Why I Became a Director of Operations for Physician Coaches and What Finally Changes When You Have One

You’ve just closed your last patient chart of the day. The clinical part is done. But before you’ve made it to the parking lot, your phone is already going.

Three messages from your team. A question that only you can answer, a decision that apparently can’t move without you, and a task that was supposed to be done last week and somehow still isn’t.

So you handle it from the parking lot.

You make a mental note to follow up.

Then you get in the car and the rest of it starts surfacing. The launch you haven’t had time to plan, the strategic conversation you keep postponing, the hire you’ve been meaning to make, but just don’t get around to.

By the time you’re home and at the table with your family, your mind can’t stop spinning. You are not really present. You’re still thinking about all the tasks that need your attention for your business.

Sound familiar?

What you are describing is an operational foundation that hasn’t caught up to the vision. And truth be told, it is far more fixable than most physician coaches believe.

I know all of this sounds familiar because I hear it every week. The reason I know what your afternoons look like is that I’m a Director of Operations for physician-led businesses and what I just described is exactly the drag I help clear.

I kept watching capable, driven physician entrepreneurs normalize the chaos.

The exhaustion had been there long enough that it started to feel permanent. And I couldn’t stop seeing how solvable it was.

In this post, I want to walk you through three things I think matter most if you’re in that place right now. The first is an observation I made years ago in a cardiac clinic that I now see play out in physician coaching businesses every single week. The second is what actually changes when the operational foundation is finally in place: real numbers, from real clients. And the third is the belief that keeps more physician coaches stuck than almost anything else: the idea that they should be able to run all of this on their own.

That last one tends to land hard. If it already has, you’re in the right place.

What a Cardiac Clinic Taught Me About What’s Missing in Your Business

Before I worked in operations consulting, I was a nurse. Then a nurse manager running a multidisciplinary outpatient cardiac clinic. Cardiologists, pharmacists, nurses, dietitians, social workers, all under one roof, all responsible for delivering high-quality care to the same patients.

What I learned there shapes everything I do now.

We had a flow problem in that clinic. When patients needed to see more than one practitioner in the same visit, a cardiologist and a pharmacist, for example, they were the ones doing the moving. Practitioners stayed put in their rooms. And because nobody had the full picture of where that patient had been or what still needed to happen, things stalled.

Patients sat in hallways. Practitioners didn’t know if someone had already been seen or was still waiting. The day ran longer than it should have, and nobody could quite explain why.

We fixed it by flipping the model. We put a simple document on the outside of every chart. It mapped each patient’s full progression for the day: who they needed to see, in what order, and what was still outstanding. The patient stayed in one room. The practitioners moved to them. And because the information lived in the document instead of in anyone’s head, the whole thing ran without anyone having to coordinate it in real time.

I have watched that same dynamic play out in every physician-led business I have worked in since. The names and settings change. The problem follows.

When there is no shared operating system, no clear map of who owns what, what the priorities are, and what the team can actually decide without checking in first, everything flows back to the physician.

They become the person everyone moves toward. Every question, every stalled decision, every dropped task ends up back on their desk because that is where all the information lives. The team is doing exactly what the system is asking them to do. They just don’t have the chart on the door.

What we built in that clinic, I build in every business I work in now: a system that holds the map, roles that have real clarity, a plan the whole team can see. Once it exists, the physician can stay in their lane while the rest of the business moves.

Why I Stopped Doing Task Work and Became the Operations Director Physician Coaches Were Missing

When I transitioned into the online business world, I started as a VA doing project management work. I went in to complete tasks.

And almost immediately, I could see that tasks were not the real problem.

Founders were working around the clock, convinced that stepping away meant everything would fall apart.

Their teams genuinely wanted to do good work but had no shared direction because priorities shifted week to week. Projects started strong and quietly stalled.

Growth plateaued. The offers were solid, the audiences were there, but the back end wasn’t built to hold the weight of what was being built on top of it.

One physician coach I worked with described it perfectly. She had left clinical medicine to build a coaching business, believing she was escaping the burnout. Instead, she found herself right back in it.

Different setting, same exhaustion. The chaos had just changed shape.

That pattern showed up everywhere I looked. It was frustrating to watch. I wasn’t judging anyone. I could just see what was causing it, and it was fixable.

When I found the Certified Director of Operations designation, I recognized myself in it immediately. The designation was about strategic thinking across an entire business: what’s the plan, what does the team need, what does the data say, what needs to happen first.

I went and got certified.

And something telling happened: my existing clients renegotiated to keep me in a bigger role. I hadn’t pitched anything new. The need was already there.

I just finally had a name for what I’d been doing.

And that moment confirmed what I’d been watching for years. The gap was in the layer of operational leadership sitting underneath their effort and their vision.

Here’s what that shift makes possible for the physicians I work with now:

• One physician I work with has reclaimed over 1,000 hours.
• One of my clients reported she makes 40% fewer decisions per week. (Yes, we track it, because if you want to change something, you have to be able to measure it).
• Another client told me she was putting out 60% fewer daily fires.

Why “I Should Be Able to Figure This Out Alone” Is Keeping You Stuck

Physician coaches and clinic owners face every challenge I just described. But there is something specific to this group that makes the gap harder to close, and harder to admit.

In clinical practice, bringing in a specialist is a sign of good judgment. You consult. You build a team around the problem. Nobody questions it. That is the job done well, right?

But that same physician starts a business and quietly decides they should be able to run the whole thing alone.

The strategy, the team, the systems, the projects. Every piece of it.

And when it gets hard, when things fall through the cracks, when the team keeps circling back for every decision, when the plan never gets off the whiteboard, the response is to push harder.

I’ve heard it directly, in these words:

“I thought I should be able to do this on my own. I thought getting help was copping out.”

That’s physician identity. Trained to be the expert in the room, the one who carries the answer and the outcome.

Here is something I noticed in the cardiac clinic and have seen replicated in every physician-led business I’ve worked in since.

Physicians are trained to transfer knowledge to patients using structured protocols. Teach-back. Confirmed understanding before discharge. They do this instinctively, because the system requires it.

With their business team, most transfer expectations through assumption. They think it, they half-say it, and they’re surprised when it doesn’t land.

The gap between those two approaches is where most of the confusion in a physician-led team lives. That’s exactly the gap I close when I step in as your operations director. I take the ideas in your head and turn them into projects with a real plan, the kind your team can actually execute and finish.

Why This Takes a Partner, Not Another Task-Doer

Most physicians don’t know there’s a meaningful difference between a VA, an OBM, and a DOO.

That gap costs them time, money, and momentum.

That’s exactly why I built the Physician’s Business Workup. It’s a single working session where we figure out which level of support you actually need, before you hire wrong again.

I’ve seen physician coaches hire a VA hoping it will free up their time, only to find themselves managing that person and still holding all the strategy themselves. I’ve seen others invest heavily in visibility before their back end could support the growth they were trying to create.

Hiring the wrong level of support doesn’t free you up. It just adds a layer between you and the same problems.

Physicians ask me sometimes whether I just set things up and step back. And in case you are wondering too, the answer is no.

Setup alone was never going to fix it. What creates lasting change is the ongoing rhythm of the partnership that follows and that director of operations is me.

When we work together, we do a weekly check-in that keeps the strategic plan from gathering dust. We build in accountability structures, because that’s what ensures projects actually finish instead of quietly stalling. And we do a regular metrics review together that catches problems early, so you’re not discovering them three months later when the damage is already done.

Businesses and teams change, priorities shift, and what holds it all together is consistent leadership maintained week to week.

That is why this is a partnership and not a project.

Stop Being the Bottleneck: Inside the 5P Operating Rhythm

My director of operations partnership is built around what I call the 5P Operating Rhythm. It covers five areas that most physician coaching businesses are missing, and the reason it works is that they aren’t treated as separate.

They’re built together as a connected system.

Planning: I build your 90-day plan with you, broken down with clear ownership, so decisions stop escalating to you. Your team knows what matters most this quarter and goes and does it. Most physician coaches I work with are genuinely busy before we start, busy, but without direction. This is what changes that.

Process: I document the steps so the quality of your team’s work doesn’t depend on who’s having a good day. A lot of what gets done in most businesses depends on the right person remembering the right steps on the right day. That’s fragile, and it creates inconsistency that eventually affects the client experience.

People: I define what your team owns and what they can decide without checking in first, so the business can function without you at the centre of everything. Most team members I work alongside want to do good work, that’s rarely the issue. What’s missing is the clarity. This is where I spend a significant amount of my time with clients, and the change it produces is fast.

Projects: I build the plan, assign ownership, set timelines, and hold the accountability so the 2 or 3 initiatives that have been stuck on your list for months actually get finished.

Profit: I look at your numbers first, before I recommend anything else, so you stop managing by instinct and start deciding with data behind you. It’s easy to not be tracking the right metrics, or to be tracking them and not be sure what they actually mean.

With me as your operations director and us consistently working through all five of these together, you’ll have clear visibility into what matters in your business. That means you stop managing by instinct and start making decisions with real data behind you.

Not one piece. All five, built together and maintained consistently over time.

If you want to go deeper on how all five pillars work together, I’ve written a full post walking through the 5P Operating Rhythm.

What Changes When the Rhythm Is Actually Running

I am in the business with you week to week, grounded and focused, not reactive or scattered.

Something unexpected comes up, you have someone to think it through with. A project stalls, there is someone whose job it is to get it moving again. A decision needs to be made, you are not making it alone.

The physician coaches I work with describe it as finally having someone who holds the big picture so they don’t have to carry it alone.

One of my physician coach clients, put it simply:

“The organized and coordinated part of the business now just happens. Not magically. Structurally.”

She shared what things looked like before we started working together, building her coaching business alongside an active clinical career. “I would be sitting in my office crying at my computer. I thought I should be able to do this on my own. I thought getting help was copping out.”

Her husband watched it happen in real time. “You wouldn’t have the business you have today if you hadn’t had this support from the start. Because I could see the hours it took, the tears.”

Her effort was never the problem. She was already working hard. The structure underneath her changed.

Projects got finished. The team moved with purpose. Strategic planning finally had a dedicated space each quarter, because there was someone holding that space.

When she relocated internationally, a full cross-country move with the legal and logistical complexity of establishing a business in a new country, the business kept running. The podcast went out on time. New members could purchase and access the program. She showed up to do the work she loves. The team held everything else.

She is still practicing clinically. Still showing up fully for her members. And her business moves without her in the middle of everything.

The foundation caught up to her vision. That’s what changed.

Is This For You?

This director of operations partnership is specifically for physician coaches and clinic owners who are already generating revenue and working with clients or patients.

You likely have a small team in place, or you know a hire is coming soon. The business is growing but it feels like it’s held together with duct tape behind the scenes.

You are spending time on work that should not be yours, and you are ready for a real partner who can think across the whole business with you.

If you are just starting out with no clients or revenue yet, this is not the right fit for where you are right now.

The physician coaches who reach out most often say some version of the same thing: “I am embarrassed about what is behind the curtain. My back end is a mess and I am not sure anyone can help me.”

Hear me out on this: the mess is the symptom, not the problem.

You do not need to have things organized before we start working together.

Cleaning it up together is part of what this is for. I have never walked into a business that was too far gone. Not once.

What this partnership requires from both of us

This works because both sides show up fully and honestly.

I will respect your vision, your expertise, and the direction you want to take your business. I am here to help you build what you have already decided to build, in a way that actually holds together.

I will give you my honest perspective, even when it is not what you want to hear.

Of course, that requires something from you too. Trust that I have your business in mind. Be open about what is not working, even when it feels uncomfortable to say. And be genuinely willing to let go of being in the middle of every decision, because giving that up is what makes everything else possible.

When both sides bring that to the table, the results speak for themselves. This is a real partnership, and like every real partnership, it runs on trust.

The Physicians Who Build Something Sustainable Aren’t the Ones Who Hustle Harder

Let’s face it. The physician coaches who build something sustainable in the next few years won’t necessarily have the biggest platform or the most content.

They’ll be the ones who got the foundation right before they needed it. Who could take on a full cohort, add a team member, or relocate internationally, and the business kept running because there was an actual engine underneath it.

Does the chaos you’ve been calling just part of building a business sound familiar?

None of that is permanent. It is what happens when the foundation is missing.

I hear this often from physician coaches who are considering reaching out: “I need to get a few things in place first. I’m not quite ready yet.”

Waiting doesn’t prepare you for this. It just delays it. Every week spent trying to set things up alone is a week you are not focusing on the work that actually grows your business.

The reason it feels hard to set things up is that you don’t naturally think in systems. That is just not how you were trained.

It is, however, exactly how I think and it is the fastest path from where you are to where you want to be.

If you have invested in support before and still felt like you were holding everything together, that experience makes complete sense. Most of the support physician coaches hire is built around doing specific things: managing content, handling admin, completing tasks.

That work can be valuable, but it doesn’t change the structure of how your business runs. You still hold the strategy, carry the decisions, and connect all the pieces yourself.

A director of operations is coming in to take the operational leadership off your shoulders.

And that’s exactly what I’ll do for you if we’re a fit to work together.

That’s a different kind of relief – the kind that moves some of that mental load over to me, not just some of the to-do list.

Ready to Stop Being the Last Line of Defense in Your Own Business?

If you read this and recognized yourself, I want you to take action.

You already know what changes when the foundation is finally built. The only question left is when you start.

What Happens in Your Physician’s Business Workup

The Physician’s Business Workup is a focused 30-minute working session where you bring one specific challenge in your business or clinic.

Together, we identify what is actually causing it and what to address first. You leave knowing exactly where the drag is coming from and what your first move should be.

No more guessing, carrying it alone or wondering if it can be different.

One physician coach summed it up simply: “Peace of mind is priceless.”

Book your Physician’s Business Workup and let’s get started.

Book your Physician’s Business Workup