“We want to build a service line.”

I’ve heard some version of that sentence in every healthcare organization I’ve worked with.

Different market. Different geography. Different size system. Same conversation.

The vision is usually strong: Better coordination. Better growth. Better patient experience. More integrated care.

And almost every time, the organization gets stuck in the exact same place:

Execution.

Not because the strategy is wrong. Not because the people are incapable. But because healthcare organizations consistently underestimate the human side of change.

A few years ago, I joined Tanner Health to help build a more integrated Heart & Vascular service line and launch a TAVR program. On paper, the opportunity was obvious:

  • Expand access to advanced cardiovascular care
  • Keep patients close to home
  • Build multidisciplinary infrastructure
  • Create a foundation for future growth
But very quickly, I realized something important:

We did not have a strategy problem. We had an alignment problem.

Everyone supported the vision conceptually. But departments were fragmented. Teams worked independently. Priorities competed. Communication broke down. The organization wanted team-based care for patients, but we had not fully built team-based leadership for program development.

And that is when it hit me:

What I actually do for a living is not service line development.

It is change management.

Healthcare Is Not Struggling With Ideas. It Is Struggling With Execution.

Healthcare has no shortage of strategy right now.

We know where the industry is going:

  • Consumer expectations are changing
  • Workforce pressures are escalating
  • Technology is accelerating
  • Financial pressure is growing
  • Care models are shifting
  • Leadership turnover is constant
The problem is not knowing what to do.

The problem is getting people, teams, and systems to move together fast enough to do it.

That is why I believe change management is now the most important skill healthcare leaders can develop.

Because if we cannot lead change effectively, nothing else matters: Not the strategic plan. Not the technology. Not the innovation. Not the conference takeaways. None of it survives poor execution.

Most Change Efforts Fail in the Same Three Places

Over time, I’ve started evaluating every transformation initiative through three lenses:

1. The individual 2. The team 3. The system

If one breaks, the whole thing breaks.

1. Engage the Individual

Change becomes organizational only after it becomes personal.

One of the biggest leadership mistakes is assuming resistance means opposition. Most of the time, resistance is uncertainty.

People are trying to answer questions leaders forget to address:

  • What does this mean for me?
  • What stays the same?
  • Will I still be successful?
  • Do leaders understand the realities of my work?
You cannot mandate commitment. You have to build it.

And that requires something healthcare leaders often rush past: conversation.

Not one email. Not one town hall. Not one slide deck.

Real communication. Repeated communication. Clear communication.

I often use a simple exercise during presentations: I ask someone to clap the rhythm of a popular song without singing the words.

The person clapping hears the entire melody in their own head. The listener hears random noise.

That is exactly what organizational change feels like for frontline teams.

Leaders have usually lived with the idea for months. Teams are hearing it for the first time.

Clear is kind. Repeat, repeat, repeat.

2. Align the Team

This is where most change efforts quietly fail.

Alignment is not agreement. Alignment is shared understanding and commitment.

I remember one leadership meeting during our TAVR build where the first slide simply said: “What we have agreed to.”

We spent the entire hour on that single slide.

At the time, it felt slow. In reality, it was the work.

Because alignment requires:

  • Listening
  • Clarifying
  • Surfacing tension
  • Addressing competing priorities
  • Building trust
Healthcare leaders often want to skip straight to accountability. But accountability without alignment creates compliance at best and resentment at worst.

Teams move at the speed of trust.

3. Design the System

Even highly motivated people eventually lose momentum if the system itself does not support the change.

Systems are designed to preserve current behavior.

Which means if workflows, governance, communication structures, incentives, and operational rhythms remain unchanged, people will eventually revert back to old habits — no matter how excited they were initially.

Your system will always win.

That is why sustainable change requires intentional structure:

  • Shared governance
  • Recurring touchpoints
  • Cross-functional leadership
  • Clear ownership
  • Consistent communication
  • Operational reinforcement
The TAVR initiative eventually became much bigger than a single program. It led to growth in Watchman, AFib ablation, patient navigation, dedicated cardiovascular pathways, and stronger multidisciplinary collaboration across the system.

But the real win was not procedural growth.

It was building a team that could navigate change together.

Because every successful transformation builds capacity for the next one.

The Leadership Skill Healthcare Cannot Afford to Ignore

Healthcare is not slowing down.

And the leaders who will thrive in the next decade will not simply be the smartest strategists in the room.

They will be the leaders who know how to:

  • Navigate uncertainty
  • Align teams
  • Build trust
  • Communicate clearly
  • Hardwire change into systems
In other words: leaders who can move people.

That is the real work of healthcare leadership now.

So here is my challenge to leaders reading this:

Look at the initiative in your organization that feels stalled, frustrating, or harder than it should be.

Then ask yourself: Are you trying to force system change before doing the work of engaging individuals and aligning teams?

Because successful healthcare leaders do not just manage operations anymore.

They manage change.

And right now, that may be the most important skill of all.