When you first started your group practice, chances are you were doing everything. Seeing clients, returning calls, submitting insurance claims, handling HR issues, fixing the printer. You wore all the hats because that’s what it took to get things off the ground. And in the early stages, that hustle works. It’s what gets your practice from idea to reality.
But then, at some point, things start to change. The practice grows, the team expands, the caseload increases—and suddenly, what worked before starts to feel unsustainable. You’re constantly exhausted, stuck in the weeds, and wondering why building something bigger has made you feel smaller. That’s the moment when many practice owners realize it’s time for a different kind of leadership. Not more effort. Not more hours. But a new role altogether: the role of the visionary.
Shifting from clinician to visionary isn’t just about delegating tasks—it’s about redefining your entire relationship to the business. It’s about going from “how do I do this?” to “what does this need to become?” It’s a shift from solving problems to setting direction. And while it’s an exciting transformation, it can also be deeply uncomfortable.
For many therapists-turned-business-owners, the idea of stepping back from client care feels almost like betrayal. You got into this field because you love the work. You’re good at it. And there’s real identity wrapped up in being the helper, the one clients rely on. Letting go of that identity, even partially, can feel destabilizing. But here’s the truth: the bigger your practice grows, the more your team and your clients need you in a different capacity. They don’t need more of your therapy skills—they need your vision, your strategy, your leadership.
The visionary’s role is to hold the long-term picture of what the practice is becoming. To look five steps ahead, identify patterns and opportunities, and ensure the entire business is aligned with its values and goals. This isn’t just about dreaming big; it’s about intentionally steering the ship. Without a clear visionary, even the most well-run practice can drift. Decisions become reactive instead of strategic. Growth becomes messy instead of meaningful.
But becoming a visionary doesn’t happen overnight. It requires a few critical mindset shifts.
- First, you have to stop equating busyness with value. Just because your calendar is packed and your inbox is overflowing doesn’t mean you’re doing the most important work. In fact, visionary work often looks deceptively “quiet.” It’s thinking time. Planning time. Meeting with your leadership team. Mapping out new service lines. Evaluating financial data. Setting goals. The work that shapes the future rarely feels urgent—but it’s always important.
- Second, you have to get really comfortable not doing everything. This means trusting your team to take ownership—and that starts with setting them up to succeed. It means building out clear roles, developing your leadership structure, and creating rhythms of accountability. It also means letting go of perfectionism. Your team will do things differently than you. And that’s not only okay—it’s necessary.
- Third, you need to shift how you define success. As a clinician, success might have meant a breakthrough session or helping a client meet a milestone. As a visionary, success looks different. It might mean seeing your leadership team take initiative. Watching your staff grow into new roles. Noticing a culture of collaboration take root. Or even simply creating enough space in your week to think clearly and lead with intention.
- And finally, you have to believe you’re allowed to evolve. You’re not abandoning your clinical identity—you’re expanding it. You’re growing into the next version of yourself, and in doing so, you’re creating space for your team to do the same. When you stop being the center of everything, it doesn’t diminish your value. It amplifies your impact.
So how do you practically start stepping into the visionary role?
Start by blocking time every week—non-negotiable time—for vision work. Not admin. Not emails. Just space to reflect, think, plan, and align. Then, begin developing your leadership team if you haven’t already. Who are the people in your practice who can take ownership of operations, clinical direction, or culture? Start training them. Give them more responsibility. Let them lead.
From there, start setting clearer strategic goals. Where is the practice going in the next year? What are the priorities? What are you saying no to in order to focus on what matters most?
And most importantly, keep surrounding yourself with other visionaries. Leadership can feel isolating, especially when you’re the one holding the long-term picture. Whether it’s through coaching, masterminds, or peer groups, find your people—those who understand the weight and the privilege of building something bigger than themselves.
This role isn’t about doing more—it’s about doing differently. And as you step more fully into it, you’ll notice something powerful—not only does your practice grow, but so do you. In clarity. In confidence. In impact. And isn’t that what we all wanted when we started this journey?
