Who owns this? Why unclear roles make you the default
This is the second installment of a three-part series on what's keeping healthcare leaders up at night. If you missed the last blog, I covered capacity, which was the most common challenge leaders named.
Quick recap from last time: in my market research with healthcare leaders this year, I kept hearing from extremely capable people running on strained systems. They rate their own leadership highly, but their time and energy much lower, and the culprit isn't really the volume of work. It's the friction inside it.
Now that we've talked about capacity, which is the biggest challenge leaders face, we'll look at the second most-cited obstacle, which is somewhat similar. Last time, the problem was having too much on your plate (and having a hard time letting go). This time, the problem is a lack of clarity around who does what.
52% of leaders say work doesn't have a clear home
About half of the leaders I spoke with described some version of work not having a clear home. Usually, it drifts upward until it lands on a leader's desk. There are decisions that should have been made a level or two down, still hanging out there until leaders notice. Problems tend to bounce around because everyone assumes someone else has it.
This pattern often starts with a strength: a bias for action. Leaders jump straight into getting the work done, the content of the work, or the "what." Those are the tactical pieces, and they feel urgent for good reason. What gets skipped is stepping back to think about process and systems, the context of the work, or the "how."
The need for speed is real. Growth means more clients to deliver for, and the market and industry keep shifting underneath you. So, in the name of speed, leaders dive into doing the work before talking about how the work should get done.
That's often where the clarity and ownership problem comes from. If you've got outdated job descriptions (or none at all) and boundaries between roles that no one can clearly articulate, this may be what's happening.
This can play out in a few ways:
The leader never got around to establishing roles in the first place (hello, startup life!).
The ownership structures are crystal clear in the leader's head, but nobody else's.
A recent reorg shuffled things around, and nothing got updated or communicated.
Roles are written down but never talked about out loud (or the other way around).
Why growth makes it worse, and why you become the default
Growth tends to move faster than the org chart. As you win more clients and customers, more work lands on your team and the number of handoffs multiplies, but roles don't get redefined at the same pace.
When nobody is sure who owns something, it goes to the person who will definitely pick it up. As the leader, that's usually you.
Over time, you become the default go-to. Not because you want to be, and not because your team can't handle it, but because the default is for everyone to send things your way. As an executive coach for healthcare leaders, I see this pattern all of the time, and I lived it firsthand while leading operations at a fast-growing healthcare services company.
In that role, compliance technically had an owner, who was a capable executive managing it alongside an already full-time job. However, when a wave of regulatory changes doubled the workload, we did what felt most efficient. We moved the problem to a different executive's desk: mine!
Spoiler: that didn't fix it. Moving responsibilities in a pinch is not the same as giving it a real owner. It wasn't until we mapped out who was doing what, and brought in expertise where there were genuine gaps, that things finally clicked.
How to give work the right address
The fix has a few parts, and I'll warn you up front that the last one is the hardest.
Define and document. Write down each person's responsibilities and the boundaries of their work. You don't have to do this alone. Work with your team to understand where people's strengths lie (this is where CliftonStrengths for leaders and their teams can help) and what makes sense for each person's functional role.
Communicate expectations, repeatedly. Once roles are clear, share them in as many ways as you can: in writing, out loud, and in multiple forums, especially when you're kicking off a major project or initiative.
Maintain it, together. Enforcement can't be only your job. Every person on the team needs to understand their own role and everyone else's, know where and when handoffs happen, and feel comfortable speaking up when things get messy or someone steps outside their lane. Consistency is what makes it stick, and it's the backbone of real leadership team alignment.
What to do this week
Please don't try to redo your entire org chart or RACI chart this week. Instead, start with one thing:
Spot the repeat offender. Think back over the last couple of weeks and find one recurring decision or problem that keeps getting routed to you because people aren't sure who's doing what.
Pick an owner. Decide who should own it.
Provide some guardrails. What can the owner of the task decide on their own? When does it genuinely need to be escalated to you?
Tell everyone involved. Let people know what's changing and put it in writing.
It sounds simple, but one recurring decision with a clear home is a real win, and it gives you a pattern you can repeat.
If you want help building a Leadership Operating System℠ that gives work a clear home (ideally, not on your desk), that's exactly what I do with clients in my healthcare executive coaching practice. Book a discovery call with me, and let's chat about what that could look like for your team.
For the final blog in the series, we'll cover what to do when the outside world keeps changing the plan on you. See you soon!
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.
