There’s a quiet agreement most of us make in business. It’s not in a contract. It’s not written on a whiteboard. But it runs everything: trust.
We trust that what worked yesterday will still work tomorrow. We trust that people we’ve known for years will keep showing up the way they always have. We trust that if we build a system—especially one that hums quietly in the background—it will just… keep working. Until it doesn’t.
I recently watched a good doctor wrestle with a hard truth: the system he built his practice on wasn’t built to grow. It was built to survive. To “just work.” And it did, for a while.
But that system relied on a single person—his biller—who handled everything behind the scenes. One login. One relationship. One gatekeeper to a critical part of his business.
And then? Silence. No return calls. No emails. No updates. Just growing confusion. Mounting stress. And a practice stuck in place, unable to scale.This wasn’t just a billing problem. It was a trust problem. And those are the hardest ones to fix.
Why This Happens More Than You Think
According to a report by the Medical Group Management Association, 47% of practices say that billing challenges are their biggest barrier to growing remote care programs like RPM and CCM. But it’s not just about codes and claims. It’s about control.Over time, many providers hand over too much authority to a single biller or vendor. It’s easy. It’s comfortable. But it can create a dependency that becomes invisible—until you try to make a change.
Systems Reflect Relationships
A business is only as strong as the systems it’s built on. But systems don’t just reflect workflows—they reflect relationships.
When those relationships are built on unspoken assumptions or outdated habits, cracks form. And when you try to modernize—introduce automation, expand into new services, or reclaim visibility—those cracks become canyons.
It’s not that people mean to create roadblocks. Sometimes life changes. Sometimes people burn out. Sometimes they just move on without saying goodbye.But the system doesn’t forgive that. It just breaks.
The Pain of Rebuilding Is Also the Opportunity
Watching this unfold reminded me why change, though painful, is also clarifying. Because once the cracks are exposed, you can finally see where the structure needs reinforcing.
You can replace a person with a process. You can swap assumptions for accountability. You can shift from "just working" to actually working—for the long term.
But most of all, you can rebuild trust. Not by going back. But by going forward… more aware and more intentional.
What’s the Takeaway?
If you’re running a practice—or any business—take a hard look at the invisible systems that keep you going. Ask yourself:
- If that one person stopped showing up, would the system still run?
- Are your most critical functions dependent on habit or design?
- Is your growth being held back by a relationship that’s past its prime?
There’s no shame in realizing something isn’t working anymore. The shame would be ignoring it.
Change is hard. But when it reveals where trust was misplaced… it also shows you where to build it better.