S8E10 - Leave, Leadership and Letting Go

Taking time away from work sounds simple in theory. In practice, many OT business owners know it can feel anything but simple.

Whether it’s a short holiday, a family trip or parental leave, stepping away often raises the same questions. Who makes decisions while you’re gone? What happens to client care? How much should you stay across emails? And how do you protect your team, your clients and your own wellbeing at the same time?

For OTs in private practice, these questions sit within a broader reality. Many businesses are already operating under pressure, with tight margins and ongoing uncertainty. That means leave planning is not just personal — it is a business systems decision.

Start with a clear leave plan

Most people do not accidentally take proper leave. It takes planning, boundaries and a willingness to let go of control.

One of the biggest traps is leaving everything until the last minute and hoping it will work itself out. In reality, leave works best when it is treated like a business process.

That means planning ahead for supervision, approvals, emails, scheduling and client communication — as well as deciding who will hold responsibility in your absence.

There may never be a perfect time to step away. But if you do not create the conditions to do so, the business can become so dependent on you that leave feels impossible.

Build a structure your team can rely on

Once the plan is in place, the next step is making sure your team can actually carry it.

Taking leave is not only about rest. It is also an opportunity to build a more sustainable business.

When owners stay across every detail, teams miss the chance to develop confidence and decision-making skills. With the right structures in place, most teams are far more capable than expected.

Many practices benefit from having a temporary caretaker or second-in-charge who can triage emails, support the team and escalate only what truly needs attention.

A clear structure reduces pressure for everyone. The team knows where to go, small issues do not escalate, and the owner is not constantly pulled back into the business.

Match your plan to the type of leave

Not all leave requires the same approach.

A short break may only need light daily check-ins. A longer holiday requires clearer delegation and escalation pathways. Parental leave adds another layer — particularly for sole traders and small practices where one person may be managing clinical work, admin and business operations.

This is where many therapists underestimate what is involved. Hiring another clinician does not replace the full scope of what a business owner does. Much of that work sits behind the scenes and still needs to be covered.

Use leave planning as a systems check

Once you start preparing to step away, gaps in your business become much more visible.

Leave planning often highlights inefficiencies that go unnoticed during busy periods — whether that’s unclear processes, over-reliance on the owner, or systems that don’t quite work.

It is also a chance to look at how your business is operating day to day. Are your workflows clear? Are your systems supporting your team? Or are things more manual and reactive than they need to be?

Review costs with intention — not reaction

This naturally leads into reviewing where your money is going.

Many OT businesses are paying for overlapping platforms, underusing features or sticking with workflows that no longer make sense. This might include double-handling invoices, paying for duplicate software or not fully utilising existing tools.

But not every cost should be cut.

Some systems significantly reduce admin time and improve workflow. Removing them may save money in the short term but create more work and inefficiency.

The goal is not to reduce spending blindly. It is to understand what each expense enables. A system that saves hours each week may be worth far more than its monthly cost.

Keep therapist experience front of mind

Efficiency on paper does not always translate to efficiency in practice.

A cheaper system is not necessarily better if it adds extra steps, reduces usability or increases daily frustration for therapists. Over time, this affects productivity, morale and service quality.

Therapist-led businesses often navigate this well because they understand the realities of clinical work. Cost matters — but so does how systems function in real life.

Understand the added complexity of parental leave
For small OT businesses, parental leave brings an added layer of complexity.

Unlike larger organisations, there is often limited capacity to backfill roles or absorb the financial impact. Even when owners want to offer paid leave, tight margins can make this difficult.

This creates a tension many business owners face — wanting to support their team, while working within the constraints of a small business model.

Understand where the money actually goes

Part of navigating this is having a clear understanding of business finances.

Service rates do not just reflect therapist wages. They also fund supervision, admin, CPD, parental leave, software, compliance and all the behind-the-scenes work required to deliver quality care.

When margins tighten, these supports are often the first at risk. Profit is not separate from care — it is what allows businesses to operate sustainably and continue supporting clients well.

Create space for strategic thinking

One of the biggest challenges for OT business owners is time.

Many spend most of their time delivering services and supporting their team, leaving little space to step back and assess the business objectively.

That makes it harder to review systems, analyse spending or plan for change. In some cases, external support can help bring clarity when decisions feel complex or emotionally loaded.

This is not about being less caring. It is about making decisions that allow the business to continue.

Sustainable businesses support better outcomes

At the centre of all of this is a simple truth.

Sustainable businesses are what enable consistent, high-quality care.

Better leave planning, stronger systems and clearer decision-making are not just business strategies — they are what allow OT services to remain stable, accessible and effective over time.

When practices are well run and supported, everyone benefits — especially the people receiving care.

Key takeaways for OTs
• Treat leave as a business process, not an afterthought
• Build clear structures so your team can operate without you
• Match your leave plan to the type and length of time away
• Use leave planning as an opportunity to review systems and efficiency
• Review costs strategically, not reactively
• Prioritise systems that support therapist workflow and efficiency
• Recognise the added complexity of parental leave in small practice
• Understand that profit enables sustainability and quality care