Healthcare leaders from around the world explored this question at the FOH Summit in Los Angeles, sharing lessons drawn not from leadership theory, but from years of leading large, complex organizations through transformation.
Moderated by Professor Shelley Dolan, Chief Executive of the Royal Melbourne Hospital, the discussion brought together experienced healthcare leaders from the United States, Canada, Saudi Arabia, and beyond.
Their message was strikingly practical: leadership through change is not about having all the answers. It is about knowing what matters, communicating it clearly, building trust, empowering others to act, and having the humility to change course when necessary.
You Don’t Have to Win Every Battle
One of the first lessons was also one of the simplest: not every issue is equally important.
Dr. Bruce Gewertz reflected that healthcare organizations can resemble small towns. People work together for years, and the relationship may ultimately matter more than winning the argument in a particular meeting. Maintaining respect through disagreement, he argued, is therefore a critical leadership skill.
Dr. Kevin Tabb offered a related lesson from his early years as a CEO. The behaviors that make someone successful as an individual contributor are not necessarily the behaviors required of a leader. Over time, he learned to distinguish signal from noise – resisting the temptation to fix everything or become involved in every issue, and instead focusing his attention on the decisions that are truly consequential for the organization.
Leadership requires judgment not only about what to do, but about what deserves your attention in the first place.
The Higher You Go, the More Your Words Weigh
Dr. Lucie Opatrny shared a lesson she learned when a member of her team told her she had spent an entire weekend worrying about an interaction they had had on Friday. Opatrny barely remembered the exchange. The experience made her realize that as leaders become more senior, their words carry greater weight, sometimes far more than they realize. A comment that feels routine to a leader may have a significant impact on someone receiving it.
Her lesson was not simply to communicate more carefully, but to understand the person on the other side. Different people respond differently to feedback, authority, and pressure. Leadership therefore requires awareness of both the message and the power with which that message arrives.
Culture Is What People See You Do
How does a leader influence culture across an organization of thousands, or tens of thousands of people?
The panel repeatedly returned to one answer: role modeling.
As organizations grow, leaders cannot personally reach everyone. Tabb described how his organization had grown from a single hospital to approximately 40,000 employees across a broad geography. At that scale, leadership depends on a clear vision, consistent communication, and strong people throughout the organization who can amplify that vision.
But communication alone is not enough. What leaders do must match what they say.
Panelists described seemingly small behaviors, how leaders treat colleagues, how they respond to problems, whether they pick up a piece of garbage in a hallway, as signals that employees notice and interpret. Values become culture when people see them practiced consistently.
Simplify the Complexity
Healthcare is extraordinarily complex. Leadership does not have to be.
One recurring theme was the importance of making organizational priorities understandable to everyone, not only physicians and executives, but nurses, administrators, security staff, cleaners, and everyone else who makes the organization function.
The strategy, Björn Zoëga argued, should be simple enough that everyone understands what the organization is trying to accomplish. That requires repetition. Leaders may feel they have communicated something many times, while much of the organization is only beginning to hear it.
It also requires knowing when not to provide the answer. When teams already have the knowledge to solve a problem, leaders can create space for them to act rather than waiting for direction from above. In complex organizations, simplifying the destination can give people greater confidence and autonomy in deciding how to get there.
Looking Outside Healthcare for Better Answers
When the discussion turned to leadership development, the panel challenged healthcare’s tendency to look inward.
Dr. Opatrny argued that while healthcare is unique in important ways, many of its challenges are not: workforce shortages, fragmentation, innovation adoption, organizational complexity, and culture exist in other industries as well.
Healthcare has already borrowed successfully from aviation, most famously through the use of checklists. The panel suggested going much further, learning from business, behavioral science, sports, Formula 1, and other environments where organizations must coordinate complex teams under pressure.
There was also a call for greater attention to behavioral science and psychology in leadership education. Understanding organizations ultimately means understanding people: what motivates them, how they respond to change, and why different people may need very different forms of leadership.
Learn From Failure, Not Only Success
The panel also questioned where leaders typically look for lessons.
Leadership literature, conferences, and webinars tend to celebrate what worked. Far less attention is given to initiatives that failed, decisions leaders regret, or approaches that others would be wise not to repeat. Yet those experiences may contain some of the most valuable lessons.
Several panelists emphasized the value of learning through stories, both from healthcare and beyond it. Tabb highlighted the particular power of personal stories that connect an individual experience to a larger organizational message. Facts can explain a strategy. Stories can help people understand why it matters.
Give People the Mission, Not Every Step
When asked how they actually run their leadership teams, the panelists emphasized autonomy over control.
Meetings should have a purpose and be as short as the work requires. Senior leaders should be involved where their involvement adds value, and deliberately absent where it does not. One analogy came from the military concept of mission orders: tell people the objective, rather than prescribing every step required to achieve it.
That requires confidence in other people. If every decision must move upward through the hierarchy, change becomes painfully slow. Instead, leaders need to establish a clear direction, give teams latitude to execute, and create checkpoints to ensure the organization remains on course.
Expertise should also matter more than hierarchy. If the person with the information needed to make a decision is several levels down in the organization, bring that person into the room. Agility depends on putting trust and information where decisions are actually being made.
Change Requires Room to Take Risk
Perhaps the most direct discussion of leading change came when the panel was asked how healthcare can reconcile innovation with its deeply embedded culture of rules and risk management.
Tabb shared an example involving physicians who began independently using an ambient AI scribe that had not been approved by the organization. The initial reaction could easily have been to shut it down. Instead, he asked a different question: Why are they using it? Their enthusiasm pointed to a genuine unmet need, and the organization ultimately adopted the product.
The broader lesson was not that rules do not matter. In healthcare, patient safety, legal, financial, and regulatory risks are very real. Rather, innovation requires leaders to distinguish between unacceptable risk and calculated experimentation.
Tests of change can be designed so that failure is manageable. Teams can consider the downside, prepare a Plan B, and determine whether trying something new is actually riskier than continuing with the status quo.
Change rarely happens entirely inside the lines. Leadership means creating enough room for people to explore what might lie beyond them.
The Takeaway
Leadership for change is less about commanding transformation than creating the conditions in which an organization can move.
That means:
- Focusing on the signal rather than the noise
- Protecting relationships even through disagreement
- Recognizing the weight that comes with leadership
- Making strategy simple, clear, and repeatable
- Ensuring actions consistently reinforce words
- Trusting teams to solve problems without waiting for senior leaders
- Learning from other industries, and from failure
- Creating space for calculated risk and experimentation
Perhaps most importantly, effective leaders do not need to have an opinion on everything or be present for every decision. Their role is to make the destination clear, model the values that should guide the journey, surround themselves with capable people, and give those people the trust and freedom to move.
