Written By: Asbel Montes, Co-Founder & Managing Partner, SGS
"There is nothing so useless as doing efficiently that which should not be done at all." - Peter Drucker
"Do more with less." - Every budget meeting I have ever attended
One asks your people to carry more. The other asks you to look at what they are already carrying.
Healthcare leaders are living through a season that feels unprecedented. Medicaid is being restructured. Payers are rewriting the rules. Federal policy seems to shift before we have finished implementing the last change.
It feels unprecedented. It is not.
We lived through DRGs. We lived through the Balanced Budget Act. We lived through the Affordable Care Act and a pandemic. The leaders who came through those seasons whole did not do it by bracing harder. They did it by clarifying what mattered and letting go of what didn't.
That is where grace enters the conversation.
When margins tighten, most of us reach for the same lever. We cut. We freeze positions. We ask the people who remain to absorb the difference. On a spreadsheet, that looks like efficiency. In the hallway, it looks like exhaustion.
Grace offers a different starting point. Efficiency through grace means removing the waste that burdens your people, not removing your people.
Every organization has this kind of waste. The report no one reads. The same data entered into three systems. The approval that requires four signatures because something went wrong once, years ago. The workaround everyone knows about, and no one has fixed. Each one is small. Together, they are heavy, and your best people are the ones carrying them.
When I look at a process, I ask two questions.
Who is carrying the weight of this?
Does this serve the patient, or does it only serve the process?
If the answer to the first is "my frontline team" and the answer to the second is "only the process," that is not a cost of doing business. It is a burden we have chosen to keep.
But there is a caution here.
Not every burden is waste. Documentation protects patients. Compliance protects the organization. Some hard things must remain hard. Grace does not mean removing every difficulty. It means being honest about which difficulties are necessary and which ones simply survived because no one questioned them.
There is a second caution. "Removing waste" can become a polite phrase for removing people. If your team hears it that way, they will hide the very inefficiencies you need them to show you. Grace requires that you say it plainly and mean it: "I am not looking for who to cut. I am looking for what to lift."
Here is the hope in this season. Change loosens our grip on the way things have always been done. The disruption we fear is also the best opportunity we will have to ask why.
Leaning into that question is uncomfortable. It may expose decisions we made ourselves.
Do it anyway.
Ask your people what they are carrying.
Then help them put it down.
