The New Competitive Advantage

Across the practices I support, one pattern shows up again and again:
Teams are working harder than ever, but the practice isn’t actually moving forward.

Clinically, misalignment shows up in familiar ways — scheduling backlogs, delayed follow-ups on shared patients, staff turnover, and referrals that get lost or never make it to the right place. Leaders often spend their week putting out fires instead of driving the practice forward.

From an executive lens, the picture looks similar: volume becomes unpredictable, revenue doesn’t match effort, patient experience wavers, preventable leakage creeps in, and operational drag begins to cost real dollars.

Here’s the part that’s often misunderstood:
These aren’t separate problems — they’re symptoms of one thing: misaligned movement.

Strategy is moving.
Operations are moving.
Leadership is moving.
Just not together.

And misalignment tends to surface in predictable patterns.
When strategy pulls too far ahead, capacity cracks — teams burn out, referring providers get frustrated, and workflows jam.
When operations try to stabilize things but leadership isn’t aligned, progress becomes temporary and undone by shifting priorities.
And when leadership is eager to push forward without strategic direction, the practice generates movement… but not meaningful results.

That’s why so many practices feel “full” but underperforming.
Busy — but not better.

Here’s the reframe that often shifts things:
Growth isn’t blocked because people aren’t trying.
It’s blocked because people are trying in different directions.

What the most effective practices do differently isn’t more marketing, more hiring, or more hustle — it’s sequencing: aligning strategy, operations, and leadership in a way that reduces strain instead of adding to it.

When that happens, volume becomes steadier, communication gets cleaner, referring partners stay confident, patients move through care more smoothly, and leaders finally gain space to think instead of constantly reacting.

It’s not glamorous work, but it’s becoming the real differentiator heading into 2026.
Not bigger campaigns.
Not more hands.
Not more noise.
More coordination. And clearer ownership of who does what, when.

So here’s the question I’m asking many practices right now — and one worth reflecting on:
Where is your team trying the hardest… but not in the same direction?

Nicole D. Smith, MHA
Founder & Principal, Healthcare Consultant
BridgeWell Consulting & Events