The Friction Audit: A Message from President Lindy Tentinger July 2026

Published in Member Communities on July 02, 2026

By Lindy Tentinger, President, VGM & Associates

There is a question I have been thinking about lately. 

What is creating friction inside your business? 

Not the obvious challenges. 

Not reimbursement. 

Not staffing shortages. 

Not regulations. 

Those are realities we all face. 

I am talking about the friction we create without realizing it. 

The friction that slows down good employees, frustrates patients, delays service, and quietly eats away at profitability. 

I recently read The Friction Project, a book that explores why some organizations make work harder than it needs to be and how small obstacles can have surprisingly large consequences. One of the insights that stuck with me is that not all friction is bad. 

In fact, some friction is necessary. 

The challenge for businesses is learning the difference. 

The Wrong Kind of Friction 

Bad friction is anything that makes it harder for people to do good work. 

It is the process that requires six steps when two would do. 

It is entering the same information multiple times. 

It is waiting three days for an approval that should take thirty minutes. 

It is the patient who calls back three times because no one clearly explained the next step. 

It is the employee who spends more time working around a process than benefiting from it. 

Most bad friction is not intentional. 

In fact, it is usually created by people trying to do the right thing. 

We add a form for consistency. 

An approval for control. 

A meeting for communication. 

A report for visibility. 

Over time, those small additions accumulate until nobody remembers why they exist. 

The Cost Nobody Measures 

Most organizations measure revenue. 

Expenses. 

Margins. 

Productivity. 

But very few measure friction. 

The problem is that friction shows up in places that are harder to quantify. 

Employee frustration. 

Delayed patient care. 

Slower onboarding. 

Missed opportunities. 

Longer days. 

Burnout. 

Every minute spent navigating unnecessary friction is a minute not spent serving a patient, solving a problem, or growing the business. 

It is a hidden tax that many organizations pay every single day. 

But Not All Friction Is Bad 

One of the mistakes leaders make is trying to eliminate friction everywhere. 

The reality is that some of the most important work in our organizations deserves more friction, not less. 

Good friction forces us to slow down when slowing down matters. 

Think about major strategic decisions. 

A new service line. 

A large technology investment. 

An acquisition. 

A significant payer agreement. 

These are not decisions that should happen with a few emails and a rushed meeting. 

The right amount of friction creates discussion, healthy debate, and thoughtful decision making. 

The same is true when it comes to understanding customers. 

Many companies move so quickly that they skip the step of truly listening. 

They launch new initiatives before speaking with customers. 

They make assumptions before gathering feedback. 

They create solutions before fully understanding the problem. 

Sometimes the best thing we can do is intentionally slow ourselves down long enough to ask better questions. 

Where to Look First 

If you want to uncover bad friction, do not start with leadership. 

Start with the people closest to the work. 

Ask your intake team. 

Ask your clinicians. 

Ask your customer service representatives. 

Ask your billing staff. 

Ask them one simple question: 

What part of your job feels harder than it should? 

Then listen. 

You will likely hear answers that have nothing to do with reimbursement or staffing. 

You will hear about processes. 

Systems. 

Handoffs. 

Communication gaps. 

Approvals. 

Small frustrations that have become accepted as normal. 

Those answers are often where the greatest opportunities exist. 

The Friction Audit 

This month, I encourage every provider to conduct a simple friction audit. 

Ask your team: 

• What slows us down unnecessarily? 
• What creates frustration for patients? 
• What wastes time every day? 
• Where should we move faster? 
• Where should we intentionally slow down? 

Then find one thing to remove. 

And one thing worth protecting. 

Because reducing friction is not about making everything faster. 

It is about making it easier for good people to do great work while ensuring the decisions that matter most receive the attention they deserve. 

Why This Matters 

This industry is full of hardworking people. 

Most organizations do not have an effort problem. 

They have a friction problem. 

The providers that thrive over the next decade will not simply be the ones that move the fastest. 

They will be the ones who understand where speed creates value and where thoughtful pauses create better outcomes. 

A Final Thought 

When businesses struggle, the instinct is often to ask: 

What do we need to add? 

Sometimes the better question is: 

What should we remove? 

And occasionally, the smartest question of all is: 

Where should we slow down? 

Because growth is not always about acceleration. 

Sometimes growth comes from removing the friction that should not exist and intentionally creating the friction that should. 

As always, I welcome your thoughts and your perspective. 

Lindy Tentinger
President, VGM & Associates 

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