I asked healthcare executives what's hardest right now. The top answer was capacity.
This is the first of a three-part series covering what is keeping healthcare leaders up at night: 1) capacity; 2) role clarity and ownership gaps; and 3) external volatility.
Here's what I kept hearing in my market research with healthcare leaders this year: these are extremely capable people running on strained systems. It wasn't really about the volume of work. It was the friction inside it: constant interruptions, tasks with overlapping or missing ownership, and recurring work handled ad hoc instead of through repeatable systems.
Sound familiar?
Most healthcare executives rate their own leadership highly (on average, about 7.7 out of 10). Yet they also rate their time and energy much lower (5.5 and 5.9, respectively). No matter how strong of a leader you may be, if your calendar doesn't protect time for deep work, you'll be pulled in a million competing directions, leading to an unsustainable situation I've experienced firsthand.
Today, I'll share more about what's driving this disconnect for leaders, beginning with capacity, which was the most common problem of all.
65% of leaders struggle with lack of capacity
About two-thirds of the leaders I spoke with felt like they didn't have enough capacity. They're wearing multiple hats because the foundation beneath them doesn't exist yet, or it's been destabilized by recent shakeups.
The reasons for this varied. Some organizations were still early in their growth, some landed more customers and sales volume than they'd planned for (a good problem, right up until it isn't!), and some faced unexpected attrition.
No matter the cause, stretched capacity forces CEOs to take on other responsibilities. The leader essentially becomes a "one-person show," handling everything from the day-to-day people management, to the company financials, to vendor management.
This happens most commonly among startup and scale-up leaders, when the company has outpaced its current staff, but hiring (or sometimes onboarding) hasn't happened quickly enough. However, problems with capacity are not limited to that group of leaders; they truly can impact anyone.
Why it's hard to hand off, even when help is available
On paper, it might seem like the reason this happens is simple: there's no one there for leaders to delegate to. And sometimes, that is true.
However, there are mindset factors that keep leaders stuck, too, and I've succumbed to them myself.
In many cases, it just feels natural for leaders to take too much on. Leaders tend to have a bias for action, which is a great thing, but you have to know when to rein it in. Without the ability to pause and relentlessly prioritize what actually needs attention, you can get into a vicious cycle of always feeling behind.
Often, leaders tie their responsibilities to how valuable they are. Being the leader who's always available and always capable of doing it all can feel like proof you're doing things right. Like I said, I've been there. I once wore my jam-packed calendar like a badge of honor.
But when that busy-ness becomes your entire identity, handing things off feels almost impossible, even when help is right there. And it keeps you stuck: the more tightly your value is tied to doing it all, the harder it is to scale the organization past you.
Break out of reactive mode and begin relentlessly prioritizing
This is the type of pattern I explore with patterns through ontological coaching, which looks at how the way you see yourself shapes the way you lead.
For this to change, you have to move from working in the business to working on the business. It's time to pause, step back, and look beyond the day-to-day long enough to ask these questions:
What is going on in the business right now?
Where am I being pulled in ways that aren't sustainable?
What would it take to redistribute this work?
Who do I actually need to hire?
Ultimately, you can't say yes to every opportunity that comes your way. This can be a tough mental adjustment, but you must know which activities will actually move the business forward, and get comfortable saying no to the rest. Again, this relentless prioritization is key for leaders who are stuck in reactive mode.
This isn't an easy change to make! That's why I walk every client through an Energy Audit at the start of our work together, as the foundation of my healthcare leadership development work. Together, we discover what time of day your thinking is at its best, what drains you, and what replenishes you. From there, we start to identify where your highest-quality energy belongs. For a leader wearing too many hats, the Energy Audit is often the first real roadmap of where to go next.
What to do this week
If lack of capacity resonates with you, here's a step-by-step to follow this week:
Look at what's on your plate. Pull out your calendar or task list for the last 1-2 weeks, and write down the recurring tasks. This includes meetings you attend, reports you review, decisions you make, and all other tasks.
Sort each item. Make a list: 1) things only you can do; 2) things other people can do with a handoff; and 3) things that could be eliminated without much consequence.
Choose one item from your second or third "buckets" and decide whether you'll hand it off or get rid of it. If you're handing it off, define who will take it, what a good outcome looks like, and when you'll need to follow up.
If there is no one to hand off to (and you can't eliminate the task), identify who you need to hire. What skills would this person need? This helps you get clear on staffing gaps.
Don't feel like you have to do an exhaustive inventory right away. No one has time for that; that's kind of the point. It's more than okay to start small!
And if you want help building a more sustainable Leadership Operating System℠, that's exactly what I do with clients as an executive coach for healthcare leaders. Book a discovery call with me, and let's chat about what redistributing the work could look like for you.
Next up in the series: what to do when you have the people, but work still lands on your desk because nobody's sure who owns what. Stay tuned!
Hope Gong is an executive coach and the creator of the Leadership Operating System℠, a framework that enables leaders to build individual and organizational systems that drive breakthrough results.
