The Quarterly Check-In: The Leadership Habit That Keeps Good Therapists From Leaving
If you're a group practice owner, I'd bet you think you're already checking in with your team enough. You say good morning in the hallway. You ask how someone's caseload is feeling this week. Maybe you even remember their kid's name and the fact that they are involved in lacrosse. That counts as healthy business relationship, right?
I would argue that it doesn't…at least not on its own. A hallway hello and a purposeful check-in aren't the same thing, and the difference between them is often the difference between a therapist who stays for years and one who quietly starts looking elsewhere.
Know Who Your Ideal Therapist Actually Is
Before we get to the relationship piece, it's worth pausing on something a lot of owners skip past. Just like you have an ideal client (or should), you also have an ideal therapist, and most of us have never actually written down what that looks like.
So take a minute and answer this for yourself, not for your practice as a whole, but for you as a leader.
What are their values?
What skills matter to you more than credentials or years of experience?
How do they like to work, independently or collaboratively? Structured or flexible?
And what do they need from you in order to do their best work (and that you’re okay providing)?
You don't need every therapist on your team to fit this picture perfectly. Nobody does. But you want somewhere around 80% of your team living in that zone, because the ones who aren't, will drain your energy in exactly the same way a wrong-fit client does. You'll find yourself managing more than leading, and that isn't sustainable for you or for them.
The Quarterly Conversation
Here's the part that actually builds retention once you know who belongs on your team. It's a healthy leader-team member relationship, and that relationship needs a container.
I've become a firm believer that meeting individually with each therapist on your team at least once a quarter is one of the most important things you can do as a leader. Not a hallway chat. Not a 5 or 10 minute check-in between sessions. A conversation that you initiate with intentionality, that's longer, and purposeful, even if it doesn't have a formal agenda every time.
This isn't just an idea I came up with on my own. It was reinforced when I read Traction by Gino Wickman and his Entrepreneurial Operating System. The quarterly conversation is built around the idea that 90 days is about as long as a person can stay focused before priorities blur and urgency fades.¹ The team at Ninety.io put it well when they wrote that without a quarterly reset, the year runs you instead of the other way around.² And this isn't unique to therapy practices either. Businesses in completely different industries have found that consistent, purposeful meetings like this are what actually create traction, not just activity.³
I learned how much this mattered the hard way. There was one quarter where I let our quarterly meeting slip. Life got busy, the timing didn't line up, and I let it go. What happened next told me everything. Most of my team reached out on their own to ask when our next meeting was. They valued that time and that connection enough to notice it was missing, even though nobody had asked them to.
So how often is healthy for you and your team? Quarterly is my baseline and my recommendation, but it might vary by person. Someone newer on your team, or someone going through a season you both know is hard, might need it more often. Someone with more tenure and more trust already built might need less. The frequency isn't the point (although I would say you don’t want it to go longer than 6 months at a time). The intention behind it is.
Rock Stars and Shooting Stars
Part of showing up in these check-ins is paying attention to who's actually in front of you. Some of your therapists are rock stars, doing excellent, steady work and not going anywhere, but they still need guidance and nurturing, not just praise on their way out the door. Others are shooting stars. They do everything you ask, they fill up fast, and then they leave, often sooner than you expected. Both are normal. Neither means you did something wrong. But both need a different kind of attention from you.
Is there a rock star on your team you haven't actually told you see them?
Is there a shooting star you've quietly been expecting too much from?
Sit with those two questions for a second before you move on. Most owners already have an answer to at least one of them.
I'd encourage you to actually write down every therapist on your team. Beside each name, note one thing you could celebrate about them from the last 3-6 months, something specific, not generic. Then note one thing to watch for, either a concern they've raised themselves or something you've noticed but haven't said out loud yet.
I do this with my own team, and what I notice every time I celebrate something specific in their quarterly meeting with someone is small but telling. They smile. They stand a little taller. That reaction is the whole reason this matters. People don't just want to do good work. They want to know that someone noticed.
This Isn't Just for Employees
If your team is built on a contractor model rather than an employee one, don't skip this part thinking it doesn't apply to you. Associates join a group practice because they want clients, yes, but also because they don't want to be alone in private practice. They care about getting and keeping clients, and knowing they're working alongside others, for something that means something, matters just as much as the cheque.
I saw this play out with one of my own therapists. We sat down to one of our quarterly meetings to dig into her client retention, and at first she was resistant. Tracking numbers felt too business or money focussed and a little uncomfortable to her. But as we worked through it together and her ideal client actually came into focus, something shifted. She wasn't just retaining more clients. She was more fulfilled in the work itself, because she finally understood who she did her best work with. That conversation only happened because we'd built enough relationship for her to sit in something uncomfortable with me in the first place.
When Someone's Struggling
This is the part worth being honest with yourself about. When an associate seems unhappy, or you can tell something's off, how do you usually respond? Do you wait for them to bring it to you? Do you address it quickly and move on? Do you avoid it because you're not sure what to say?
And separately, how do you want to respond?
There's often a gap between those two answers, and closing it is leadership work, not personality. People want to be led. They want to know you're steering the ship, and that means you're the one instigating the connection, the support, the celebration, and the accountability. Not waiting for them to ask for it.
Where to Start
You don't need to overhaul anything this week. Start here:
Write down the name of every therapist currently on your team.
Beside each name, note the last time you initiated a purposeful check-in with them, one longer than five or ten casual minutes.
Add one thing you could celebrate about them from the last few months.
Add one thing to watch for.
Circle whether they're a rock star, a shooting star, or somewhere in between, and let that shape how you show up for them next.
This was actually the focus of one of our conversations inside Group Practice Connection this month, and it's exactly the kind of thing I'd love to work through with you directly, whether that's inside the membership or in individual coaching. Building a team that stays isn't about doing everything the way I would. It's about showing up as a leader consistently enough that your team feels it.
If you want support putting this into practice, I'd love to have you in Group Practice Connection or explore what individual coaching could look like for you.
Sources
Wickman, Gino. "The Quarterly Conversation." EOS Worldwide Blog. https://www.eosworldwide.com/blog/594-eos-the-quarterly-conversation
"The EOS Quarterly Meeting, How to Operate in a 90-Day World." Ninety.io Blog. https://www.ninety.io/eos/blog/the-eos-quarterly-meeting-how-to-operate-in-a-90-day-world
"Good Meetings Lead to Real Business Traction." Pallet Enterprise. https://palletenterprise.com/good-meetings-lead-to-real-business-traction/
