What I thought my week looked like

If you’d asked me a few years ago how I split my week, I would have said something like mostly seeing patients, with a bit of admin and a bit of looking after the business around the edges. That’s roughly how it felt, and I had no real reason to doubt it because nobody was checking.

I don’t think that’s dishonesty on my part. I think most owners genuinely don’t know where their time goes, because the week doesn’t arrive in neat labelled blocks. It arrives as one long string of things that each seem necessary in the moment.

What it actually looks like

When I started paying closer attention to my own week rather than guessing, the shape of it was different to what I expected. Clinical time was still a large share, but the next biggest share wasn’t the strategic or growth work I assumed I was doing. It was a long tail of small decisions and small fixes, rosters, a supplier query, a staffing gap, a question that only I could answer because nobody else had the context.

None of those things are wrong to do. Most of them genuinely needed doing. The problem wasn’t any single task, it was that they added up to a week where very little time was left for the kind of thinking that only an owner can do, the decisions about where the practice is heading rather than how it runs today.

The work that quietly eats the rest

The pattern I noticed in our own week is that small, low value decisions tend to arrive with more urgency than large, important ones. A staffing gap for tomorrow feels more pressing than a decision about next year’s direction, even though the second one matters far more to where the business ends up. Urgency and importance aren’t the same thing, but they feel the same when you’re the person everything routes through.

I also noticed how much of my week was spent being the only person who could make a call, not because the decision was genuinely hard, but because I hadn’t handed it to anyone else or written down how I’d want it handled. That’s on me, not on the team.

What I’ve started protecting

The honest answer is I haven’t solved this either. What’s changed is that I now try to notice when I’m the bottleneck for a decision that doesn’t need to sit with me, and I try to protect a smaller number of hours each week for the forward looking work rather than letting it get pushed out by whatever feels most urgent that day.

It isn’t a dramatic shift. It’s a handful of hours reclaimed here and there, and a bit more honesty with myself about what actually filled my week versus what I assumed filled it. We go into this in more detail, including how we think about handing decisions off properly, on the owner time page of the playbook.