“I Was Ready to Lead Until I Became the Leader.” Considerations for Emerging Academic Healthcare Leaders

Contributors: Jennifer Tomasik, SM, FACHE and Erin Konkle, PhD 
To learn more about Jennifer and Erin, click here.

 

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You earned your leadership role through excellence. Perhaps your research was innovative, or your clinical skills exceptional. Maybe your grant funding was impressive, or your capacity to educate the next generation of clinicians stellar. You were tapped on the shoulder to take up a leadership role, where you knew you could have a broader impact. Then you took the role and discovered something unsettling: the capabilities that got you the job don't fully translate into what is now needed for you to succeed.

We have witnessed similar scenarios in academic medicine and healthcare over time. The autonomous problem-solving that made a faculty member successful now collides with the collaborative decision-making that leadership demands. The deep focus that drives a researcher’s productivity conflicts with the constant context-switching required to manage a department. A department chair stepping into a health system role is no longer asked to consider only their department's needs, but how those needs fit into the larger medical center, university, and healthcare system. It's exhausting. It can often be lonely. The very skills that need refinement are the ones on which their reputation was built. Emerging leaders are asked to trade direct control and individual achievement for influence and institutional impact. That trade-off can be unnerving, as many new leaders lack formal training to bridge the gap.

If this resonates, you are not alone. Research from the Center for Creative Leadership shows that up to 60% of managers say they've never received leadership education. This number is even higher for physician leaders. According to research by the Medical Group Management Association and Jackson Physician Search, 67% of physicians are interested in pursuing leadership roles, while only 18% received formal business or executive training during medical school. The challenge is universal: transitioning from individual contributor to leader requires an identity shift that takes time and intentional development. Nearly every leader faces these challenges, and we offer a few insights below to help.

From Expert to Leader: Building Capacity Across Four Dimensions

Effective leadership in academic healthcare depends on four interconnected areas: Strategic Purpose, Culture, Team, and Stakeholder Engagement. Overlooking any of these can weaken the entire system. For example, a healthcare organization facing a $30 million shortfall felt stuck and unable to advance major cost-cutting and revenue-generating initiatives crucial for improving its financial stability. It wasn’t until they recognized the importance of unifying leadership, building trust and accountability, developing and communicating clear goals, and engaging board members and frontline staff that they made real progress toward their financial objectives. These elements continuously influence and reinforce each other, either strengthening or weakening the system.

Strategic Purpose: From Problem-Solver to Direction-Setter. Leadership requires a different focus. Instead of being the primary problem-solver, you must now clarify which problems matter most for your time and attention and why. This involves building systems that keep routine decisions off your plate, coaching others to find solutions rather than solving problems yourself, and helping your team understand how their work advances institutional priorities. Your role is now to set the direction and guide your team in finding their own way.

Culture: Making Your Operating System Visible. Culture — "how we do things around here" — shapes every interaction and outcome in your organization. Your role is to make the implicit explicit by articulating clear behavioral commitments and holding everyone accountable. Model the behaviors you seek, recognize when others exemplify them, and address breaches promptly. Cultural change occurs through consistent daily actions. 

Team: Developing Capacity. Leaders have shifted from being the go-to experts to becoming talent builders. When team members bring you problems, resist solving them directly. Instead, coach them through the thinking process, create stretch opportunities for emerging leaders, and openly share your own learning, wins, and mistakes. 

Stakeholder Engagement: Growing Your Influence. Each leadership level introduces a broader network of stakeholders with various priorities and viewpoints. Your role becomes translator and bridge-builder, helping different groups understand each other's interests and constraints and find common ground. Influence replaces control as your primary tool, requiring you to invest in relationships before you need them and to communicate in a way that resonates with each audience.

Getting Started

The transition to becoming a leader doesn't happen overnight, but you can start immediately. Depending on your organization’s needs, any of the four dimensions is a good place to begin. They're interconnected, so progressing in one area naturally strengthens the others.

If you start with Strategic Purpose, begin with strategic alignment and planning sessions. Gather your team to clarify your unit's top three priorities. Map how these connect to institutional goals, then work backward to identify what must stop, start, or change to achieve them.

If you begin with Culture, perform a culture assessment. Ask your team to describe and compare the current culture to the desired one. Identify three to five specific behaviors that would close that gap. Make these behaviors visible through regular discussions, recognition, and accountability.

Starting with Team Development allows you to assess your team's current skills against future requirements. Spot growth opportunities in upcoming projects and intentionally assign challenging roles. Hold regular one-on-ones focused on development rather than task updates.

Begin with Stakeholder Engagement by conducting a listening tour aligned with strategic interests. Meet individually with key stakeholders to understand their priorities, constraints, and definitions of success. Record areas of agreement and disagreement and communicate action.

No matter where you start, commit to regular reflection and adjustment. Remember that leadership development is an ongoing process. Each cycle through these aspects strengthens your capability and confidence. What feels uncomfortable now will become second nature with practice. The expertise that brought you here remains valuable, offering credibility and insight. Your influence will also grow from developing others, building systems, and creating conditions where your entire organization can succeed. This is the essence of leadership, and while it differs from what initially brought you here, it enables you to continue transforming your organization and influencing your field.

 

Contact Jennifer at: [email protected] 
Contact Erin at: [email protected] 

 

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