By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

One of the most common frustrations mid-level leaders share with me is this:

“I know what needs to be done, but I can’t get leadership to take it seriously.”

It is tempting to believe that once you have a bigger title, people will finally listen.

But buy-in does not arrive automatically with authority. It grows when you build influence. And influence is available to every leader, no matter where you sit.

See the Issue Through Their Eyes

Senior leaders are navigating an environment of competing priorities, limited resources, and pressure from many directions. Their attention is often stretched thin.

When you bring forward an idea, they are less concerned about how you are going to make it happen and more focused on whether it moves the organization toward its goals.

The first shift is to translate your ideas into their language.

Ask yourself: What strategic concerns are on their mind right now? How does my recommendation help to advance those priorities?

When you frame your input in their terms, you position yourself as an ally rather than another competing demand.

Present Insights, Not Just Problems

Leaders hear problems all day long. What gets their attention is insight paired with solutions.

Instead of saying:

“Our team is stretched too thin.”

Reframe it:

“Here are two ways we could realign responsibilities to hit our targets without burning people out. I’d like your perspective on which option aligns best with the bigger picture.”

The difference may feel small, but it changes how you are perceived. Rather than handing leaders another burden, you are stepping in as a thought partner who is already thinking one step ahead.

Build Trust Through Consistency

Buy-in depends on credibility. Senior leaders are far more likely to support your ideas when they see a track record of reliability behind them.

Do you prepare thoroughly for conversations?

Do you advance even when no one is checking?

When the answer is yes, people notice. Credibility is built in small moments long before it is called upon in big ones. The steadier you are in execution, the more weight your voice carries in decision-making.

Share the Why, Not Just the What

Buy-in grows when leaders see how your idea strengthens more than just your immediate team. Mid-level leaders often make the mistake of explaining only the tactical fix, without connecting it to the organization’s larger mission.

Senior leaders want to know: How does this enhance the revenue or expense picture? Does it improve patient care delivery, quality or clinical outcomes ?

When you make that link clear, you demonstrate that you are thinking like an enterprise leader, not just your department, division, or program.

Practice Influence as a Habit

Gaining buy-in is not about one perfectly crafted pitch, it’s about a pattern of habits:

• Translating issues into senior leader priorities.
• Framing solutions with clarity.
• Following through consistently.
• Making connections to broader goals.

Each of these habits makes your influence stronger.

Over time, the leaders above you begin to see you as someone who can be trusted to look beyond your lane and contribute at a higher level.

Moving Forward

You do not need to wait for a promotion to earn buy-in, and you do not need a bigger title to be taken seriously.

What you need is to shift how you show up: speak in the language of strategy, position yourself as a problem-solver, build credibility through consistent delivery, and link your ideas to the larger vision. That is how influence is earned, and that is how those in the middle begin to lead in all directions.

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If this resonates with you, I invite you to download my free guide, Leading Up, Down, and Across from the Middle: Grow Where You Are, Then Grow Beyond. It offers practical tools to help you expand your influence, strengthen your presence, and take the first step toward leading with greater impact.  Download Here