Public health practitioners look for the exposure behind a cluster of cases before treating any one patient. Nicholas Mukhtar, a consultant based in Fort Lauderdale and trained in public health and public policy at Johns Hopkins, applies that habit to companies, and a May 2026 column he wrote for the Cyprus Mail lays out how.
He sorts clients into two groups. “I look at companies in two buckets,” Mukhtar has said. One is the large, established company that behaves like a big-city government. The other is the startup, where a few people cover 20 roles. Both, he wrote, tend to react to whatever problem is visible without asking what produced it.
Four Reactions and the Questions Behind Them
1. The budget overrun. A department runs over budget, and leadership cuts headcount. Mukhtar’s first question: Who, on paper, holds decision-making authority?
2. The revenue dip. Sales fall, and marketing gets restructured. He looks at the reporting cycle, and at how late it surfaced the problem.
3. The executive exit. A C-suite departure sets off an overnight reshuffle of the reporting chain. He wants to know if anyone wrote down communication expectations before the team grew, or if they were simply improvised.
4. The overloaded founder. A startup founder handles everything personally. Mukhtar traces the pattern to a team that’s never been given enough clarity to operate on its own.
Many owners, in his experience, build systems only after growth arrives. He recommends the reverse order. “Build the infrastructure before you need it, because by the time you need it, you can’t afford the downtime,” he wrote.
The Cause He Finds Most Often
Across healthcare, wealth management, family offices and startups, Mukhtar points to communication breakdowns more than any other cause, estimating they account for about 90% of the problems he encounters. “People just need to talk,” he wrote.
A Grammarly study conducted with The Harris Poll estimated that ineffective communication costs U.S. businesses up to $1.2 trillion a year. Mukhtar connects that loss to the distance between a plan and its execution.
Each sector shows that distance in its own way, according to the column. Medical directors see delayed care decisions and friction between clinical and administrative leaders. Family offices inherit estate plans nobody in the family understands, drafted by someone who is no longer around to explain them.
Mukhtar calls himself pro-simplification and argues that the people at the bottom of an overbuilt system, whether in healthcare, government or business, absorb its costs. He made a related case for clarity over speed in the South Florida Reporter.