What employees want, what organizations need, and how administrative leaders bridge the gap

Practice administrators often find themselves in the middle, weighing what employees want against what the organization needs. Those tensions may never go away entirely, but leaders can still thrive while managing them, according to Katie Lawrence, Psy.D., M.H.A., CMPE.

Lawrence, a consultant with Willow Strategy Group in South Carolina, has more than 20 years of experience in health care operations and transformational leadership. Her recently completed doctorate in leadership psychology focused on thriving as a leader in rapidly changing environments. She presented "More than Resilience: Thriving as a Healthcare Leader" at the Medical Group Management Association (MGMA) 2026 Annual Conference.

In a video interview, Lawrence said competing priorities are built into health care leadership.

"What an employee wants and what your employer wants may be slightly different," she said.

A solution that works for everyone is often possible, she said, if leaders step back and consider the whole system rather than only the problem in front of them. She also discussed how different groups within a practice need different things. Nurses may need different support than nonclinical team members who are less familiar with medical terminology, and leaders should prepare those staff members to support the clinical team without making them feel less important.

Lawrence's research, based on a survey of 145 health care executives, looked at seven competencies that predict thriving: adaptive performance, cognitive flexibility, growth mindset, emotional intelligence, political skill, leadership self-efficacy and reflection. When all seven were analyzed together, adaptive performance and political skill stood out. Political skill means understanding relationships and using them to reach organizational or personal goals, and Lawrence said it shouldn't be confused with manipulation.

"Political skill can sometimes feel like a terminology that means manipulation. That's not exactly what it means in the academic literature," she said.

In her session, she suggested ways to build that skill, such as taking a couple of minutes after a meeting to reflect on who spoke up and how they were received, and asking a few colleagues for 15-minute conversations to strengthen a network. The most effective approach, she said, is to learn about a skill and then talk it through with a coach, mentor, colleague or boss.

That work matters whether leaders are supporting patients or the physicians and nurses who care for them, she said.

"I think it all matters because we can care for one another in health care," she said.