Based on a PracticeCare® podcast conversation, Tracy Cherpeski on Time Leadership vs. Time Management, with Tracy Cherpeski, a business consultant and executive coach who works with private practice owners around the world, and host of the Thriving Practice Podcast.
Why should practice owners slow down if they’re trying to grow?
Because moving fast without clarity is what creates the problems you’re trying to outrun. Slowing down first gets you clarity on what you’re actually trying to accomplish. Cherpeski draws a hard line between speed and haste: haste is frantic and unclear, speed is smooth and controlled, like driving with your hands on the wheel instead of just flooring it. Clarity, in her framing, produces speed.
What’s the difference between time management and time leadership?
Time management assumes you have direct control over your time, which isn’t really true. Time leadership starts from a different place: get radically clear about the outcome you want, then direct your time toward it.
In practice, that means time leadership is the strategic layer and time management is the tactical layer. Cherpeski says most practice owners have never actually made that distinction, even though they use time management tools every day.
What’s the ABCD quadrant system, and how does it work?
Draw a box, split it into four quadrants. A is what needs to happen today — capped at five items, and two of those should be personal, not work tasks. B is what needs to happen by the end of the week; those items move into A as the week progresses. C is longer-term, typically a three-to-six-month project, and gets chunked down into B as you’re ready to work on it.
D is where a task gets one of three treatments: do it now to get it off your plate, delegate it to someone else, or delete it outright. Cherpeski calls all three of these delegation — you’re either delegating to yourself, to another person, or to the trash. The system gives you a fast way to sort a task the moment it shows up, instead of reacting to it as an emergency.
How should a practice owner handle a distraction or “shiny object” when it comes up?
Don’t fight the distraction — sort it. Cherpeski, who calls herself “the queen of distraction,” says her go-to move is to notice she’s been pulled off track, get curious about why, and then ask which quadrant the distraction actually belongs in.
Most distractions aren’t emergencies. If something isn’t truly urgent, it moves to B or C instead of hijacking the day. Real fires still get handled as fires. The point isn’t to ignore everything, it’s to stop defaulting to “this is urgent” just because it showed up.
How do you calculate whether a task is worth your own time?
Look at what you’re spending versus what you’re investing. Cherpeski’s example: if a provider’s time is worth $200 an hour and they’re doing marketing tasks a $20-an-hour staff member could handle with the right guidance, that gap is money left on the.
The number gets more concrete when you factor in opportunity cost. If freeing up an hour lets a provider see two more patients a day, the real cost of DIY tasks is the hour itself plus the patient revenue that hour could have generated instead.
What did this look like for one real practice?
Cherpeski describes a client running one of the largest neuropsychology practices in the Southeast, who started out solo with one admin and grew to two locations, ten techs, several admin staff, and nine or ten providers. As the only board-certified forensic psychologist on the team, she was still taking a mix of regular and forensic cases.
Cherpeski’s advice: stop taking regular cases entirely. Forensic cases were higher-volume, higher-value work only she was credentialed to do. Everything else went to the team, freeing her to spend more one-on-one time with staff, which is where the practice found its real bottlenecks. The shift surfaced inefficiencies that had been sitting there the whole time, just never addressed because no one had the bandwidth to look.
How should a practice owner get started today?
Draw the ABCD quadrant and use it for a week or two before doing anything else. Cherpeski’s advice is to skip the deeper “get clear on your dream” work at first and just start sorting tasks practically. The data from doing that for a week tells you more than any amount of upfront planning.
The second move: pick one thing already on your plate, ask honestly whether it needs to be you, and if the answer is no, hand it off.
A final note
Time leadership about being honest with yourself about what actually deserves your attention, and having a real answer, not a guess, when something new lands on your desk. Practice owners who build that habit stop reacting to every fire and start choosing which ones are worth walking toward. That’s a skill, and like most skills, it gets built one deliberate choice at a time.