Frontline to Front Office (Part I)

In the run up to MCTI's invitation-only summit in June 2025, I've been thinking about the path to leadership in mission critical teams.

In some fields, the leadership pipeline always starts on the frontlines. Every Chief in the fire service started out as a firefighter, and the Chair of every ICU spent time as a practitioner before taking on leadership responsibilities. These shared lived experiences help build trust and credibility among mission critical teams, and nudge leaders toward decision-making that reflects operational reality.

But, not all leadership pipelines work that way.

On mission critical medicine teams, leaders can have very different origin stories from the providers they're leading. Department chairs and CMOs are often people who have practiced medicine for years, but the CEO or COO of a hospital may come from a business, finance, or operations background with zero direct experience at the bedside.

That’s not inherently bad. Running a complex institution like a hospital takes a broad range of skills. But when leaders and operators come from separate training backgrounds and professional cultures, their perspectives, priorities, and risk tolerances can diverge.

The challenge for MCM teams is to close that gap.

Since decision authority and resources are often controlled in the C-suite rather than on the frontline, closing this gap frequently means providers working at the coal face have to proactively help senior leadership understand what actually happens at the sharp end of care.

If you're on the frontline, how are you working to bring senior leadership into the realities of your world? (CEOs and COOs are probably not going to come work the night shift with you, but MCM teams can still bring them in to see the real various degrees.) What language are you using to connect your operations and your needs to outcomes leadership are tracking?

If you’re in the front office, how are you leaving the comfort of your surroundings to actively build relationships with those doing the work on the ground? How often are you learning from them, not just about them?

Teams don’t need to be uniform, and they're frequently stronger when they're not. What they need is better translation between perspectives.

Curious how this works in your world - are leaders in your field evolved from frontline providers, or are they brought in from other pathways?

Good luck out there.

Dan