The “Wait and See” Cybersecurity Mindset Is the Biggest Risk Facing SME Healthcare Providers

After years of working with small and mid-sized healthcare providers, one pattern shows up again and again: cybersecurity investments are deferred until something bad happens. Tools like multi-factor authentication (MFA) are viewed as optional, inconvenient, or “something we’ll get to later.” Even when MFA is explicitly required by PCI-DSS, strongly encouraged by cyberinsurance carriers, and recommended by every major security framework, many organizations still take a wait-and-see approach.

In healthcare, that mindset is no longer just risky—it’s dangerous.

Compliance Isn’t the Real Reason to Act (But It’s the First Warning)

Let’s be clear: MFA is not a “nice to have.” It is already required under PCI-DSS for systems that touch payment card data. Cyberinsurance providers increasingly mandate it as a condition of coverage. HIPAA enforcement is also moving in a direction where basic security controls—like MFA—are no longer implied best practices but expected safeguards.

Yet compliance alone rarely motivates meaningful change. Too often, organizations implement controls just enough to pass an audit, check a box, or satisfy an underwriter. When MFA is framed purely as a compliance requirement, it becomes something to resist rather than something to embrace.

That’s a mistake.

The Reality: Most Healthcare Breaches Don’t Start With Advanced Attacks

There’s a persistent myth that cyber breaches are the result of highly sophisticated attackers using zero-day exploits. In reality, most healthcare breaches begin in much simpler ways:

• Stolen or reused passwords
• Phishing emails that harvest credentials
• Compromised remote access accounts
• Exposed email inboxes

In these scenarios, MFA is often the single control standing between an attacker and full access to systems containing ePHI.

When MFA is in place, a stolen password alone is usually not enough to cause a breach. When MFA is missing, the attacker is already halfway in the door.

Why “We Haven’t Been Breached Yet” Is a False Sense of Security

Many SME healthcare leaders say some version of: “We haven’t had an incident yet, so the risk must be low.” In cybersecurity, this logic is deeply flawed.

Not being breached is not the same as being secure. It often means:

• You haven’t detected the breach yet
• You haven’t been targeted yet
• You’ve been lucky

Healthcare is a high-value target precisely because organizations are under-resourced, operationally stretched, and hesitant to introduce friction into clinical workflows. Attackers know this. They count on weak authentication because it consistently works.

MFA Is Not About Perfection—It’s About Prevention

Cybersecurity is not about eliminating all risk. It’s about reducing risk to a level where common attacks fail.

MFA does exactly that.

It doesn’t require a massive security program.
It doesn’t demand a full-time security team.
It doesn’t stop clinicians from delivering care.

What it does is break the most common attack chain used against healthcare organizations today.

If an organization can only do one thing to improve its security posture, MFA should be at the top of the list.

The Cost of MFA vs. the Cost of a Breach

For SME healthcare providers, budgets are always tight. But this is where perspective matters.

The cost of implementing MFA is measurable, predictable, and relatively small.

The cost of a breach is not.

A single incident can result in:

• Operational downtime
• Patient care disruption
• Regulatory investigations
• Legal and notification costs
• Loss of patient trust
• Increased insurance premiums—or loss of coverage altogether

Many breaches that make headlines could have been prevented with basic MFA deployment on email, remote access, and administrative accounts.

HIPAA Is Catching Up to Reality

Historically, HIPAA has been criticized for being vague about “reasonable and appropriate safeguards.” That ambiguity is disappearing. Enforcement actions increasingly point to the absence of basic security controls as evidence of noncompliance.

In other words, “we didn’t think we needed it yet” is becoming harder to defend.

Organizations that delay MFA implementation are not just behind best practices—they are exposing themselves to regulatory, financial, and operational risk that leadership may not fully appreciate until it’s too late.

Leadership Must Reframe the Conversation

The resistance to MFA is rarely technical. It’s cultural.

Leaders worry about:

• User complaints
• Workflow disruption
• Adoption challenges

But the real leadership question should be this:
Are we willing to accept preventable risk to avoid short-term inconvenience?

Healthcare organizations routinely manage complex clinical workflows, regulatory requirements, and patient safety protocols. Adding MFA is not beyond their capability—it simply requires prioritization.

The Bottom Line

MFA should not be implemented because:

• An auditor asked for it
• An insurer demanded it
• A regulation may soon require it

It should be implemented because it is the most effective first step in preventing a breach.

For SME healthcare providers, cybersecurity does not start with advanced tools or massive investments. It starts with foundational controls that stop the most common attacks cold.

The wait-and-see approach has run out of time.
The cost of waiting is no longer hypothetical.

If you want to prevent a breach, MFA is not optional—it’s essential.