Recently, the night before speaking at a conference, I had the chance to share dinner with the Chief Operating Officer of a rather large state-wide comprehensive health system in the Midwest. We were joined by a former colleague of hers who also has spent years working in healthcare.

Throughout the evening, we traded stories, talked about the state of affairs in healthcare, and collectively bemoaned the lack of training and support most front-line leaders get to navigate the people management challenges they face every day. I enjoyed the chance to spit-ball and “shoot the breeze” with these sharp, experienced ladies, especially because they each had spent years on the front lines in healthcare. They get it.

It was during this conversation that the COO made an observation I hadn’t really considered before.

We were talking about what I often talk about in workshops and keynotes: drama. The gossip, infighting, cliques, and score-keeping that infect many healthcare teams to one degree or another. That’s when she said this:

“You know, Joe, I’ve found that if that kind of drama is happening on a team, it’s often because they are overstaffed.”

“You mean understaffed?” I replied.

“No,” she said. “Overstaffed.”

All at once, I was struck by how absolutely accurate her statement was.

As I travel the country training managers from so many walks of life in healthcare, I’ve seen for years the impact of understaffing. Every day, clinics and hospitals struggle to find and retain talent, suffer budget cuts that lead to barebones staffing, and endure the agony of call-offs. These are the understaffing pain points most every healthcare manager has encountered or lives with regularly. And surely these cause their own kinds of drama in clinics and hospitals everywhere. Truth be told, I can’t remember the last time I met a front-line healthcare leader who told me she thought her clinic was overstaffed. That’s why the COO’s statement initially caught me by surprise.

But what if you are overstaffed and don’t realize it? What happens when you have more people working than you truly need?

In short: drama. The truth is that there’s all kinds of research in psychology, sociology, and employee engagement that tell us that employees who are engaged live in a kind of intellectual “sweet spot” where the full breadth and scope of their talents and experience must be brought to bear during the workday in order to be successful in their job. If the challenges of the role exceed their abilities or don’t rise to an appropriate level of difficulty, people are less likely to be engaged. It’s the latter scenario that lends credence to this COO’s observation.

When employees are bored, they look for problems to solve. Sometimes those problems aren’t really problems. They also can spend time, as well as mental and emotional energy, on things that otherwise wouldn’t be worthy of it if the role was indeed more testing of them.

When clinics are overstaffed, there’s not enough to keep everyone firing on all cylinders. Downtime, boredom, or not enough to do simply create opportunities for drama to creep in.

So … if you are experiencing higher levels of drama at your site, ask yourself: Are you overstaffed?

What do you think? Have you experienced this? Does the concept compel you to look at some of your clinical teams where drama is present through a different lens? I’d love to hear your thoughts, ideas, and comments. Leave them in the box below and let’s discuss!

Joe Mull, M.Ed, is a leadership trainer and keynote speaker. He works with healthcare organizations that want their practice leaders to engage, inspire, and succeed. To learn more or bring Joe to your site, visit