Why Healthcare Leaders Are Saying
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Transforming Healthcare Coaching Podcast — Episode 75: Why Healthcare Leaders Are Saying No to Promotions. A conversation between co-hosts Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, and Klaus Grim, PA-C CPC ELI-MP.

Klaus Grim: Welcome everybody to a new episode of Transforming Healthcare Coaching, and today we're talking about what we're hearing from our clients, our healthcare leaders, about what they need in 2025, 2026. And so, Lily, you and I work a lot with healthcare leaders in our Transforming Healthcare Coaching company. What are you hearing from healthcare leaders about what they need?

Lillian Liang Emlet: I would say probably the biggest thing we're hearing is, it's too much. There are just so many things happening. Between new clinics, opening buildings, expansion of different healthcare systems, not enough people to work the shifts. People having unexpected health reasons, they have to be out for a little bit. Running so lean that we can't deal with normal life, I would say is the biggest thing. And then just the unpredictability of trying to find good talent to be part of the group in a consistent way that isn't transactional, that really isn't about just going to the highest bidder for salary. These unintended consequences really are starting to hit home on a chronic basis, I think almost every healthcare group.

Klaus Grim: So a lot of these challenges have been building up. And why do you think they're more prevalent right now for healthcare leaders than, for instance, before COVID?

Lillian Liang Emlet: I think right now it's the combination of so many factors. We never really fully recovered after the pandemic, and there's been so much change to the point where chronically for the last five years, every leader — if you're still in that position. I think a lot of leaders have exited, taken part time, or aren't willing to pick up the mantle. I know so many junior talented people who are saying, I'm not even willing to become the next person in line. Because they see what's happened to others before them in terms of, how am I going to balance all of that? How am I going to balance my family? I have young family. I want to be present. What's most important to me is also being a human being, a partner. I have relationships, I have other dreams as well. How can I do both that and also lead the team when these problems are not fixable? There's a lot of false narratives going on out there in terms of people not willing to engage and just thinking that the system is the problem. Forgetting that we as the people have some control over that.

Klaus Grim: Yeah. I think that is a very important thing that a lot of people come to us for, and what we've done in our own research too, of learning what the best strategies are to create positive change in our work environments. And oftentimes it requires a combination of individual change as well as systemic changes. And sometimes systemic changes are very hard to work on and hard to change. And that's one of the challenges I think that most of our healthcare clients face. And I think COVID actually opened the doors. Obviously there were a lot of challenges and a lot of unfortunate things that happened as a result of COVID for our patients and work environments. But it also, I think, shed light on the challenges that we have and that something needs to change. And we've seen some changes on wellness and programs and focusing on individual provider wellbeing as positive growth that needs to happen in order to create a healthy workforce. So what are you hearing from your healthcare leaders when they reach out to us? What specific language are they using and what are they actually asking for?

Lillian Liang Emlet: I think a lot of it is trying to understand their own role and trying to figure out a better way to negotiate and be a better person at the table. Just like in any particular group or team, holding everyone's perspective is really important, and sometimes there's worry that their perspective will not be heard as well. And so a lot of it is about clarity and confidence and being able to be succinct with the bottom line. In terms of hearing both perspectives, I think the person who's more talented at being able to hold another person's perspective — meaning the system, the finances, the facilities. It takes an army to be able to run the facilities that we run, whether it's inpatient, outpatient, private practice owners actually get a taste of this in their own small offices because it's a lot to manage in terms of every line item. And I think most healthcare frontline people don't really think about that. And I think that's where the disconnect can happen. As leaders, our job is to know all of these things, so people often come to us when they realize there's a lot that I don't quite know or understand, and I'm not sure where to move forward. And as you and I both know from our team coaching practices, it's okay to not have all the answers. What's more important is to be able to give voice so that we all can learn together. And the faster we learn, the faster we do, the faster we can do tests of change, the faster we'll be able to move forward in the market.

Klaus Grim: And to stay well throughout that process. And so I'm curious, you mentioned earlier that a lot of healthcare leaders are afraid to step up or become healthcare leaders and step into new roles because they know the challenges that healthcare leaders face that impact their day-to-day life personally and professionally, and they don't know if they want to handle all that extra stress. Is it really worth it? Is that extra pay really worth it? So in the healthcare leaders that have reached out to you with that issue, what do you see as transitions or transformations that happen as a result of a coaching relationship?

Lillian Liang Emlet: I would say probably the biggest thing is greater foundational strength. When we coach energetically, the whole person, we get everything sort of tucked in. Your personal life, your health, your mental health, your curiosity, your learning, your relationships. And when all of those things are calibrated correctly, then you have the capacity to learn and be able to hold strong tensions in the boardroom with ease. So a part we often don't really realize — we're often living on unstable foundations with sleep, rest, hygiene, relationships, commitments, and just making sure that we've done a full inventory. So awareness, as you and I have spoken about many times on our podcast and in our medTHRIVE group coaching community — awareness is step number one in foundational. That very first month as you join the community really is about taking stock of where you are. And I'll argue that we also have to take stock almost every couple months, because you've made progress, things will start to become plateaued, and that becomes your next learning edge. And so the question for each person is, depending on what you're working on, depending on what you're facing, you feel like you're almost recalibrating all the time. And so the question will be, how often do you need to reset so that you can do what's most important and not be wavered off into the next new shiny object. And you and I are both emergency medicine providers. We know about shiny object syndrome.

Klaus Grim: Yeah. And we follow that oftentimes, and we neglect a lot of the other things that we want or know we should be doing. And so you brought up some excellent points about why we see a lot of our healthcare leaders struggling to take these advances into their careers or personal life. And so I had a beautiful question for this. I just lost it.

Lillian Liang Emlet: It's okay. I'll come to you.

Klaus Grim: Yeah. So that's why it's so important to take that step back and see a bigger picture, which oftentimes we struggle to do. And you've mentioned doing it frequently, to take stock of yourself, maybe even every month, when shifts and changes are happening, which are oftentimes very important. And so how do you recommend somebody do that? How do you recommend somebody who is in a healthcare leadership role and they're saying, I don't have time for this, I don't know how to do this. I hear all this advice about reset and figuring a way to center myself and ground myself. How do they do that?

Lillian Liang Emlet: It's a really good point you bring up. You can't get to the daily practice until you try somewhere. So I think the question is, once a week can you begin to look at your schedule and think about things? Can you do at least a weekly meditation or an hour for yourself? Do something that helps you get clarity, whether that's reading or journaling. And the reason why we created the Reset Retreat in January 2026 is primarily because we realize leaders especially are always chasing and running after the pre-structured quarterly business reviews and the annual reports and the monthly deadlines. They feel like they're on the hamster wheel because they're over top of normal clinical practice. There's this whole other invisible land of business administration and just keeping everything running. That's a whole other second set of projects that most people have never had to think about. If you don't take a step back at least once a year for yourself, if not twice a year — most people would argue in really good business practices at least twice a year to recalibrate — then you're not really following the data right in front of you.

Klaus Grim: I —

Lillian Liang Emlet: I would argue that probably most healthcare providers don't follow any data at all. They just are running the race, fixing the things, caring for everybody, and have sometimes forgotten about themselves. And I also argue that most healthcare professionals, especially leaders, care so much about their team and winning for the team that they sometimes have forgotten their mission statement, their personal mission. I'm not talking about the organization's — or they've got those down. But it takes a really strong human to be able to run the best athletic race that you can for your group, for your team. And your stakes are higher as a leader. And so I think with higher intensity of leadership, you need higher intensity of self-care.

Klaus Grim: I love how we're talking about reset and how we created this retreat specifically for that, to help people take that step back. And it's actually really funny, Lily. I prepared a presentation recently for PA students and one of the things was to give them some form of exercise to find some kind of transformation for themselves, create a goal for themselves, and I'm doing it with them while we're in the lecture. Because wellness should not feel like an extra homework assignment, number one. And number two, we don't give ourselves enough time to do that. So if we say, okay, go do it after class, you're so busy doing so many other things, that it's actually also even empowering to do it with other people in that moment. And so the Reset Retreat is that opportunity to say, I can get CME, I can hopefully get reimbursed by my organization, and I can focus on me and make a good strategy for the year ahead for myself and for my teams, and show up authentically and do that with people and gain insights from other people who are in similar roles. So, Lily, who is this retreat made for? What healthcare leaders?

Lillian Liang Emlet: So it can benefit anyone from the newly promoted assistant nurse manager all the way to the C-suite. Because that beginning nurse manager really needs to think and embody what rising through the ranks will look like. And so this is the beginning of a habit that all leaders should have in their tool belt of practices. Whether you are leading 500 people or you're leading 20 people, the recipe for burnout is not thinking through your developmental life cycle as a leader. And I have to admit, I wish I had known some of these things when I was younger. When you take on different positions and you stress and worry about what those transitions and inflection points will look like, you always have to come back to the practice of understanding what your values are, what you're curious about learning, what have you outgrown, what could you see differently, what accountability would you put in place, what values do you uphold by doing this, when will you do a recheck, who will be your buddy along the way. So I guess I'm giving a sneak preview to what we're going to be talking about, but all of these things are really important so that you could achieve what you want to do in the coming year. I didn't know about any of these things until I entered this entrepreneur land — being in community with people who are in different stages of the same journey of self-improvement, serving others, holding themselves and their values first, so they become the best leader of their business, group, person, all one and the same.

Klaus Grim: Yeah, and we don't know what we don't know. And so that's something beautiful about what we have created with this Reset Retreat is that we've invited healthcare leaders of all professions within healthcare — nursing, APP, physician, and many others. It's very hard to include in a short episode. But we get to shed light about what their challenges are, and you get to hear, and that may influence your own journey within your own organizations. And Lily, I'm very curious because everybody hears the word retreat. How is this different from a typical leadership retreat, a conference, a wellness program, or just executive coaching that they may have experienced before?

Lillian Liang Emlet: Yeah, so I think with executive coaching, the one-on-one relationship that you have — obviously this is a group. We are only going to take up to 20 people max, and so depending on who registers. We have decided as a collaborative group of coaches that we are capping it on purpose so that we can give everyone the one-on-one attention and possibility, and also for the confidentiality and safety so that everyone has a chance to speak and get their work done. This is definitely not a conference. We're not about learning new pre-created talks. Obviously the podcast is our platform to give you information in this auditory format. We want everything to be a live experiential moment. The first day is really about using nature and using Sedona and leveraging its power and beauty to disconnect and reconnect with nature, because we know that nature is very grounding for many people and is a hard reset. As some people have commented, in some ways nature is our natural way of detoxing. When we turn off the phone for a little bit, go for a walk and just be glad to be present in the space. We'll have a little bit of networking and getting to know each other on that first evening, as we come back from nature and our individual practices to come back together and start getting curious about who we are going to be hanging out with for the next day. And then the whole day on Sunday is really going to be experiencing, working. I need to break it to people — you will be working and thinking and doing probably some of the hardest, strangest work they've ever done with the questions we're going to pose to you as we workshop what your ideal life and needs look like for 2026, so that you can achieve impossible dreams and also think about realistic dreams and goals.

Klaus Grim: The work is fun. It's work on you. It's targeted towards you and your individual lifestyle, both at home and at work. They all go hand in hand. And so this journey and this retreat, what's unique also about it is that it's being led by certified professional coaches, which I think is a very unique aspect of a retreat that many healthcare professionals experience — that we're helping you unlock your own answers. Because you're your own unique genius and you have the ability to create powerful transformations within yourself and your team. It just needs community support and the right guidance. And that's what we hope with this Reset Retreat, is that you take your time for yourself to say, I can make time for myself and be well for myself and my teams. And so, Lily, why now? Why are we doing this retreat now, and what makes this particularly timely in January?

Lillian Liang Emlet: One, January is a time for a new year, and I would say that most of us are running ragged in all of December just trying to get through the holidays, the scarce coverage, all of the celebrations. And with the new year, there's lots of great energy in terms of staying committed. I think a lot of times people have a hard time staying committed to these really big goals. It's really important mid-January to plan and strategize what will happen if things don't work out, and also if there are things that you didn't think of as your New Year's resolutions. So partly it's the calendar year, partly also because it's the one downtime month where we're all sort of in hibernation. A great book in the name is Wintering. And it's really all about the fact that the winter is meant for restoration, and it's that time when the seed germinates right before the spring can happen. It's in this deep work that's necessary to hear your own voice so that you can craft a plan forward with everyone that needs to support you.

Klaus Grim: That's beautiful. I love that. And I'm always a sucker for new year goals and new year strategies. And so that for me is a highlight of my year — making intentional goals and changes and being very intentional about it. So thank you, Lily, for talking about what our healthcare leaders have said and needed, and why we created something so unique to address these challenges. And so for those who are interested, in the note you'll see a link to more information about our Reset Retreat that's happening January 17th and 18th in Sedona, Arizona. And please reach out to us if you want to ask more individualized questions. We would be happy to talk and we look forward to seeing everybody in the next episode.

Lillian Liang Emlet: And more importantly, if you have heard this episode and you wish that your boss could get a Reset Retreat and have greater clarity to lead you, your team, your groups through some challenging times — I can tell you that we have heard so many stories of really hard times for so many groups. Send this to your boss and tell your boss to send it to their boss, because the chain is quite long in healthcare and there are many people who can benefit. So thanks so much for listening.

Klaus Grim: Yeah, share with a friend, share with a colleague, share with a boss. We'd love to reach out and see what transformations we can help within your own teams. Thanks, Lily.

Lillian Liang Emlet: Thanks, Klaus.