Access, Culture, Chaos: The Things That Sneak Up When You’re Not Looking

Looking Around the Corner (Without a Crystal Ball)

If you work in cardiovascular care, you already know this job doesn’t come with much breathing room. One minute you’re putting out a fire with staffing, the next you’re untangling payer updates, and somewhere in there you’re supposed to be “strategic.”

The truth? Most of us are running so fast that we’re basically staring at our feet. But the leaders who really change the game are the ones who can lift their heads and look around the corner. Not because they’re magical fortune tellers, but because they’ve built the muscle of noticing. Patterns, whispers, little shifts that tell you something big is about to roll downhill.

I’m not going to give you some polished leadership framework here. I’m going to give you the messy version. The real-life, “how do I do this when my inbox looks like a dumpster fire” version.

Why It Matters (a.k.a., What Happens When You Don’t Look Ahead)

I’ll never forget watching a practice hit a wall with patient access. Referral volumes were climbing, but new patients were waiting eight to 10 weeks for a cardiology appointment. By the time leadership realized how bad it had gotten, local primary care providers had already started sending their patients to another health system. It wasn’t that they didn’t care about access. It was that they were so buried in daily problems, they missed the slow creep of an issue that turned into a referral crisis.

On the flip side, I worked with a group that made access their “look around the corner” focus. They tracked referral-to-appointment time every month, played out “what if volumes spike” scenarios, and proactively hired advanced practice providers (APPs) to build a rapid access clinic. Instead of losing patients, they gained market share.

Same story – different outcome. The difference was having the discipline of to notice before the problem exploded.

Habit 1: Make Space to Think (Even if It Feels Impossible)

I know your calendar already looks like a game of Tetris. But if you don’t carve out time to think, you’ll never see what’s coming.

• Block one hour a week: Literally label it “strategic brain time.” Don’t fill it with email. Use it to scan MedAxiom reports, read payer updates, or just sit with the question: “what’s brewing that could knock us off our feet six months from now?”
• Protect silence: Some of my best “aha” moments came while staring at a wall, not a spreadsheet.

A colleague of mine calls it “strategic Fridays.” Once a month her team sits down and asks a single question: “What’s about to change?” That’s it – not “what broke today?” but “what’s about to?” Thanks to that habit, they were weeks ahead of the curve on a referral access problem that blindsided everyone else in their region.

Habit 2: Don’t Just Look at Data – Tell the Story

Hospitals love dashboards. Colorful graphs line the walls of the meeting rooms. But here’s the thing: numbers don’t talk unless you make them.

• Always ask: “so what?” If your no-show rate for follow-up climbs, what does that actually mean? Is it transportation barriers, burnout in your scheduling team, or a cultural problem where patients don’t feel connected enough to value the visit?
• Pair data with people: Numbers tell you what, but conversations tell you why.

I’ll give you an example. One program was alarmed at rising turnover among nurse navigators. The data suggested “staffing crisis.” The conversations told them “culture crisis.” Navigators felt invisible, with no voice in leadership meetings. Leadership changed the structure to include them in monthly planning sessions. Turnover dropped, and patient navigation outcomes improved.

Looking around the corner isn’t about having more data. It’s about asking better questions of the data you already have.

Habit 3: Listen Where Nobody Else Is Listening

Change usually whispers before it shouts. And it whispers from the edges.

• Ask your staff: “What feels harder now than it did six months ago?”
• Listen to patients: Are they saying it takes too long to get a callback? Are they complaining about fragmented care between cardiology and primary care?
• Watch team dynamics: If your APPs are whispering about burnout or your cath lab techs are grumbling about fairness in call schedules, don’t dismiss it. Those whispers are the future shouting at you.

I’ll never forget a service line that brushed off staff concerns about call burden. A year later, they were dealing with mass turnover. Compare that to another group that listened early, restructured call, and turned what could have been an exodus into a retention win.

Habit 4: Run “What If” Drills

Strategic plans are great until reality shreds them. That’s where scenario planning comes in.

• Pick two or three “what ifs:” Like: what if your two most senior interventional cardiologists retire at the same time? What if your referral growth outpaces your APP hiring by 20%?
• Stress test it: Ask: “What breaks first?”
• Do it as a team: The point isn’t to predict the future but to build agility.

I worked with a group that mapped out “what ifs” around succession planning. They didn’t wait for a resignation letter to panic. When a physician finally did announce retirement, the team already had a roadmap. Recruitment was smoother, patients didn’t feel abandoned, and the group avoided chaos.

Let’s Be Honest: It’s Messy

This isn’t about perfection. You’ll miss some things. You’ll prepare for scenarios that never happen. You’ll get it wrong sometimes.

But looking around the corner isn’t about being right. It’s about being ready. It’s about shifting from “oh no, we’re drowning” to “we saw this wave coming, and we’ve already grabbed a life jacket.”

And honestly? It feels better. Your staff trusts you more. Your doctors stop bracing for constant chaos. Patients feel the stability.

Quick Wins You Can Try This Week

• Block one hour on your calendar: Call it “looking around the corner.” Protect it.
• Add one agenda item to your next leadership meeting: “What’s coming at us in the next six months?”
• Ask one frontline staff member: “What’s getting harder right now?”
• Take one dashboard trend: Ask “so what?” three times until you land on an actionable story.
• Write down one wild “what if” scenario: Share it with your team.

Small, scrappy steps beat a glossy binder full of strategic priorities that nobody reads.

The Takeaway

Healthcare doesn’t give us many calm days. Cardiovascular care, even less. But if you want to stop living in survival mode, start looking around the corner. Not with a crystal ball, but with habits that make your team alert, adaptable and ready.

Your future patients, and your future self, will thank you.

Call to Action

Here’s the part nobody says out loud: you don’t have to do this alone. Some days you need help with the big stuff, like redesigning your access strategy or tackling culture issues head-on. Other days you just need a partner who can take a thorny project off your plate or step in with leadership support when your team is stretched thin.

That’s what the MedAxiom Care Transformation Services team does. We roll up our sleeves with programs of all sizes. We’re here to fix the small but nagging things that eat up your week, and we’re here to walk alongside you on the big strategic lifts.

If you’re ready to stop reacting and start leading, let’s talk. We’d love to collaborate on what’s next for your program.