Nicole: Hi, and thanks for joining me on Lead Better, the show that helps clinician CEOs grow and scale their business without giving up their lives or their Sundays. I'm your host, Nicole Harlow, and today we're going to go into an episode that for me was one of those, like, it's come up time and time again in running my business where I've had these moments where suddenly I realize that I am the bottleneck. I'm the problem. And I want to be able to go through this compassionately with care.
Nicole: But before we really dive into more of the strategy side of things, I'd like you to just sit with me and take a breath for a second. Okay. Lean into this, right? If your business feels heavy, if growth feels slower than it should, if everything seems like it somehow has to run through you, I want you to repeat something with me out loud if you can. I am the bottleneck in my business. Okay. Let's repeat it again. I am the bottleneck in my business.
Nicole: And I say this as someone who there is currently at least one way that I'm the bottleneck in my business that I'm working to repair and create systems around. So this isn't just a one-time thing. You'll find yourself at various levels of business becoming the bottleneck over and over again. So our job is really to find out and figure out where we've become the bottleneck in our business and create the systems and automations and the team structure that we need to make sure that we get ourselves out of that.
Nicole: Okay. Because being the bottleneck, it's not like an accusation, it's not a failure. It's not, oh my God, I've done something wrong. It's a signal. And this is really a truth that most founders never hear. So every successful business hits a moment where the leader becomes a constraint. Again, I'm going to repeat this. There is always a moment for every founder in every business where the founder, the CEO, becomes a constraint. That's not because you're doing anything wrong. That's because the business has outgrown the version of leadership that built it.
Nicole: So the person and the leader that you were when you started isn't the leader that you are now and isn't the leader that you're going to be in six months, a year, and several years. You're the one making every decision, right? This is how it starts, right? And you may still be at this point. You're making every decision. If things slow down when you step away, if you're not able to actually step away from the business, your team waits instead of moves, right? They don't feel empowered to make their own moves. And you find yourself as the emotional shock absorber for everything, right.
Nicole: So whether somebody signs on as a client or not, you're the emotional shock absorber. If somebody is happy with the service or not, if leads are coming in, if sales calls are coming in, if people are booking, if service is slow, you and your nervous system, when you are the bottleneck and you're the CEO, is taking on all of the pressure. You're the shock absorber for everything. So those are just some things like that's how you know that you are a bottleneck, right.
Nicole: And it doesn't mean that you're bad at delegation. You may not even know the right things to delegate, or you may be delegating things that the team's waiting still for you to make decisions. They don't feel empowered. So that just really means you've reached the edge of your current leadership identity. That's a good thing, right? All of this is a good thing. Being able to see it, feel it, identify. This is a system that we can build on, really. And I think if you are the bottleneck, the system can't expand until you do.
Nicole: So the question really is in what ways do you need to expand the container so that you're not the bottleneck anymore? And this actually can be true of your team. Sometimes we stop being the bottleneck and we actually transfer the bottleneck onto a member of our team or someone on our team. For example, I see this a lot in clients that have a front desk staff. They've taken their bottleneck and they've actually moved it over to their team. And then their team is now the bottleneck, right.
Nicole: So that's kind of part of our job in the systems architecture, is really going in with Lead Better, going in with our clients and seeing where are the places where either the founder, the CEO, the business owner, whatever term you feel like you want to jive with, or the team or both are bottlenecks in different spots. So in today's episode, we're going to talk about why becoming the bottleneck is actually predictable and normal, what science and systems theory says about why this happens, and how to shift from being the constraint to becoming the architect of growth without working harder or losing control.
Nicole: So I think that's really important too, is like we don't want to grow at all costs. And I think that's why this show is about like growing and scaling while also having a life and while also not giving up every Sunday. Maybe I don't know. We're CEOs. Maybe we have to work a Sunday. I don't actually mind. Sunday is like a day that I like to sit down and in fact I did a reel on this just recently up on Instagram around what my Sunday CEO date is something that I want to try to lean into here and keep consistent for 2026, is using it like an hour, 45 minutes on Sunday to actually go through and just like plan what I want to be doing for the week.
Nicole: So as the way I see it is the goal of leadership is not really to be essential to everything. It's to build something that works because of you, not only when you're there, right? So this is an important distinction, right? It's just like we can really become the complete identity of our business. And maybe you're like a solo provider, a solo like a health coach or a solo functional medicine practitioner where everything is you and the business. And that's okay. That just means we need to create systems that take the pressure off of you and allow you, just because you're a solo practitioner, doesn't mean that you'll always be the bottleneck because we can use systems to take that pressure off so that you can focus on just really being in your zone of genius.
Nicole: So, one thing, and I think just making sure that I'm really naming this clearly is that being the bottleneck is not a failure. And it doesn't mean that you're not organized and it doesn't mean you did something wrong. It really is a developmental stage of leadership. So as long as we can get on the same page with that, that really understanding where you're the bottleneck is actually a signal of you're in a new developmental stage of your leadership. So you become the bottleneck right before your next identity shift.
Nicole: So if you feel like overwhelmed, burnt out, everything's on your plate right now, congratulations. That means that you are ready to up-level into a new sense of identity. Now, this could be something that I like to teach about is the terrain of going from clinician to CEO because there's a path, right? Just not every clinician is a CEO, just not every CEO is a clinician. But for some of you out there, you are transitioning from clinical work into entrepreneurship, business ownership. You have a mission and a vision that includes running a business, a clinic, things like that. And so this is a normal developmental stage of moving more into your leadership and more to come about the terrain between the clinicians and CEO. But I just wanted to cue that up. That's I think a big theme for this year and something we'll be talking about a lot.
Nicole: So, with this episode and just going into more of the strategy side of that, it's not about working harder, it's about leading differently. So, let's go a little bit into the science of bottlenecks and why this is actually predictable. So we kind of expect bottlenecks to happen. So, bottlenecks are mathematical, they're not moral, they're not, like I said, I'm just gonna keep like hitting this home. That doesn't mean that you did something wrong or you were disorganized, that you find yourself as the bottleneck. Like I said, I found myself as the bottleneck many times over the years. And when I feel like I've solved one bottleneck, I'll find it in a different place. Okay, cool, I'm ready to level up.
Nicole: So the foundational idea from kind of an operations science is that in any complex system, output is constrained by its narrowest point. By improving anything outside of the bottleneck, we don't necessarily improve results because what we're finding is the constraint is the narrowest part. So often that will be you. Sometimes it'll be your team. You guys will be the narrowest point, and that will be the constraint. And so when you can find that and identify that, and a good way to like understand this in a little more of a practical way is you can ask yourself, like, what would happen if we brought in a hundred leads, or even 10, right? Just start the numbers up. Like, what if we had 10 new leads a week, 10 sales calls? What if we had a hundred? What if we had a thousand?
Nicole: And you can like stair step the numbers up and you can translate this into patients as well. What if we had 10 more patients a month? What if we had a hundred? What if we had 50? What if we had a thousand? And so do this thought exercise and you'll very quickly see the places where the business, yourself, the team is a bottleneck because you might say, I know for myself, like I'm the bottleneck presently because I'm the sole salesperson. So I can only take on so many calls per week. And so if we were to scale and run Facebook ads and spend a thousand dollars a day on Facebook ads, it wouldn't even like I would be the constraint there because there's only so much until I build that architecture, which I actually am currently doing. That's my bottleneck work that I'm doing right now.
Nicole: Until I build the systems that can support elevating and scaling that, I will be constrained at that point. It doesn't matter if I have the team to do fulfillment. It doesn't matter if we can take on 50 clients. If I can only do, if I look at my calendar and you got to be really like just super specific looking at your calendar to be like, how much time do I actually have? If I only have time for, let's say, three sales calls a week, then my marketing efforts are pointless in a way. It's pointless for me to spend more money on ads. And I see a lot of clinics doing this. Well, we're just gonna throw more money at ads. We're just gonna double down on our marketing.
Nicole: And if you're listening to this and this topic is resonating with you, it's January 13th when I'm recording this. January 20th, which is next Tuesday, 7 p.m. Eastern Standard Time, I'm teaching a webinar all about predictable patient flow. And actually, we're gonna go into this very topic, which is sometimes it's not about marketing harder. It's not about throwing more money or more time at marketing. If this system, if you haven't worked out the constraints and you haven't worked out where you're the bottleneck, your team's a bottleneck, your systems are a bottleneck because they're non-existent or they're not predictable, then no amount of marketing harder is gonna help you at that stage. But more on that, if you want to jump on live with me next Tuesday, put the link in the show notes below for you to sign up. And if you're listening to this afterwards, I'll put the replay there. So if you want to learn more about this topic, that's gonna be sitting there right there for you, ready to go.
Nicole: Just to reiterate, a system can only grow to the level that its constraints allow, right? And so the translation for clinics and founders is if you're their constraint, the business can't outgrow your decision speed, your emotional regulation. This is a huge one, right? We may show up every day, but if we're emotionally dysregulated, we're not able to be a great container for the business growth. Your availability, like I was saying, availability issue. If I was to take my example for sales, my emotional regulation is gonna be a big part of it.
Nicole: Because if I am an introvert, for example, and I don't want to talk to so many people every week, I'm gonna be a constraint just from an emotional regulation side of things, just from a personality side of things. And then there's also availability. And so in sales, those two constraints come together for me personally, because I could create all the availability in the world. I could say I have 40 hours this week just to devote to sales. I have delegated every single other thing, and this is the only thing that I do this week is do sales calls. My nervous system, personality, introversion, emotional regulation would not allow me to do 40 hours of calls every week. I would be so burnt out, it just would be impossible, right? I'd have to really work on building that container. And that's not a goal of mine. My goal is not to be a 40-hour a week salesperson.
Nicole: So you get to say, you get to lean into these places where you may be the bottleneck and say, ask yourself, really get down to it and just say, is this something that I would like to get better at? Is this something that I want to lean into and grow this container? So that could be like content creation or sales or delegation, or there's like so many different things that you can lean into. And it could be eventually delegating, getting all of that off of your plate. So you can just really focus on just being such an amazing clinician. For some of my clients, their goal is to, or their happy spot is really just, I just want to see patients and I want the rest of it to just be taken care of. That's awesome. Lead Better, you work with us, we take all of that off of your plate.
Nicole: And then for some people, there's also they want to move away from the clinical side and move more into their thought leadership. So that could be speaking on stage and creating content and writing a book. And these are both of those are awesome choices. And maybe it's a little bit of both. But I want to invite you to just feel into whether A or B feels a little bit more aligned with where you're at your leadership stage right now because the strategy is slightly different based on which one you feel more aligned to. But either way, Lead Better can help you with that. We're just about taking things off of your plate so you can focus on A or B or a combination.
Nicole: Yeah, so when you're the constraint, your business can't outgrow your decision speed, your emotional regulation, your availability, and also your tolerance of delegation. This is a real thing. There's delegation tolerance. Some of us are naturally good delegators, some of us are more inclined to be like, I'm gonna do it all myself because nobody else can do it like me. Some of us are a little more shy and we don't want to step on people's toes or ask them to do things. So you also have your own individual tolerance for delegation, which is a skill and a muscle that you can grow. But these are all kind of part of the constraints, and no amount of marketing will fix this.
Nicole: No amount of marketing will fix your emotional regulation. It won't fix your availability, it won't fix your tolerance for delegation, it won't fix your decision speed. So more marketing, more leads can sometimes equal more decisions that you have to make. So we want to make sure that we get that part of it because then every strategy can waterfall down from those constraints there. And I think part of this conversation is also recognizing that the founder's nervous system, that's you, clinician CEO, is the system. Like you, especially in the early days, or if you're still really involved with the process, your nervous system can really dictate a lot of the structures and the system that this business is built on.
Nicole: So anytime you have decision fatigue, cognitive load, stress pattern looping, if you're holding all the decisions, if you're context switching constantly, if you're acting as an emotional shock absorber, your nervous system stays in a threat response. So this leads to things like over control, right? You won't let people actually feel empowered to do the work that they need to do. Delaying things, this is why you find you've got four lead magnets and a program and all these things, and you've got like reels on your phone that you've never posted. You're just like delaying because the nervous system is in that threat response. You can find you can be avoidance, right? You can get into avoidance. Then you can also find yourself leaning into micromanagement. This is disguised as having high standards, right.
Nicole: So you're like controlling, micromanaging. And I think we all probably default to one or a little combination of these, right? Over control, delay, avoidance, micromanagement. We probably have your own unique signature and way that you respond to like stress when your nervous system feels taxed. But it's really good to know this, right? And know that the business mirrors the state. So until you remove yourself as the bottleneck, the business will be responding to your emotional state. So when you're a regulated leader, you have a scalable system. When you dysregulate, you got fragile growth. And we can see that mirrored in our business and our business growth.
Nicole: So I think it's important to talk about the real bottleneck because sometimes we tend to think about it in black and white to-do lists and deliverables. And this is my identity where these are my to-do list items that I have to do. But it's actually a little bit deeper than that. The bottleneck is at its core a leadership identity shift. Something that I see with a lot of the clients that I work with is this practitioner to CEO gap. So you're moving from your practitioner identity into your CEO identity. And when I say moving from practitioner to CEO, this doesn't mean that you're moving out of clinical work. Clinical work can still be a huge part of your weekly hours spent in and on the business, in and on the clinic, right? But there are different identities.
Nicole: So I want to do a little matchup like practitioner identity to CEO identity. So practitioner identity solves problems. The CEO identity designs systems. Practitioner values responsiveness, CEO values repeatability. Practitioner carries the business. CEO builds containers that carry others. Okay, so really important distinctions there. So a lot of CEOs, clinician CEOs, stall because they try to scale output without upgrading their identity. And that's a big theme for this year in this podcast and working with clients is upgrading identity from practitioner mode into CEO mode. We act as the bridge and the hands and the strategists to get our clients there, but part of the client work is stepping into that identity shift. We can create the system to support the new CEO identity.
Nicole: Because I want to make sure that this episode is really actionable. I want to go through just a quick bottleneck audit together. So I'm going to throw out three different core types of bottlenecks that you may be experiencing in your business. And I want you to just take a note of which one. And it may be a combo of two or three. The first theme is a decision bottleneck. So this looks like everything waits for you. The team's capable, but they're hesitant. So they come to you all the time with they're like waiting to have you like make every decision for them, tell them what to do, and they're not empowered to just take ownership over whatever that section is. And then you're also the final approval on everything. So things, you're the decision bottleneck because you're constrained by having to make decisions all the time.
Nicole: The second kind of core theme is an emotional bottleneck. So this looks like the team mirrors your stress, right? You have a front desk that's you're stressed out, burnout, your front desk is stressed out, burnout. You absorb tension to keep things calm. So you've got like interpersonal relationships inside of the clinic, and then you're dealing with a patient, expectations and their emotions, team emotions, financial success of the business, and you're absorbing all that tension so that everybody around you stays calm. And then growth feels heavy instead of expansive. This is the emotional bottleneck.
Nicole: And the last theme is a structural bottleneck. So this means you don't have clear systems for booking, for follow-ups, for lead handling, internal handoffs, or maybe it's got taped together, or some things have systems or some things don't. And what you do is you compensate with effort instead of your infrastructure here. So you just put more effort into it, more elbow grease instead of actually building the infrastructure. Most founders are a blend, but typically I find that one dominates. So I'd be curious to know which is yours, right? Are you a decision bottleneck? Are you an emotional bottleneck? Are you a structural bottleneck?
Nicole: So here's another short but helpful little experiment that you can perform this week. So it's a one-week CEO experiment. And what I want to do to do what I want you to do is for the next, let's say, five to seven days, as you're working every day, ask yourself if I were not allowed to be the bottleneck here, what would have to exist instead? You're not asking yourself, what should I do? But what system, what decision rule, what boundary, what automation, what role clarity would have to exist because you weren't the bottleneck.
Nicole: For example, I can ask myself around our sales process. If I wasn't the bottleneck, what would need to exist instead? That's somebody else in that role. That's someone who feels empowered to make decisions, who's empowered to close the sale, who's empowered to qualify leads to say this is a good person to spend our time getting on a call with. So I want you to go through and I want you to identify the places where you are the bottleneck and where decisions or emotions or things are landing on your plate repeatedly, and ask yourself if I wasn't allowed to be the bottleneck here, what would have to exist instead? Systems, decisions, boundaries, automations, role clarity, a specific role, somebody in that role right there.
Nicole: And I think this is gonna give you a lot of information by the end of the week of just writing down what places are you the bottleneck? And just deciding in an order of operations, like which one should get tackled first. And this is super powerful work because leadership is not being essential to everything, not being essential to every to-do, every sales call, every patient, every call, email, decision that needs to be made. If your business collapses when you step away, you don't own a business, you are the business. That's not power. That's a precarious situation.
Nicole: So my role within Lead Better as a systems architect and a growth partner is not to replace the founder at all. It's to remove them as the constraint. So to take that clinician CEO and find the places where they're the bottleneck and also dig deeper to see if there's places where the team is the bottleneck as well. And do this through systems, automation, clear decisions. How do we make decisions? And CEO level containment. This is part of my job. And that waterfalls down to creating automations and systems and using AI tools and all of the good stuff. But that isn't like for each client, it's completely customized because every client, clinic, business owner is going to be completely different.
Nicole: The way you want to work, your the kind of leadership that you want to embody, this type of schedule you want to embody, what you're looking for, and what your roles of your business are going to be different. So I want to start with that like what's the vision? And then how do we work towards removing you as a constraint, removing your team or people on your team as a constraint if that's where they're at too? Freeing up more time and energy to go into being a better clinician, for example, or sitting down and writing your book, or like working and digging into your thought leadership, creating a podcast, right?
Nicole: So I need space every week at least one day to sit down here and work on my thought leadership here with creating content because this is where all the juicy stuff comes from. I don't get this if I'm just like spending every day reactionary answering emails and then answering questions from the team and then doing client work and then maybe hopping on sales calls, if that's what every day looks like. I haven't carved out a spot. I need to make sure that I'm carving out a spot to work on my own leadership, right? That's what recording this podcast is. First and foremost, it's information for you to help you grow and be a better leader. But at the same time, it's helpful for me because I'm creating a body of work, I'm a leader, I'm showing up as a leader, and I'm also getting really clear on my messaging as I do this.
Nicole: So that's why I'm always an advocate for clinician CEOs creating podcasts, because this is a place where you can like really clarify more than social media, more than a little reel that you put together. This is where you do more of the deeper work. And this is the stuff that could turn into a talk or a book or an online program. I think a lot of ideas can come out of this. So that's just a segue and a little bit of a sales for podcasts, which if you want us to help you start a podcast, we can definitely do that. So in the show notes, you'll also see a link to Podcast Better, which is where you could get started with us as our podcast production team.
Nicole: So if this episode felt uncomfortably accurate and really feels like it dialed into a few different places where you are the bottleneck, that's usually a sign that you're ready for your next leadership layer. I would love to work with you in Lead Better to help build your foundation, remove you as a constraint. And so if you want to learn some more information about working with us at Lead Better, you'll also find that down in the show notes or at leadbetterhq.com. Thank you so much for spending this time with me, and I will look forward to the next episode with you. Bye now.