Ep. 228: The Missing Piece in Urgent Care Growth: Clear Vision and Leadership
About this Episode
Most urgent care owners spend time training their teams on what to do.
But very few take the time to explain why it matters.
In this episode of Walk-Ins Welcome, Nick and Michael break down the concept of vision casting and why it is one of the most overlooked drivers of team alignment, culture, and growth in urgent care clinics. The conversation was sparked by a real client situation where staff resistance wasn’t a training issue. It was a lack of clarity around direction.
They unpack how failing to communicate the vision leads to confusion, disengagement, and resistance to change. More importantly, they walk through how to fix it. From telling the story of how your clinic started to clearly defining where it’s going, this episode gives a practical framework for building buy-in at every level of your team.
If your clinic is implementing changes but your staff isn’t fully on board, this is the conversation you need.
Topics Covered
🧠 Why training alone doesn’t create buy-in and what’s missing
📉 How lack of vision leads to resistance, confusion, and turnover
📖 Why storytelling is a critical part of leadership and culture building
🎯 How to clearly communicate where your clinic is going and why it matters
💬 Why your team needs a vision, and what happens when they don’t have one
🤝 How to align your team’s personal goals with your clinic’s growth
⚙️ Simple questions to help you define your mission, vision, and values
🚀 Why your vision must be big enough to include your team’s goals
🔁 The importance of setting goals and resetting them as your clinic grows
“Your dream has to be big enough though for all of your team members dreams to fit inside of it.”
Nick Hoard, Patient Care Marketing Pros
PCMP (00:00)
Hey, what's going on everybody? You're listening to an epic version of Walk-Ins Welcome brought to you by Patient Care Marketing Pros with Nick and Michael. What is up? I know this is, I feel like it's been a minute for some reason, but I think it's been a combination of just travel and all the things and vendor interviews and stuff like that. But here we are. Yeah. You guys, you guys have been at the UCA conference or coming back fresh off of that. And I know that was a great time. You had a packed house at your talk. Yeah.
We counted at 112 at my talk, which was good. Who's counting? Who's counting? I was not, but somebody else told me which I was appreciative of. But no, yeah, we were in Chicago last week. We'll actually have a full UCA recap episode coming very soon. I'm gonna wait on Steve for that one. But no, it was a good time. First time in Chicago. I saw a little snippet of that. That was some good content, man. I didn't get to go. I was back here holding down the fort while you were out there making it rain for us and
saw a snippet come across TikTok and I'm like, that's good content. Not that I expected anything less, but I was like, I need more of that. tell you those there's your teaser. Exactly. I tell you, my, you know, my talk last year on the front desk, I've had a lot of interaction, you know, during the talk, this one, had to pull it out a little harder, because I didn't want to talk about how they were doing something wrong. I had a little bit that going on today. went and
Sometimes we still have some local clients that we work with that are urgent care related, just simply be from our legacy agency that has just been with us for what feels like ever. Very good loyal people. And I love them and I'm happy to help them. And so if they ask me to do something, I'm going to do it. Nicole says, hey, I want you to come and talk to a group of people. And I'm like, sure. And I was thinking, man, I'm going to hook these people up with some good stuff. And she goes, by the way, they're financial planners. And I'm like, well.
got nothing. Because financial planners are allowed to say absolutely nothing. there's a regulation around them. I mean, we filled out on the urgent care side regulations around some of that. But so today, we're going to talk about vision casting. And the reason why I brought this up. So it's actually born out of this morning. This is how we do our podcast, by the way, an idea pops in, hey, we should probably talk about that. anyway, so this morning, I was meeting with a client, working on some front dash training for them.
multi location client. If they're listening, you probably know who you are. And we're talking about, hey, we're we've been around for a long time. We're making these changes. We have some staff resistant to changes from the standpoint of how to now do e registration versus traditional registration. Like that's a big deal change for them. And then hey, we need to shift our front desk mindset from just a receptionist to more sales oriented. A lot of resistance there. And I asked the question in the call, like, well, have you
explain the vision behind it, the why behind it, or you just kind of train them on it. And they're like, Yeah, we haven't done any vision casting at all. I say, Well, it's gonna be a big deal. Because they need to understand where this company is going. Because it's been going a certain path now for 20 plus years. But now all these changes are happening. So they don't, as an individual, like I wouldn't know what to expect. I haven't been explained to like, what's going to happen next year? Like, are we? Why are we doing this? We never had to do it before.
And so like, yeah, you're right. We haven't done any of that. So cool. think that's a huge first step. I'll say, I'll be honest, I'll be the training for front desk will be much better if the vision casting is done prior. So anyway, so that's where this conversation like, Hey, Nick, let's talk about vision casting, because that's something you're very good at. Well, thank you. ⁓ And I think that's something that every company needs. You can't be as an owner. You can't be quiet about the vision. You can't be hidden about it.
And you got to be transparent. And we even had our mastermind a few weeks ago and it was daunting for the people that attended of the idea of being transparent with their employees. It didn't feel natural to them, but it feels natural to us. Let's talk about it. love it. think honestly, there's two parts of vision casting. I think when most people think of talking about the vision of the company is where we're going. And we're going to talk a lot about that today. know ⁓ there's a missing piece.
in most people that they don't do. And I think we do this. I think we do it well. We maybe not do it as frequent as we should. And that is storytelling of where we came from. Right. Part of the vision of where you're going stems in where you've been. Right. ⁓ We have a saying around here. Remember why you started because things are going to get tough. ⁓ So you have to do you have to remember why you started what you're doing and and know where you're going. And it has to be crystal clear.
I'll throw this out here ⁓ for patient care marketing pros and walk-ins. Welcome. We're on a mission to help 100 clinics get to 40 patients per day plus. We're on a mission to do that and our team knows that. Not locations, but actual brands. Correct. 100 brands. If it were location based, we'd be cooking with gas, but we're talking about just individual brands. We do that by helping you get more patients, delivering better care, getting repeat visits and scaling, right? So we have the core values attached to the vision that we're casting out there.
And it's because we want to make a hundred million dollar impact in the ⁓ in the ⁓ in the urgent care health care marketplace. ⁓ So that happens with cheeks in the seats coming into your clinics. And if we're helping you get to those 40 patients per day across all these channels, we know that. But why did we start? How did we get here? Right. I know I could tell the story, but how did we get here, Michael? How are we in urgent care? Yeah, mean, so in the background is, know, patient care marketing pros is
technically part of Nick the marketer, which is a generalist agency which you started originally Nick is a real person, you've been listening to him for years now. ⁓ I used to have to say that when I would talk to somebody about Nick the marketer and say he's a real guy. Like he's not just a figurehead thing. I may still be a figurehead, but that's not the point. But anyway, and so we had start that journalist started I came I came on about a year later, very small, like home, trying to get things going type of company.
And just like everybody else, we got smacked around by COVID. ⁓ And COVID, as we all like in the urgent care space, COVID was a good time for money, bad time for stress. In the marketing space, COVID was a bad time. 100%. 100%. We were watching agencies drop like flies. Agencies dropping, we were watching our clients saying pause, not necessarily cancel because they were we were all in that boat of
I don't know what's about to happen. It should blow over by summer. It'll be fine. And even though they're not clients anymore, we have to give credit where credit's due to Elisa Dove and Michael Sebrin and Felicia Fortune. During that time in the agency, ⁓ we weren't an urgent care niche yet. And we had an urgent care. That was an urgent care. That was the urgent care. Multi-location urgent care that while everybody else was jumping ship, they were buying more from us. They kept this company afloat.
And I remember you and I saying, of course, other decisions were made as part of this, but I remember us saying, we're going into the urgent care niche. They were there for us. We're going to be there for them. That's how we got here. But that's part of the story of where our vision comes into play. OK, well, that's where we've been. How are we going to go to where we're going? What kind of real impact do we want to make? Well, great. We've had a long conversation about us. Let's talk about your clinic. Right? When's the last time you, clinic owner,
told a story about how you even started the clinic in the first place. Yeah, because you have to think about if your company is over one or two years old, which sounds very young, but if it's over one or two years, there's a good chance there are people there that weren't there when you started. Right. And the people that were there when you started probably understood some of the vision because they're like, hey, you had to explain it to them in the interview and kind of like convince them to come work for you.
Not you, Not you. But that's the reality of startups, right? There's a little bit of convincing because you're literally saying, hey, take a bet on me because I have this idea and I know it's gonna have a lot of confidence around it. And then the person like, yeah, I'll take a bet on you. guess, you and so you're like, have to kind of sell it, right? Right. Well, after a year or two, and you maybe that person's left or whatever, you bring on new people, the new people just see an established business that's still figuring stuff out, but established.
And so like the vision of it doesn't have as much impact as to like to get them to come on. Right. Like the conversation doesn't have to be there. So I could easily see where their vision was really well communicated the first year or so and then probably stop communicated once things started moving. What's the next generation? Yeah. Yeah. I feel like at this point I'm a grandparent passing on stories even though we're new in business ish in the grand scheme of things. What I'm talking about is like we're two employee generations removed inside of the company.
of the original cast and crew. You were around for it. Hannah was around for it. But now it's not just me carrying these stories, it's you guys carrying these stories. Hannah affectionately reminds me all the day. I've only been here one year longer than she has. She lets me know that regularly. And I got Hannah beat by you. I got Hannah beat by months or whatever. ⁓ But you carry those stories along with me. But the new folks on the team, if we don't tell them, they'll never know. No, and they'll never know the struggles, the reasoning.
gut reaction we may have to certain things. Well, I mean, there's there's things that to this day still I hate to use the word trigger, but there's things that still trigger me just off of decisions in the past that have affected us. But how does all of that play into where we're going? Well, if somebody stepping into your clinic and they don't know all of the history of the clinic, they're not going to get the inside jokes. They're not going to get the knuckle bumps. They're not going to understand your fears and anxieties.
They're not going to understand this weird push that the company like your coworkers have towards something like why is this a big deal? Yeah, so there's no buy in if you're not casting a proper vision. It starts with a story. Where did we come from? And then it it propels itself with the vision, right? Where are you going? So if you're a clinic and you're on a mission to help 40 plus patients per day, like that's aligns with our mission. But what I mean is if you're trying to get to 40 patients per day.
All that sounds like to them is greed. If you don't tell them why you want to get there. And by the way, I just want you to know, I'm giving you permission business owner to business owner. It's okay to want to make money. That's okay. That is a worthy, a worthy mission. It's okay to build and sell. Yeah, there is. There's nothing wrong with that. mean, technically you're not going to live forever. So it's going to be sold or closed at some point. Correct. So I just want you to understand one of the things that I struggled with early on in business, Michael is
trying to come up with some kind of a compelling vision that other people bought into. Because do you remember what it is for me? Do you remember my why? You probably do. With Preston. Preston. Yeah. Well, that has no emotional attachment or value to you whatsoever, but it's everything to me. Yeah. I think about it every day. I have a I'm not going to go into detail here because it's in the time and place for it, but I have an autistic son. And my whole goal for starting Nick the Marketer in the first place outside of need to pay my bills was I wanted him
in case he went into the world and the world didn't want him, I would. Yeah, yeah, I would. That doesn't resonate with anybody here from this. It does. I just didn't think it would. Right. Right. It does actually resonate. I didn't think anybody would care about that. But they do care about that. And they do attach themselves because let me tell you a secret that I've learned. Michael, you've learned this as well as most people don't have vision. No, don't. A lot of entrepreneurs like, not?
Yeah, but I'm not even talking about the entrepreneur. I'm talking about the employees. yeah. Your team doesn't have vision. No. By the way, I'm not beating them up for that. I'm just saying their vision is your vision. So if you don't give them a vision, they have no vision. They're clock in, do my work, make some money, go home, do it again. Correct. And I'm telling you what, without the stories to carry you in the hard times and the vision to propel you to your goals.
it's going to become monotonous. You're going to have a revolving door business. And when I mean that is you're going to have a revolving door of employees because they don't know why they're there. What's cool about the team that we've built here, and I'm sure some urgent cares that are out there as well, is they know exactly why they show up every day. Well, you know, it's interesting too, because I think a provider has some of like, you know, they understand like I'm helping people per se, but everybody else, they don't get that
shot of ⁓ success in their brain, right? Where I just made somebody feel better. Chances are, I was just part of some process type of things where they go. it's challenging. It's challenging to say, here's my vision. I need you to understand it because it also feels selfish, right? Like in your mind, like this is just all about me, but it's really not. Like you have to fight that. ⁓ And I really, think about how, I'm like imagining right now how the owner sitting down
making his next hire and he's trying to explain the vision of the company and it's not going to be pie in the sky because we've we've heard the pie in the sky visions from lots of people. I'm going to be the best whatever at this thing and nobody else blah blah blah. Like OK let's be realistic right. Like where's the not just I'm going to be amazing. It's more of what else are you doing because I know a lot of urgent cares we talked to they do like making impact in the community where hey we're building like especially you.
rural clinics, you had a mission there, right? Like, there's no health care in the city because it's a farm city and it's like 50 miles to the next hospital. They need something, let's fix that for them. So like, there's probably some stuff around that, but people just don't get in until they've been explained. ⁓ Today, the business that I spoke at, Nicole, who's been a friend for a long, time. ⁓
one of the things she came up after to want to say thank you for coming and talking and also to talk a little bit about ⁓ I can't remember the name of it. So I apologize in advance, but she's got a philanthropy through DF Hughes ⁓ that where they go in. project. Thank you. That's what it's called. You got me there. So the mending project where ⁓ women of abuse battered that kind of situation, she goes in and helps them fix their homes. Yeah. And you know what? There's that's vision.
Yeah, that's vision. Let me tell you about about that. Nicole isn't the owner of that company. Right. So you as a team member can have vision. That will be incorporated into the business and that comes with influence. Yeah. Right. So if you're listening and you're not the business owner and maybe that you're you're the marketing person or maybe you're the ⁓ the front desk.
receptionist or what I call the closer. you know, that's another story. ⁓ You can have influence. The previous job that I worked at, I'll never forget. It was the day I decided that I wasn't going to work there anymore. I'd been working there for about four and a half years at this point. And I finally emailed the owner, this was a bigger company, but I emailed the owner because at least I could email him and have access that way. And I said, I know what we're supposed to be doing every day.
All right. But I don't know why we're doing it. What is the vision you have for this company? And he railed me for that. Really? I think inadvertently, I called him out without trying to. That wasn't my goal. That's interesting. want to be upset. He was pissed. Huh? I mean, he berated me through email and copied my manager to where my manager came out apologized to me for it. But. ⁓
⁓ But what I'm saying, though, is ⁓ the reason of me bringing that up is your A players in your company, they're also thirsty for that. yes, 100 percent. Like, I totally agree with the idea that the people that are owners, if you have people that are pushing you for things like that where they want to have a bigger bite of it, right, have a bigger understanding.
They're wanting for a reason. It's not just to aggravate you. And I say like if the owner gets that aggravated off a request, like there's some bigger issues there that's well beyond like you probably triggered somebody you probably don't need to be there anyway. That was the response. And that was like in my talk, I told in part of my talk, says, Hey, this is the biggest challenge when you start making changes in culture. Don't react.
Right. Because when you react, you're not going to get what you want. ⁓ I actually struggle with that personally. So yeah, I can get that. You know, that's one of your benefits and blessings and giftings is probably the word I'm looking for is the ability to not react to situations. Yeah. Sometimes I just don't react at all. I know. There's that piece of it. Well, everything has its benefits and everything has its drawbacks. There's no just 100 % great for every situation, right?
But as far as casting vision, all right, well, that's great, Nick. You've convinced me that we need to cast vision for our team and that we need to have one. But guess what? I don't have one. Okay. That's also okay. Sometimes you need to sit down and ask yourself some questions. Right? ⁓ The first question I would ask is, why did you start? Or why did you leave what you had before? Yeah. Remember why you started. That's thing number one. There was something that caused you to want to do this.
It could have been, I remember early on in the company, we were this conglomerate of misfit toys, of broken pieces from other companies, of all the things we hated about the other companies. And I'll tell you what, the pendulum swung the other direction. We became too lenient because of the, for me, I became too lenient because I was so micromanaged that I'm like, I'm not micromanaging anybody. You know what I mean? I don't know what it is for you. You can speak to that on your own, but like,
for Kimberly being worked to death to death. Right. mean, nights, weekends, vacations. She couldn't she couldn't get away from her job. Yeah. And so feel that ⁓ all this stuff. Right. So when we first started early on, we were just this island of misfit toys of things that everything broken about us. We wanted to leave at the other company and start this new thing. And that's what we did. Right. ⁓ So anyway, remember why you started? We talked about that start there. Yeah.
All right. What are you trying to accomplish? What are you trying to accomplish? It's okay if it's selfish. not judging you. I'm just saying write it down. Right. ⁓ If your job is to build a clinic to sell or to go from one clinic to 10 clinics so that private equity wants you and you're becoming attractive at that way. And then you can go retire. Yeah. If that's what you want, that's fine. Your dream has to be big enough though.
for all of your team members dreams to fit inside of it. That, if you're not thinking that way, that is selfish in a degree that you don't want to be in. And you know, one of things I touched on and I talked to was, do you understand the goals of your people? Because if you don't understand and you can't help them meet their goals through the company that you're running, why would they need to stay there? a lot of them are like, yeah, we don't really know.
they want. I this one of the job like, yeah, sure, they need a job. But there's probably more to that, right? And pull it out of them. Right. So yeah, I think it's a because I agree, like, it gets kind of vague when you're saying, understand your why. And then how do you make your vision big enough for the people inside of you for their dreams? Like that can go very different for lots of people. So I can see what I what do I do with that? Well, sometimes you need to understand what their dreams are. That right there.
⁓ My dream, not mine personally, but like what if they came to you and it's your front desk person, for example. Well, my dream is to be the manager of people. And okay, how can me as the vision caster and the leader of this organization help you get to where you want to be? It may not be money. It may just be training, teaching courses, whatever, right? It may giving them their first taste of responsibility. Right? That could be you building their dream into yours, by the way.
But you brought up the biggest thing I wish I thought of it as your idea is not mine ⁓ is freaking ask a man. Yeah. Like if you're not doing regular meetings with your team start. That's a good place to expand your vision and dream as well. Here's a really good thing if you don't know what you want. Ask your team what they think. Yeah. Hey what do you think it is we're doing here. Well and we and we did that question and we did that with ⁓ our 40 patients per day.
We had it because before we had the 100 brands reaching 40 patients per day per location. ⁓ We were just 100 brands. We had no specifics beyond that. In part, that's because we were told that through other agencies like you got to put a number to it, right? But then when we realized, no, we know the impact of 40 patients per day. Right. We know that 23 patients per day, you're a business that's not dying. 40 patients per day, you're a business that's growing and you're looking to
And you're essentially attacking that dream you've been wanting to attack. And so that's where we recognize that. But no, the idea of just simply asking. And there's a fear that goes with asking. I get that because you're afraid of they're going to tell you something that like I wasn't expecting that. honestly. Or they'll say, I just need money. Cool. Why do you need the money other than just living? Right? Like there's something grander there. Like I don't, I'm convinced that we're not put on this earth to wake up, do a job, go home.
eat, sleep and do it again. Like there's more to life than that. And get off two weeks a year for good behavior and weekends to mow your grass. Exactly. I do think about grass mowing because it's one of those. Why do I want this? Why do want this grass mowing? Why do I care about this grass all of a sudden? Yeah. Why does this matter so much? I know there's a little bit instant gratification when it is trim. I that feels nice. But why do I care? Yeah. But I could just shave my beard if I want to That's funny.
Well, I will add the last caveat in my mind to this is we remember while we're starting, we're asking questions about like, what is it we're trying to accomplish? And then the third thing for me is setting goals to those things, right? So again, ours is 100 clinics, 40 patients per day. Yours could be something entirely different. I don't want to tell you what that is. But two things about this, because I failed. One is set a goal. Two is reset the goal. That's the part I failed on. And what I mean by that is we hit a milestone in the company.
that I don't. It's not that I didn't expect to hit it. It's just that I didn't think about what to do after we hit it. Now what? How much of a setback was that for the company though? Yeah, I didn't move the goal. We should have celebrated it. And we did and we did some celebrate that but we never reset. Now they were like, cool. And it's so funny because when we hit that goal, that was like a big goal for the previous company I worked for. And you know, at that time, was like, this is going to change everything. And then when we hit it here, I was like, well,
got a little more money and a little more problems. 100 % the money changed, but so did the problems. Yeah, they absolutely did. So there you go. Remember why you started, okay? Ask questions to figure out what it is you're trying to accomplish and then set goals to reach. That literally is the framework and so a lot of people will call that mission, vision and values. Yeah, a little bit. Honestly. All your business courses will call it that.
So you've already heard our mission. Well, you've heard our mission to help 100 clinics. The vision is for Preston to have a place to work. That's my own personal vision from a company we want to make. We want to help our clients, our community, and our employees reach their full potential. That is our vision now. That's a formal one. ⁓ And then our core values as a company. I showed you what they were told you about the more patients, ⁓ better care, repeat visits and scale.
But internally for us, and I want you to develop this for yourself as well is culture trumps everything. Win-win partnerships. All right. Exceptional client experience and embrace ownership. So those are our guardrails internally. And those have evolved over time. have. Yeah, I think that's a reminder too, if you have set up some of those things at the beginning, it's okay if it changes because you may realize that wasn't specific enough or maybe that was too specific and we had to adjust out.
But it's a real thing. and I, and one of things that we do struggle with is, can people repeat it easily, but they can fill it, right? Like for them to repeat it and say like, maybe, but they can see it in action is where it matters. It's one, you know, the culture part, you know, we, one of the favorite things that I got out of my talk was the 10 words thing. And we joke about that. We joked about it yesterday or yesterday. They were like two words, two words. then, you know, we laugh, but then
It did shut us up. What I wanted to go to read. was like 126 minutes after it. Maybe 42. Yeah. Well, real quick, now that you mentioned it, you have to do a quick 10 words. A quick 10. What's it about? Just real quick for those who don't know. And this is not our original idea. It came from a book. And I cannot remember the name of the book. I've talked my head. It's a business book. We raised a company, by the way, reading books together as a company or podcast or whatever. It's not a bad idea. It's a good way to have a good time.
But anyway, in that book, there's one thing that was very particular called 10 Words. And so 10 Words is simply a way of saying, shut up, you're about to get in a lot of trouble, but we're not going to make this awkward. So, and the easiest way to say it is if you're about to say something that's going to really make somebody mad or cross a line, the person nearby should say, hey, 10 Words, and your reaction should be, you're right.
and just stop. And I'm pretty good about that. You're pretty good about that. I think most of team is. And typically it revolves around politics or religion, just to be honest with you. Or a rant on a client or something. If I hear a rant on a client, I'm pretty quick to shut that crap down. They pay our bills. I know they made you mad. Sometimes our awesome clients in the urgent care space can be a little persnickety. at the same time, that's anybody and anything. I'm saying we could have 10 word our CPA.
He didn't word it himself. We had to go find a new one. We've recently been fired. All right, personal stuff. Hey, I do want to say this though. If y'all need some help or some coaching or some direction, one, I want to tell you to go reference, just do a search on the search bar for EOS.
with Lynn Askin, L-Y-N-A-S-K-I-N. He's been on the podcast before. That's what I'm saying. Just do a search on the podcast for Lynn Askin. That is a great episode about how to do EOS, Entrepreneurial Operating System, inside of your clinic. That's thing number one. Thing number two, I love talking about this stuff. So if you ever just want to book a meeting with me, two things will happen. One, we'll talk mission, vision, and values. Two, I'll try and sell you digital marketing. That's how that's If it makes sense. So listen, I've enjoyed this episode. This was a great idea. I love talking.
Yeah, knew you would but I just I had forgotten when I met with the people this morning. It became super obvious like, okay, y'all are talking about shifting an entire like 20 plus year old culture into the 21st century. Have y'all talked about why and right now I was like, okay, cool. And then that's where it triggered all this. So I love it. There you go. Well, hey, thank you for listening. As always, if you could smash that subscribe button and leave us a review. It's been a minute since we've had one and
tell you what, if you leave us a review, I will find it and I'll shut you out on the next podcast. And I'll say this, I know you're out there because we had lots of people come up to us at the UCA event saying we've been listening for years and like, I've never seen you leave us a review. Michael calling you out right here. It helps us. It does help us and we appreciate you listening. We value your time greatly. So thank you. We'll see you on the next one. See you.
