By Eric Massey
Picture a typical day for a reactive HTM director.
The phone starts before they finish their first cup of coffee. A tech is out. A piece of imaging equipment went down overnight. A customer is already frustrated. By 9 a.m. they are three fires deep with nothing on their actual priority list touched. By 5 p.m. they have worked a full day and cannot point to a single thing that moved the program forward.
Sound familiar?
This is not a workload problem. It is not a staffing problem. It is a systems problem. And it is the most common leadership pattern I see across HTM today.
The good news is that it is entirely fixable. But fixing it requires a shift in how you think about your role as a leader from someone who responds to everything to someone who has built a program that runs with clarity and consistency, whether you are in the room or not.
The Hidden Cost of Reactive HTM Leadership
Reactive leadership has a price tag, and most of it never shows up on the work order.
When a program runs in constant reaction mode, four things happen consistently:
- Overtime spikes. Unplanned hours cost significantly more than scheduled ones. When there is no system, everything becomes an emergency, and emergencies are expensive.
- Vendor spend increases. Without a service delivery plan, every downtime event starts with confusion — who services this device, who is the backup, who do we call if we need additional support? That chaos delays response time and almost always ends the same way: a call to the OEM at premium rates because nobody had a better answer ready.
- Staff burns out and leaves. Reactive teams lose their best people first. High performers want structure, growth and a program worth being part of. When none of that exists, they go find it somewhere else.
- Clinician trust erodes. Inconsistent response times and unpredictable communication undermine the confidence hospital leadership has in HTM. Once that trust is gone, it takes a long time to rebuild.
None of these show up as a line item on a work order. But they compound. And over time, a reactive program becomes significantly more expensive in dollars, in people and in reputation than a proactive one.
Overtime is a planning failure, not a staffing problem. That is the mindset shift everything else builds on.
The HTM Leadership Gap
Here is the hard truth about HTM leadership: we promote great technicians and give them no leadership system to work from.
A high-performing technician responds fast, fixes things and moves on to the next problem. Those are exactly the skills that make a great tech. And they are exactly the habits that can limit an HTM director if they are never replaced with new actions.
I lived this. Early in my leadership career I thought answering every call immediately and jumping on every issue as it came in made me a good director. Customers liked my responsiveness. I felt productive. But I was not building anything. I was just moving fast on a treadmill.
The shift from technician thinking to leadership thinking is not automatic. It has to be intentional. And it starts with building systems that let your program run even when you are not personally touching every issue.
The Foundation: Every Asset Has a Name, Plan & Escalation Path
The most important system a proactive HTM leader builds is the service delivery plan. Not a document that sits in a folder. A living framework that tells your team exactly what to do when any asset goes down — before it goes down.
Every asset in your program should have:
- A primary coverage owner. This is the tech responsible for that asset.
- A backup and escalation path — including secondary, tertiary, ISO partner, OEM — defined in advance, not figured out in the moment.
- A time-based escalation trigger: if unresolved in two hours, notify the director and senior tech; six hours, contact ISO; 12 hours, contact OEM.
- Automated routing built into the asset management system, so the right person gets the right call without anyone making a judgment call under pressure.
When this is built correctly, your team knows exactly what to do when a device goes down. They do not call you to ask. They follow the plan.
That is what operational independence looks like. And it is built before the crisis, not during it.
Eliminate Status Calls With Shared Visibility
One of the biggest drivers of reactivity in HTM programs is the status call. A device goes down, and suddenly everyone (the customer, the director, hospital leadership) is calling each other trying to figure out what is happening.
Proactive programs eliminate that cycle with shared visibility. Critical device alerts that automatically notify the customer, the director and all relevant leadership in real time. Status updates that go out as events happen, not after someone asks.
When everyone is looking at the same timeline, the phone stops ringing. The customer does not need to call because they already know what is happening. The director does not need to chase down the tech because the update is already there.
Proactive communication is not just a customer service tool. It is a leadership discipline. It is how you stay informed without being in the middle of every repair.
Plan PM, Staffing and Capital Proactively
Reactive programs are not just reactive in how they handle break-fix. They are reactive in how they plan — or fail to plan — preventive maintenance, staffing and capital.
A proactive program distributes PM workload intentionally across 12 months. It cross-trains staff so no single tech is the only person who can touch a critical asset. It uses scheduling discipline to eliminate the midnight emergencies that drive overtime because the work was planned, not ignored until it became urgent.
The same logic applies to capital planning. When you track end-of-life and end-of-support dates years in advance, you eliminate forced purchases. You eliminate the conversation where an unserviceable device forces an emergency capital request that nobody budgeted for. You replace it with a data-driven plan that aligns HTM, finance and clinical leadership around a shared forecast.
Predictable programs are trusted programs. And trust is built through planning, not reaction.
Final Thought
The reactive HTM program is a systems gap.
Most directors running reactive programs are working hard. They care about their customers, their teams and their equipment. They are just doing it without a framework that lets the program run at a level that matches their effort.
Over the next few months, this series is going to build that framework piece by piece. Service delivery plans. Full life-cycle management. Financial discipline. Executive influence. The skills that turn a reactive program into a high-performing one.
Start this month with one question: What is the most reactive part of your program right now?
Name it. Write it down. That is where the work begins.
