Two Levels Up, Two Levels Down
Plans are worthless, but planning is indispensable.
Dwight D. Eisenhower, Supreme Allied Commander and 34th U.S. President
Two years after I left the ambulatory care center I'd helped build, the anniversary celebration I'd started was still being held in the same way. The individual doctor performance tracking I'd pushed for, over real resistance in favor of team-level scoring, was still the system in use. None of that held because I was a particularly gifted hospital administrator. It held because years in uniform had trained me to build things that don't depend on me being in the room to keep working.
Most of what I actually apply from that training isn't tactics. It's a small number of habits of thought that turned out to translate almost directly into running a business — and a couple of places where the two worlds genuinely diverge, in ways worth being honest about.
The job is to translate, not just to relay
Any leadership position sits sandwiched between two audiences with different concerns. Above you are people whose own success depends on yours — a battalion commander answers to a brigade, which answers to a division, and each level up cares about the mission in terms one step more abstract than the level below it. Below you are the people actually executing, who need direction concrete enough to act on, not just intent passed down verbatim.
The military trained this as a specific discipline: think two levels up and two levels down, not one. A battalion commander doesn't just take direction from brigade — he has to understand how division defines success, because that's the frame his own brigade is ultimately being judged against. And he doesn't just direct his companies — he needs visibility into how the platoons underneath them are actually organized and tasked, because that's where his own plan either holds together or quietly falls apart.
I've found this particularly useful when translating an enterprise priority into an operating workplan. The person executing the task needs to understand what they are being asked to do; the manager needs to understand why it matters to the hospital; and the leader above them needs to understand how that work contributes to the broader strategic objective. A line manager needs to understand not just what the hospital director wants, but what's actually driving the COO above the director. A COO, in turn, needs to think not only about what the CEO needs, but what the board or shareholders are ultimately measuring the CEO against — while staying equally aware of what's happening two levels down, at the line-manager level, where a strategy either becomes real or doesn't. Skip a level in either direction, and you're leading on incomplete information, whichever direction you're facing.
A plan needs intent stated as clearly as its tasks
Military planning has a structure most business plans skip entirely: a clear statement of intent, the concept of operations, explicitly named constraints and assumptions, and a breakdown of groupings and tasks that trace back to that intent. What makes it work isn't the format — it's the discipline of stating the why with as much precision as the what, before anyone starts assigning tasks.
Most business plans I've seen do the opposite. They're heavy on tasks and targets and comparatively silent on the intent those tasks are meant to serve, and on the constraints and assumptions the whole plan is quietly resting on. That gap is exactly where a workplan can technically be delivered and still miss the point — a target hit, an initiative completed, and the underlying intent nowhere close to satisfied, because no one wrote it down clearly enough to check against.
Mission command works only when intent is unambiguous
The military's other core habit is mission command: focus on the outcome, and leave the how deliberately flexible, as long as the intent is met. It's a genuinely freeing way to lead — it trusts the people closer to the ground to find the best path, rather than dictating method from a distance they don't have context for. I've tried to bring that same instinct into how I lead in business, and most of the time it works well.
But it only works if the intent was stated as an outcome in the first place, not as an activity. If a team is told to "run more events" rather than "acquire customers efficiently," reporting back that events were run is a completely faithful answer to the instruction as given — even if it tells you nothing about whether the actual goal was met. Mission command's flexibility on the how only holds up when the what was defined sharply enough to check against; if it wasn't, what looks like a communication failure lower down is usually really an intent failure higher up.
There's a second limit worth naming: mission command assumes the how genuinely doesn't matter to the outcome, and that isn't always true. A battalion can take a hill by several different valid routes. A linen inspection technique that misses a hidden object doesn't produce the same outcome as one that catches it, no matter how confidently the report says the job is done. Knowing which kind of situation you're in — one where the method is genuinely flexible, and one where the method is the safeguard — is its own judgment call, and getting it wrong in either direction costs you something different.
The habit that doesn't always transfer
The biggest adjustment moving from military leadership into business has been this: not everyone weighs organizational good over personal interest the way military training assumes as a baseline. Some leaders, in healthcare as much as anywhere, optimize for what serves their own tenure rather than what serves the institution beyond it — and it's an understandable instinct, since most corporate incentive structures reward exactly that. It's clouded some of the longer-term thinking I've watched happen around me, and I've had to adjust my own expectations of others accordingly, without letting it change what I actually optimize for myself.
That's the same instinct behind the anniversary celebration and the individual doctor tracking still running two years after I left. I didn't build those expecting credit for them later — I built them because a structure that only works while a specific person is watching isn't actually a structure, it's a habit borrowed against the future.
The parts of military leadership that have transferred best into running a hospital aren't the ones about command. They're the ones about building something that keeps holding together once you've stepped out of the room.