As healthcare leaders navigate a year marked by regulatory uncertainty, vacillating payer environments, and persistent workforce strain, leadership expert and MGMA consultant Amy Lafko says one thing is clear: organizations must evolve the way they lead, onboard, and support their people.
In a recent episode of the MGMA Insights Podcast, host Daniel Williams sat down with Lafko — creator of the People First Method, speaker, consultant, and former physical therapist — to explore how medical practices can create cultures where staff thrive and patients ultimately receive better care. Drawing from decades in rehabilitation, hospital operations, urgent care leadership, and medical group practice, Lafko offers guidance that is timely, actionable, and grounded in lived healthcare experience.
Healthcare’s Volatile Outlook Demands Adaptability
With regulatory and insurance shifts looming in 2026, Lafko says leaders must be equipped to adapt quickly and support teams through constant change. “We [were] looking at tea leaves ... at the end of 2025," she said. "What’s going to happen with subsidies? What’s going to happen with insurance? Who’s going to be in these roles next year?”
That uncertainty, she emphasized, places extraordinary demands on leaders’ emotional steadiness and responsiveness. “The number one skill that leaders really need to have is adaptability,” she said. “Our world is changing faster than ever.”
Importantly, adaptability is not a trait; it’s a capacity leaders can build. Skills such as resilience, emotional regulation, and supportive team environments directly improve how practices weather disruption. As Lafko suggests: The pace of change is not slowing, so the ability to adapt must accelerate.
Why Conflict Feels More Intense — and Why Leaders Must Address It
Williams noted an apparent rise in workplace conflict and asked Lafko whether practices are indeed seeing more friction or simply talking about it more openly. Lafko explained that the perception of increased conflict is real, but the root cause is often misunderstood.
“It’s not necessarily that there’s more true conflict,” she said. “But what is happening is that everyone’s set point of frustration is higher.”
Uncertainty raises emotional strain, reducing team members’ ability to interpret situations clearly or respond calmly. Lafko explained, “When there is so much being thrown around and thrown at us… the flash point for conflict comes more quickly.”
Additionally, many team members — especially those new to healthcare — lack strong role models for productive conflict. Instead, she frequently sees patterns such as shutting down, lashing out, quitting, or avoiding conversations altogether.
Training staff in conflict resolution, she says, is not just a leadership competency; it should reach every level. “Why wouldn't we want our staff to know how to engage in productive conflict, no matter what level they're at?” Lafko asked.
Practices that invest in this see immediate improvements. Lafko described a recent engagement where frontline staff learned conflict‑resolution tools: “Things that they used to say, this is an issue, they've realized the difference between a request and a conflict that needs to be resolved.”
The takeaway: Equipping staff with conflict‑resolution skills reduces escalation, increases autonomy, and frees practice managers from unnecessary mediation.
The People First Method: Rethinking What It Means to Serve Patients
Lafko’s signature framework, the People First Method, challenges a deeply ingrained healthcare mantra: “patient first.” As a physical therapist, she internalized that philosophy early in her career. But as a leader, she saw the unintended harm it could cause.
“When I'm interacting with a staff member, then I'm actually running over the staff member to get to the patient,” she recalled. She even admitted, “I literally ran over the therapist to go in and treat myself because I'm like, it's all about the patients.”
This realization was pivotal: Leaders do not directly care for patients — their teams do. “If I'm not treating a patient,” she said, “my job is actually to treat and support and coach the team because that's the only way that the patient's actually going to get the best care.”
"People first" does not diminish patient importance. Instead, it reframes how leaders achieve exceptional patient outcomes — by prioritizing staff engagement and emotional well‑being.
Onboarding as Alignment and Inspiration, Not Orientation
Every January, practices welcome new staff, yet traditional onboarding often leaves employees disengaged from day one. Lafko knows the experience firsthand.
“'Welcome aboard. Go sit in this cubicle and watch the videos on our EMR,'” she quipped, describing a typical day‑one scenario. “That is not going to align anybody to your organization."
"That certainly isn't going to inspire them to come back tomorrow," she added.
In the people-first approach, onboarding becomes an intentional process of connection, clarity, and mission‑orientation. Lafko encourages practices to start with relationship‑building — even hosting a “get‑to‑know‑you‑welcome party” — and reinforce how each role aligns with organizational values.
She also emphasized weekly touchpoints focused on learning, progress, and leader support. These check‑ins, she explained, allow leaders to understand “where you need support so that you can do your best work.”
The patient‑first onboarding mentality (rushing new hires to full schedules) undermines long‑term commitment. “That new team member is never going to really feel fully committed to the group,” Lafko warned.
The investment up front pays off exponentially in retention and culture.
A People‑First Culture Starts with One Element: Willingness
When Lafko works with organizations striving to build better cultures, one trait differentiates those who succeed. She said it sounds really simple, but "it starts with willingness."
Practices may say they want culture change, but balk when meaningful change requires time or discomfort. “We want to change them," she said. "And yet then when it really comes to putting the work in, they say, 'oh, but we don't want to change that part.'”
For people‑first cultures to work, leaders must commit to investing time, leveling expectations across the organization, and acknowledging that improvement requires learning and iteration.
“We may not be perfect at it,” she said, “but we want to work on it.”
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Amy Lafko
MGMA
