was given. And if the person who wrote the question wants to tell me what the thinking was, I'd be happy to hear that, but I would think that it's such a universal problem... And a problem that we bring our skills to bear on...

I don't know why you wouldn't pursue that, and God bless you for being willing to do that difficult work. I'm thinking of parents who lose babies, parents who adopt babies, or try to adopt babies and lose babies.

I'm thinking of where in our culture do we not have grief? I think about, you know, 50 people on the subway car, and they all have their own story. And how many of those 50 stories don't have multiple stories of grief?

Can you help? Can you help soften the blow? Can you help with the transition?

A dear friend of mine passed away a year ago. He was three weeks older than me, and some of the people here in this room know him. And this was the anniversary of his passing just recently. But when he died, I was on the phone with his wife, I was actually going down to see him the day he died, but his wife called us off, so to speak, because he passed and she didn't want us to come at that moment. And she said, "I don't want you to remember him with sadness. I want you to remember him with gratitude, and that's what he would want."

And all the places I went-- because he was somebody that was very visible in APA and a lot of the same circles I travel--the places I went, I spoke to the gratitude. Even if I was tearful, I spoke to the gratitude.

For people who work with grief, I know I'm running on and on about this, but I hope I'm making it clear what do I think about it. I think, go for it. It's amazing that you're willing to help.

Write your mission statement in a way that addresses why, and how you touch the souls of the people that you're here to help.

Your vision and your mission can also address how you assess the quality of the work you do, how you assess the outcomes. Do you have outcomes measures? What are they? Are they researched measures? Are they measures that you personally developed? How long do you take them? What are those measures? How do you provide for clinical excellence?

Your vision can determine whether or not, and we'll talk more about this in another segment...

But whether or not you have things like restrictive covenants in your contracts that you write with your clinical staff. Your vision can determine whether or not, I think I may have mentioned this, whether you have weekend hours. Whether you train your staff beyond HIPAA. Probably everybody knows HIPAA nowadays. But train your staff beyond HIPAA. And look at HIPAA as the floor, not the ceiling.

And do you put energy into that? Do you spend the time talking about informed consent? Or is a signed release enough? I would suggest to you it's not enough. But so many people think it's enough.

Do you invest in your practice in so many different ways? Do you use a billing service? How do you screen or vet that billing service? How do you cope with the stressful days?

So when I'm, for example, doing the divorce work I do, some of it is a bit stressful. And on my way home, I'm thinking, boy, that family really gave me a hard time. I'm also thinking about, yeah, well, you know, maybe you helped those two kids that you don't see, just a little bit. Because the parents decided about soccer and math tutoring in the meeting. And it took a whole hour to get them to agree on soccer and a math tutor. But this kid is now playing soccer on one team, not two. And this kid is getting a math tutor. And great, and you just helped.

So your vision can also help on those difficult days. This is hard work we do, and it impacts us. And knowing why you're doing it and keeping that why up close, is helpful.

I went to Disney years ago, and I asked for what time something was starting. The fireworks were starting at Epcot. And I asked somebody who was sweeping up. He reached into his pocket, and he pulled out a card, and he gave me the answer.

Why did that happen? Somebody decided we're printing cards, everybody has a card. And we want to be able to have everybody answer basic questions like that. So the fellow sweeping up the cigarette butts back then had those basic questions.

The answers to those basic questions... That was a vision, that was part of vision.

What does the secretary or your receptionist or your answering service or your virtual office, how do they handle a new call? How do they handle somebody who's lost? Do you give out your cell phone to new patients if you have an office that's hard to find?

All of that is part of how you address your vision, how you live it.

Your vision also creates the culture. Are you a team? Are you not a team? Are you working together? Are you competitors?

We have how much...?

>>

VOICE FROM AUDIENCE (OFF MIC): 30 minutes.

>>

DR. ZIMMERMAN: 30 minutes left, okay, thank you.

Do we have another question, did I see?

>>

VOICE FROM AUDIENCE (OFF MIC): I have a vision statement.

>>

DR. ZIMMERMAN: Wonderful! This is the first vision statement, or the one on grief?

>>

VOICE FROM AUDIENCE: The first vision statement from the first question.

[CROSSTALK].

>>

DR. ZIMMERMAN: Okay, could you just read the question again and then the vision statement?

>>

VOICE FROM AUDIENCE: Okay, I'll repeat the first initial question: "I've done research on how couples cope with stress. I'm passionate about helping people thrive in their family and social context, despite difficulties, stressors, trauma, etc. I've struggled to develop a good vision statement that doesn't sound too routine. Everyone helps people cope with stress... Any suggestions?"

And here's the vision statement: "Helping Individuals and Families Thrive. Everyone should be able to thrive no matter what kind of obstacles they've endured in their lives, trauma, disability, financial hardship. I want to help people cope by strengthening interpersonal relationships."

And then there's a comment: "Sound too broad?"

>>

DR. ZIMMERMAN: So I think you're on the right track. I think my first reaction is it needs a little bit of refinement. I can't kind of do that out of my head. [LAUGH] But it needs a little refinement. You used the word "thrive" twice, I probably would use it once. And I would try to get to why you want to do this.

So can you read it one more time please, sorry... [LAUGH]

>>

VOICE OFF MIC: That's okay, you want to do this?

>>

[INAUDIBLE VOICE]

>>

VOICE OFF MIC: The vision statement right there.

>>

[INAUDIBLE VOICE]

>>

VOICE OFF MIC: There.

>>

VOICE FROM AUDIENCE: Helping Individuals and Families Thrive. Everyone should be able to thrive, no matter what kind of obstacles they've endured in their lives, traumas, disability, financial hardship.I want to help people cope by strengthening interpersonal relationships.

>>

DR. ZIMMERMAN: So I actually might start with the end. I might start... Since you're interested in doing couples work, I might switch it around a little bit and speak to the importance of healthy interpersonal relationships and healthy couples. Helping families, and them as a couple, whether there are children or not... Helping couples and families...deal effectively with not only the traumas, but the stresses that we face. And that the focus is on building those skills.

So the "why " is to help build healthier couple and family, I'm going to say, units. I wouldn't use the word "units," but just in terms of my thinking. I would say units...I would say, helping strengthen the couple and the family...to deal with life's challenges.

And I'm making it shorter and shorter. So you had maybe three sentences, I'm maybe down to one.

But that's very different than saying," I'm Doctor Zimmerman and I work with couples to help them get along better and deal with trauma."

So the second, the one I just said, is more like the mission. But doesn't have the why, and doesn't have that passion.

Now, if we go back to some of...some of these points here. If you have that vision, how does that affect who you hire?

I apply for a job. I do a lot of work with kids. And I'm really good. But I might not be right for you.

I do a lot of couples work. And I believe that couples really need to--I don't believe this... But I believe that couples really need to fight it out. That conflict is good and it brings kind of a healthy cleansing. And that those arguments are worthwhile, and I need to do that. Is that going to be aligned with your practice and your vision for your practice?

What do you say to me as a caller who says, "Gee, what kind of couples work do you do? My partner and I are having difficulty. What kind of couples work do you do?" You're going to have a different answer than that other couples therapist that I just mentioned. So it impacts there as well.

How do you decorate your office? What colors are you using? What does the office feel like?

What does it feel like in terms of gender? There are a lot of people that do couples therapy. And now as we have more and more women in the field providing the services, I'm hearing the reverse of what I used to hear. Which was the women felt distanced from the male clinicians.

And now I hear that [LAUGH] the men, many men felt distanced from the female clinicians. "She can't relate to me." What are we doing if we only have one gender in the room? What are we doing to be able to relate?

If we have two genders in the clients, what are we doing to be able to relate to both of those clients, and how are we doing that?

From the magazines in the waiting room to the pictures on the wall, to the colors we use? So we could do that throughout.

Policies, our cancellation policies... Do we have a cancellation policy that's 24 hours notice? How many of these couples have kids? If most of these couples have kids and you have a 24-hour notice, at 7:00 o'clock PM, the five-year-old threw up. [LAUGH]. The five-year-old got sick. You get a cancellation for 9:30 tomorrow morning at 7:30 PM the night before. That's not 24 hours. You have a 24-hour cancellation policy. Why would you have a 24-hour cancellation policy if you're working with both parents? To working with one parent, with individuals, maybe so. Because maybe the other parent takes care of the child if both parents are in the same residence. But if you're clearly having a couples practice, you're might have to look at changing that policy. That policy might not work. They can't give you 24-hours notice, routinely.

So I hope that answered the question. If there's a follow-up, feel free to email that in.

We still have a few more minutes to go today. Were there other questions?

>>

VOICE FROM AUDIENCE (OFF MIC): I have one.

>>

DR. ZIMMERMAN: Yeah.

>>

VOICE OFF MIC: If you don't mind...

>>

VOICE FROM AUDIENCE: A new question... "I recently joined an online referral platform. How do I screen callers/people who email me to make sure they're in line with my vision/mission statement before they come in? Previously, referrals were tighter, based on professional word of mouth.

>>

DR. ZIMMERMAN: So I believe it's important to actually speak to the potential client before they come in. There are some practices that have online platforms for scheduling. There are some practices that have an office manager or a receptionist handle those first calls and then schedule the client.

But I believe that--this is not APA's belief [LAUGH], I'm speaking for myself... I believe that it's better to have that call yourself. The client gets to hear your voice. You get to hear theirs.

You could actually say, if we looked at this couples practice as an example, you could actually say, "By the way, part of the way that I work. I don't know if you've been in couples therapy or if you've seen it on TV, or what have you... But part of the way that I work is this way..."

You could actually express your vision. This is why I do the work.

I often do that with the divorce work. I'll often say to the caller, when they say, "So tell me about what you're doing and what is this all about?" And I'll say, "Well, I can't speak for what it's all about for everybody, but for what it's about for me, this is why I do this work..." And I will give them that vision statement, or something pretty close to it that I've already said.

So you certainly can do that if you speak personally with the client before hand.

You also could do something where you don't agree to accept them into treatment. You agree to do a consultation. Somehow, many of us are of the notion that what you're doing from the start is your beginning a course of treatment. And I wonder about that.

How can I agree on the phone to begin a course of treatment, or have my receptionist agree that I'm going to begin a course of treatment, when I haven't even assessed why the patient's there, and the fit between what I do and what they need? Or even my approach and what they need, or my vision and what they need, and what they want?

So you could also, in terms of that question, you could also agree or state that one of the things you do, or the way you work, is you have a two session, three session, one session, four session, depending on the type of problem and the expanse of it. That's a consultation. And during that time, they'll have a chance to ask you lots of questions of how you work. You're going to ask them lots of questions about their history, their symptoms, why they're here, what their goals are... And at the end of that time, you'll be able to either speak to the direction you're going to go or what you think is best.

So that gives you some option in terms of not necessarily just jumping right in, not necessarily trusting whoever is making the referral. And certainly, if you're on an online platform, not just trusting what you're getting. It also gives you a chance to ask some questions over the phone.

So, for example, let's say that you don't have emergency coverage. And you don't want to be available 24/7. And the person says, on the phone, "I'm depressed." Well, if they say that to the receptionist, the receptionist might mark down "depressed," and they're coming in next Monday at 9:00 o'clock.

If you're on the phone, you might say, "I can't really get into great detail now, but can you tell me just, is the depression of the extent that you think you might be at risk of hurting yourself or hurting somebody else?" The person says yes, [LAUGH] we're in a different clinical situation than if the person says, oh, no.

The person says, "I've had depression for a really long time, years and years and years. I've had three hospitalizations. My psychiatrist recently moved, and I don't have any medicine."

Well, we may be in also a very different situation where I might be making different clinical recommendations at that point. So using that phone call as a brief screening option can be very helpful.

And using the consultation as a time to really look at client-clinician fit can also be very helpful. So you're not just taking your chances with those calls. You don't want to waste not only your time, but you don't want to waste their time if your vision is high quality and relates to high quality service provision. You want to have good fit and you want to make sure that you're not bringing clients in where you don't provide the care that they need.

I hope that helped with that question.

Are there other questions that we have at this point? We're good? Okay.

So I'd like you to maybe spend a moment or two just jotting down why you do this work.

And I'd like you to jot it down not in terms of salary, because you could do lots of work if you get paid for it. In fact, that's why we call it work. We don't call it volunteerism. So there's plenty of places that you can work and get paid.

So why do you do this work? Why do you want to be in practice? And I would love it if some people who are joining us remotely could respond to that question. Just type a one sentence without even giving it thought. Why do you do this work? And let's see if we can get some answers to that question that are coming in.

And if you can relate it to the specific kind of practice you have, that's even better. We'll just give a moment for that. And if we have those come in, just call them out as they come in.

I mentioned how, while we're waiting for that, I mentioned how the vision can also help you cope on those difficult days. It also can help you center. There are a lot of ethical dilemmas that come up or ethical challenges that come up. There are challenges in your relationships with your clients or patients that come up. And your vision can really help you center in terms of how you respond to those. So the more that you can be clear about that, the better in terms of being able to respond to those situations.

The ethical challenges are often subtle and they're often spur of the moment. And yet require a lot of situational awareness. And a lot of clarity about why you're doing the work you're doing.

I'm thinking of a case where I had a signed release to release a record to the person's attorney, and the person was suing as result of being hit on the head with a lead pipe and the injury that occurred. And the person also had told me in the course of treatment, which I had happened to document, because I

documented it for whatever reason... I didn't, I wasn't thinking about the case... That they'd also stolen a laptop.

And I could have released, based on the signed release and the request of the patient, and the request from the patient's attorney. But what occurred to me, is that if I release, is the theft of the laptop likely to help the person's case?

>>

[LAUGHTER]

>>

DR. ZIMMERMAN: [LAUGH] And I decided that it wasn't likely to help the person's case, not that I'm a lawyer to make that decision from a legal standpoint, but I had enough concern about that being in the record.

I also was very certain I wasn't going to change the record... [LAUGH] I've heard of people that have done that, not that I recommend it, I don't.

But I wasn't going to necessarily release that. And I decided to get a release to speak to the attorney. I spoke to the attorney and said, "There's stuff in this record that I think is not going to be helpful to your client."

"Well, I want to see the record anyway."

"I appreciate that, but I'm telling you that there's something in the record that I think is really not going to be helpful for your client. And I'm writing that I've told you that on the top of the file, " you know, the, well, when we had handwritten notes. "I'm writing that in the file."

Some people still do. And that's going to be there. Because the attorney might have to produce that. And if it didn't work out so well, I want it to be clear that I gave that advice to attorney.

As soon as I said that, the attorney said never mind.

But I risked the client being upset with me and the client's attorney being upset with me. But that was part of functioning based on my vision.

I think we have something.

>>

VOICE FROM AUDIENCE: Yes, we have a statement: "I strive to provide additional coping strategies when people are struggling and need help."

>>

DR. ZIMMERMAN: So the why you do this is to give people those, those struggling people coping strategies. And I would, I guess, say to that go deeper. Go deeper. That's a good why. But I don't hear your passion in that. So if you're going to work on that, I think it's a great start. If you're going to work on that, show me your passion. Work to get that, where's that touch you? Why are doing...

That person's not here so it's hard to have a dialog. But I would say to you, if you were here, "And why do you want to do that?"

So one of the things that you can ask yourself if you're having trouble with the why, is ask it again. In fact, there's some sentiment to do a little bit of meditation, clear your mind, and then answer the question, why do I want to be in practice? And when you stop, answer it again. And when you stop, when you run out, answer it a third time. And sometimes by doing it a third time or even a fourth time, you get a different answer. You get a deeper answer.

Yes, and--not yes, but, but yes, and, yes, and... Yes, and...

How we doing in terms of... We have another one?

>>

VOICE FROM AUDIENCE: Yes, we do.

>>

DR. ZIMMERMAN: Great.

>>

VOICE FROM AUDIENCE: Okay, here's another one: "To provide affirmative psychotherapy to clients who may be misunderstood, disenfranchised, and marginalized because of their racial, sexual, and gender identities."

>>

DR. ZIMMERMAN: So I notice I'm nodding a lot, [LAUGH] so that's hitting me, that's hitting me.

I might consider, like we said on one of the other ones, about perhaps moving some of the words around to get to the heart of it, the disfranchisement--if that's a word--to get to that first, get to that early, rather than have that be kind of towards the end, and to maybe think about shifting it from the negative to the positive.

So why are you doing the work? Because I want to help normalize, or fit in, or recognize the humanness, recognize the validity of the humanity, the diversity of humanity. Somehow I would look to moving it more from the negative to the positive. Because that also tells the user of your services... What's in it for them, as I said earlier today, and why you're there for them.

I think we have another?

>>

VOICE FROM AUDIENCE: Um-hum. "I do this to compassionately assist others to live life as an empowered and positive experience."

>>

DR. ZIMMERMAN: Great, put that on your website. So, many times we don't say that on our website.

What we say on our website, again, is here's my degree, here's my training, here's the work I do, I treat these disorders... I use these therapeutic techniques and strategies, which people don't know the abbreviations to, and this is what I do.

Maybe make that the banner, maybe make that bold or something like that, bold on you website.

>>

VOICE FROM AUDIENCE: Okay, another one... "To encourage people and share with as many people as possible the mind-body-spirit strategies we know can help them live richer, fuller lives."

>>

DR. ZIMMERMAN: That tells me why. It could go one step deeper, and I don't mean this in a challenging, facetious way, but so what? [LAUGH] So, why is that important? And take it even deeper.

I'm not worried that we're going to go too deep into our vision statement. I'm not worried that we're going to go too deep into our hearts, I think sometimes we don't go deep enough.

So, yes, that probably would work just fine what's there, but I might even look to go deeper... Why is that important? Now, because, say, everybody knows why it's important to live richer, fuller, lives... But maybe there might be something underneath that even.

Do I sound like a psychologist, I'm afraid? Occupational hazard...

Okay.

Any questions, thoughts?

>>

FEMALE VOICE FROM AUDIENCE (OFF MIC): No, I think it's been very helpful, I love the part about putting the passion in and continuing to ask why, so that your passion and your values are transformed, or not transformed, but are clear. And that the folks understand who you are as a person.

>>

DR. ZIMMERMAN: Which folks?

>>

FEMALE VOICE FROM AUDIENCE (OFF MIC): The potential client or patient.

>>

DR. ZIMMERMAN: Do we have sound?

>>

MALE VOICE FROM AUDIENCE (OFF MIC): You can kind of hear it but if she could repeat it, that would be great.

>>

DR. ZIMMERMAN: Okay, I'm sorry.

>>

FEMALE VOICE FROM AUDIENCE: Hi, thank you. I love the whole idea of ensuring that we have passion in the vision statements, that we communicate who we are as people, and what is important to us, and that we make that information available to everyone who comes in contact with us.

>>

DR. ZIMMERMAN: So that, I couldn't agree more. That would be the everyone, would be your clients, your patients, your referral partners, your staff, your subcontractors, you know, your attorney, your practice consultant, whoever comes in contact with you, your accountant, that what you stand for and why you're doing this is known throughout.

Our friends at Southeast Psych, if you come in contact with them, or if you meet one of them at convention, you'll know you met one of them. [LAUGH] For those of you that know them, and I know a number of the people that work for them, when you meet them, they are living it. Now, I'm sure they have bad days like all of us do, but when you meet them, they're living it.

So, yes, it's everybody, and that you really live that. And that especially is so important on those difficult days as we were talking about earlier, so thank you.

>>

FEMALE VOICE FROM AUDIENCE: No problem.

>>

DR. ZIMMERMAN: To wrap up... You have invested a small fortune in your practice. You've invested that not only in your training, your loans, and payrolls and fees that you give, or pay to other people... And the compensation, and the benefits, and the rent that you pay, your overhead... If you're in solo practice, if you're in a group practice...

And the health of your practice as an organization, which we'll talk about in the next segment, the health of your practice enables you to serve the community. You can't do it, whether you're for-profit or not-for-profit... And there's some practices that are not-for-profit, and I applaud them, and there are some practices that are for-profit, okay, and they both have to be viable. You can't serve the community if you're not sustainable.

A practice of any size... My practice today of one, plus some affiliate people like my accountant and people I rent space from, and that sort of thing... My practice of one is an organization, just as is my practice when it was 20 clinicians and support staff and seven offices, etc., etc.--that was also an organization.

Given the investment, given the duration of the journey of the organization, 30, 40 years of you being in practice, probably, maybe longer... You need a guiding sense of direction. And your vision gives you the guiding sense of direction.

And I'd like to close by saying, don't just know who you are. We do a lot of work around, who am I? And if you remember back to those early exercises and many different kinds of sensitivity groups, and what have you, is, who are you? And you go through the roles of who you are and all of that.

Don't just know who you are, know why you are.

Thank you.

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