You Can’t Run 2025 Medicine on a 1998 Operating System

Healthcare isn’t breaking because people stopped caring.

It’s breaking because we’re still trying to run 2025 medicine on an operating model designed for a completely different era.

Clinicians are not the problem.

The workforce is not the problem.

The mission has never changed.

What’s changed is the operational reality surrounding the care.

Across hospitals, behavioral health programs, ASCs, and physician practices, I keep seeing the same pattern:

We don’t have a clinical crisis.

We have an operational design crisis.

Today’s friction points are structural:

Documentation expectations that outpace staffing capacity.

Revenue cycle teams forced to clean up errors instead of preventing them.

Anesthesia and behavioral health shortages that quietly determine throughput.

Workflows built for reimbursement models that no longer exist.

Leaders trying to fix system problems with individual heroics.

Healthcare doesn’t need more task forces or another tech bolt-on.

It needs a new operating model built for today’s reality:

Clarity in service-line purpose.

Simpler, smarter workflows.

Roles aligned to capacity.

Case-mix and payer optimization.

Predictable staffing models.

Prevention-driven revenue integrity.

The organizations that succeed in 2025 and into 2026 will be the ones that stop patching old systems and start redesigning how work actually gets done.

— Stacey Shane

Elevate Health Consulting Group Llc