Where Are You Going? (And How Are You Getting There?)

view of countryside with mountain range

Using the Vision/Traction Organizer™ to elevate your vision and achieve your goals

By Liz Plowman, PT, DPT

“Most entrepreneurs can clearly see their vision. Their problem is that they make the mistake of thinking that everyone else in the organization sees it too.”
– Gino Wickman, Traction: Get a Grip on Your Business1

A clear vision and a plan to achieve it are essential to elevate any business. When we treat patients, we have a vision of their end result (long-term goals), waypoint measures to move toward the end result (short-term goals), and action items to achieve the short-term goals (plan of care). As business owners, we need a systematic way to ensure that our business is healthy, growing well, and moving in the right direction. There are many systems out there, as any internet search will show. Traction™, a system developed by Geno Wickman, is one such system that is gaining traction (pun absolutely intended) among physical therapy practice owners.

In his book Traction: Get a Grip on Your Business,1 author Gino Wickman states that successful entrepreneurs must have a clear vision of where they want their business to go and a concrete and actionable plan to achieve that vision. While many companies have lofty business plans upward of 20 pages that gather dust on a high shelf, Wickman advocates developing a Vision/Traction Organizer (V/TO™) that is brief (two pages), fluid, and immediately usable. To create the V/TO™, the leadership team must come together and answer eight key questions.


Your business must have established core values, and these must be defined first as every subsequent business decision will flow from them. Wickman states, “Your core values should become a guiding force in your organization.”1 Most entrepreneurs know what their core values are but have difficulty articulating them. In his book The Pumpkin Plan,2 author Mike Michalolwicz describes core values as “immutable laws.” To discover what immutable laws you have, think about things that cause you the most stress. These are probably violating your immutable laws or core values. If you become stressed and upset when people are late, punctuality is one of your core values. In my practice, the core values are (1) punctuality, (2) accountability, (3) compassion, (4) respect for personal time, and (5) no drama.

Core values drive everything in your business and must, therefore, be defined first. Your team must share your core values, or the business cannot grow in the right direction. Hire and (when necessary) fire around your core values.


To define your core focus, Wickman states, “You and your leadership team should define, with absolute clarity, your two truths: your reason for being and your niche.”1 Your reason for being is why your practice exists—its purpose. Your niche is what your practice specifically does to fulfill its purpose.

Growing up, I called my father the “King of Goals and Objectives” because his answer to almost any question had to do with goals and objectives. Whenever I would come home with a new idea—a class I wanted to take, a club I wanted to join, a part-time job, a college major I was interested in—he would invariably ask me, “How does that fit with your goals and objectives?” It was frustrating but illuminating. It taught me to make decisions aligned with my roadmap and save me from “shiny object syndrome.”

It is very easy to fall prey to “shiny object syndrome” in business. Physical therapy is a broad industry, and there are many potential practice niches. It is tempting to follow every lead and be everything everyone needs, but quality is inevitably sacrificed. Businesses that do well identify a niche and focus on that alone. In The Pumpkin Plan,2 Michalowicz analogizes this to growing a giant pumpkin. To grow a giant pumpkin, the farmer cannot cultivate every pumpkin in the patch. He must identify the most promising pumpkin and devote his time, energy, and resources to that single pumpkin. Wickman states, “While a new idea may look like a no-brainer on paper, it’s simply not worth doing if it’s not a part of your core focus.”1


After developing your core values and core focus, imagine where you want your practice to be in 10 years. This is your long-term vision and your destination for the road map you will create. Set a specific and measurable long-term goal. This is the time to think big! Your 10-year target should spark excitement.


Identify your “perfect client” based on your answers to the first three questions. These clients fit with your core values and core focus and are ideally people with whom you enjoy working. Be as specific as possible in describing your perfect client. Include geographic (Where are they?), demographic (Who are they?), and psychographic (How do they think?) characteristics.

After you have defined your perfect client, identify your “Three Uniques™”: three things that differentiate your practice from others in your area. Why three? Unless your practice specializes in something that absolutely no one else offers, your competition will likely provide something similar. If you focus on three things that differentiate you from the competition, competing businesses may offer one or two of the same things you do, but they are unlikely to provide all three. “No one else should do all three the way you do,” Wickman states.1 The Three Uniques™ of Southwest Airlines are low fares, on-time flights, and having fun. Other airlines may offer one or two of the same things, but no other airline provides all three the same way. The same should be true of your practice’s unique differentiators.


While the 10-year target is your “destination,” the three-year picture is a major “waypoint” toward the 10-year target. It should be a measurable and attainable mid-range goal that is a little closer to grasp than the long-term goal. This is the goal toward which your action plan (see below) will move. Due to rapidly changing market and industry conditions (think COVID-19), there is questionable utility of any detailed strategic planning past the three-year mark.


Questions one through five established your practice’s vision. Questions six through eight address the Traction™ component of the V/TO™. The purpose of Traction™ is to take your clearly established vision and accomplish it. Focus on a few key measurable goals for your one-year plan that will progress you toward your three-year picture. Your annual budget should support the one-year plan. If your practice were your patient, your one-year plan is the equivalent of your short-term goals.


In his book First Things First,3 author Stephen Covey invites the reader to imagine an empty glass jar with rocks, gravel, sand, and a glass of water next to it. The jar represents your day. The rocks are your most important responsibilities, the gravel represents your everyday tasks, the sand represents disruptions, and the water is anything else that occurs in the day. The rocks must go in first to make everything fit inside the jar. However, our habit is to fill the hypothetical jar with gravel, sand, and water, and the rocks never fit inside. Following this metaphor, identify the “Rocks” for your practice. With the one-year plan in mind, identify crucial objectives (ideally three to five items) to focus on for the next 90 days. These are the most essential things to accomplish in the next quarter to move toward your one-year plan.


The final step of the V/TO™ is to identify the potential obstacles that could prevent you from achieving your established goals. By anticipating potential issues, you can be proactive in developing a plan to avoid or overcome them. While not every problem can be foreseen (again, think COVID-19), many can. If you plan for potential obstacles, they are less likely to cause damage or steer your plan off course.

After answering all eight questions of the V/TO™, write down your answers in a concise format. A template is available for download at www.eosworldwide.com/vto. Then, and most importantly, share your V/TO™ with everyone in your practice. The vision must be shared by all, not hidden away for leadership only. Involve the entire team and let them help you achieve your vision to elevate your practice to new heights. 

Disclaimer: The author has no affiliation with the Entrepreneur Operating System (EOS®), Vision/Traction Organizer (V/TO™), or any of its affiliates, nor is she receiving any compensation from these entities. The information contained in this article is for educational purposes only and is not intended to endorse or sell any product.

action item

1Wickman G. Traction: Get a Grip on Your Business. Expanded ed. edition. BenBella Books; 2012.

2Michalowicz M. The Pumpkin Plan: A Simple Strategy to Grow a Remarkable Business in Any Field. 1st edition. Portfolio; 2012.

3Covey SR, Merrill AR, Merrill RR. First Things First. Reprint edition. Free Press; 1996.

Liz Plowman

Liz Plowman, PT, DPT, is based in Tomball, Texas, and the owner of Pain Boss Physical Therapy. She can be reached at Liz@PainBossPT.com.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

Are you a PPS Member?
Please sign in to access site.
Enter Site!