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Healthcare leaders are often praised for holding everything together. But what happens when the organization only works because one exhausted leader keeps pushing, solving, absorbing, and carrying what the system itself should be designed to hold?

In this episode of TouchPoints: Moments that Matter in Healthcare, Melissa Gilkes-Smith sits down with Markes Rembert Jr., MBA, MS, ACC, to explore what 18 years inside healthcare and dental operations can teach us about leadership, operational architecture, and the hidden cost of running an organization on willpower.

Markes brings experience across community health centers, academic dental institutions, multi-site practice environments, and his current work at Callen-Lorde Community Health Center. Together, Melissa and Markes discuss how mission-driven healthcare settings shape leadership, why identity-conscious leadership matters, and how operational problems often reveal something deeper: the leader’s own patterns, pressure points, and blind spots.

The conversation introduces the idea of the “willpower organization” — a workplace where high-performing leaders compensate for weak systems through personal effort, urgency, and over-functioning. While this may look like dedication from the outside, it eventually costs the leader, the team, and the patient experience.

At the center of the episode is Markes’ CPRCAR framework, a six-step operational leadership model designed to help healthcare leaders move from reactive management to a structure that can actually sustain performance. Melissa and Markes walk through how the framework works, where leaders often get stuck, and how stronger operational architecture supports culture, accountability, team dynamics, and patient care.

They also discuss executive coaching in healthcare: what it is, why leaders resist it, and how tools like the Hogan Assessment can help identify derailment risk — the moment when a leader’s greatest strength becomes a liability under pressure.

This episode is for healthcare executives, practice managers, operations leaders, dental leaders, and anyone who has ever wondered whether they are leading a high-performing organization or simply holding a fragile one together.

Because strong leadership is not about carrying everything yourself.

It is about building something that can hold.

Connect with Markes on LinkedIn or visit his website at coachmarkes.com