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Eleven years in healthcare operations, fixing the system rather than the operator. Connect below — or read what I’ve been thinking about lately.

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Most-read posts.

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Origins

Where care breaks down

Growing up, I often helped my parents navigate the healthcare system — translating forms, decoding bills, and sitting in waiting rooms that were never built for people like us. That early view of exactly where care breaks down is what pulled me into operations. Two decades later, I’m still closing the same gaps, only at a much larger scale.

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Operations

Building the road while it moves

Startup operations is not what people think it is. It isn’t spreadsheets and calendar invites — it’s building the road while the car is already moving, then rebuilding it the moment volume doubles. The best operators I know are quietly obsessed with the boring systems no one notices until the day they fail.

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Leadership

When leadership gets tested

Change is when leadership actually gets tested. Anyone can steer when the roadmap is clear and the numbers are climbing. What separates real leaders is how they hold a team together when priorities shift overnight and no one has the full picture yet — that’s where trust is either built or quietly lost.

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Systems

Building around the problem

We’re very good at building around problems. We add a workaround, another checklist, one more hire to absorb the mess — anything but naming the broken process underneath. Real fixes are unglamorous, and they usually mean undoing work someone was genuinely proud of and admitting the original design was wrong.

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Scaling

Growth reveals the cracks

Growth doesn’t create problems — it reveals them. The cracks were always there; volume just makes them impossible to ignore any longer. Scaling well is less about moving faster and more about being honest, early, about what was fragile all along — and fixing it before the pressure finds it for you.

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Expansion

The map hides the dependencies

Expanding into a new state looks like a map exercise until you’re deep in licensing, credentialing, and payer contracts that all read differently line by line. What shows up as a single launch date on a slide is really dozens of interlocking dependencies that most teams only discover the hard way, weeks after they promised go-live.

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Culture

People problems in disguise

Most ‘people problems’ are actually system problems wearing a costume. When someone keeps dropping the ball, the honest question is rarely ‘why won’t they try harder’ — it’s ‘what in the workflow makes failure the default.’ Fix the system and most of the people problems quietly disappear.

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Decisions

Deciding in the room

“We’ll circle back on that.” “Let’s take this offline.” We’ve built an entire vocabulary for postponing decisions without ever admitting that’s what we’re doing. The teams that move fastest aren’t smarter or better resourced — they’ve just made it safe to actually decide things in the room, while everyone is still there.

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Access

The patients broadband forgot

Expanding access to care through telehealth sounds simple until you meet the patients broadband forgot. Access isn’t just a working link and a login — it’s language, trust, devices, bandwidth, and a system that stops assuming everyone starts from the same place. The technology, it turns out, was never the hard part.

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Also published: Patient Safety Isn’t Seasonal (PSQH)  ·  A Love Letter to Healthcare (Swaay.Health).