Where Confidence Comes From for Healthcare Leaders:
Capacity, Not Certainty

Transforming Healthcare Coaching Podcast — Episode 121: Where Confidence Comes From for Healthcare Leaders. Host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP in conversation with Vicki Landers, DPT MHA PCC. Published August 10, 2026.

Vicki Landers: Somewhere along the way, we turn that off in our brains, and we start to attach, "I'm not worthy of love no matter what. I'm only worthy of love if X, Y, Z." We're trying so hard that we forget who we are. And when you can let go of the trying, that becomes confidence in and of itself. It's really very powerful to just be and to be present. It takes a lot of letting go of the trying to get there

Lillian Liang Emlet: We've been trained to always have the answer. Somewhere in our education, confidence gets quietly redefined as being certain, knowing the diagnosis, knowing the dose, knowing how it ends. And so when we step into a room when the answer isn't available, and in healthcare, you know, that actually happens quite a bit more often than we want to acknowledge, we don't feel confident in that we feel like we're failing. And so we're gonna talk, be talking and unpacking this idea a little bit deeper with, our guest, one of our coaches at Transforming, Vicki Landers. she started as a clinician, and now she spends her days helping healthcare professionals find a steadier place to stand with career transitions, and also, as a professional speaker. And so, thanks Vicki for joining us today.

Vicki Landers: Thanks so much for having me. This is one of my favorite things to do

Lillian Liang Emlet: Yeah. so I guess I'll start our conversation off with, the word itself. when you want to feel more confident, what do people usually mean? And then where does that definition gets them in trouble?

Vicki Landers: So I think it's really interesting the thing that you said first, which was this idea of certainty equaling confidence. because that is we have this idea that if I know it, then I can be confident. But that really is where we miss the mark, that's like a belief that I have to have already developed a skill or I have to already know something in order to have confidence. When I want people to start to think about confidence as more of a belief in themselves, that they have the capacity to meet whatever challenge is coming to them at the moment

Lillian Liang Emlet: It's really interesting. I've been reading some work, related to, how do you become confident from a neuro or a cognitive perspective, from education perspective? And so much of it is tied to action. Like action first so that you fail, you go through the process, and then it's in that failure learning process is that confidence is built. That's, it's an active creation

Vicki Landers: I love this idea of creating confidence, 'cause a lot of people don't see it that way. they're like, "Failure is failure." Well, first of all, we don't learn without failing. and if we can get past this belief that trying something and failing is a problem, and instead shift that to trying something and failing a skill, that in and of itself is a skill to recognize that failure is something that teaches us. that learning how to learn is actually a huge part of having confidence in your ability to manage whatever's coming at you.

Lillian Liang Emlet: Yeah. It's really funny, whenever I give my talks on growth mindset, and whether they're of growth or fixed mindset, everyone raises their hand, "Oh, I have a growth mindset. I am." But almost always reality is underneath, and they hate being pointed out. they just like the outcome. They actually just like getting the A. They like, having accomplished a project. They like getting the paper done. But they often forget about the whole growth journey along the way. So it's interesting that you're talking about the, the loving to learn how to learn. some people really do embrace it, but I will acknowledge that I think there's a lot of people who really don't love the friction for learning, the space where learning actually happen has a lot of friction in it

Vicki Landers: Right? You don't learn without friction because you have to tie it to something, and that something is a lot of times the friction. so many people have a misunderstanding of what a growth mindset versus a fixed mindset is. and I like to help people see that, a fixed mindset is a belief about yourself, you don't actually have... That what you have is what you have, and can change. and that if we really believe that we have capacity, then that's where you move into that, that pattern of, "I can grow," and the capacity is about growing and not about that particular outcome. 'cause when we get so focused on, I want the A, I want the whatever I'm looking for," you're really focused on the wrong thing. you're not focused on the process by which you get there, and that process, if it doesn't involve a level of belief in yourself that you can walk through the process, you're undercutting your own capacity

Lillian Liang Emlet: So it's really interesting that you point that out because, we started this conversation about confidence. So I guess how does confidence and imposter syndrome weave its way together?

Vicki Landers: Well, imposter syndrome is kind of a whole little bucket all of its own, that comes from a lot of different places. But I actually, I was in a conversation a couple of days ago. I'm gonna go off the rails for a second. I was in a conversation about this idea of like when you're a child or when you have a child or you look at a child, you love the child. The child is worthy of love always and no matter what. And then they grow, and they're still worthy of love no matter what. And then as they get even older, they're still worthy of love no matter what. But somewhere along the way, we turn that off in our brains, and we start to attach, "I'm not worthy of love no matter what. I'm only worthy of love if X, Y, Z." And so that can build into this, "Well, I'm not worthy because I don't have X, Y, and Z," but you would never say that about a child. So what's the difference between a child being worthy an adult being worthy? And when we get derailed and stop thinking that we're worthy, it removes our ability to focus on process and instead shifts us to, "Well, I got to have the outcome 'cause I got to prove I'm worthy."

Lillian Liang Emlet: so interesting. it is true though. It is interesting how, people do feel like they're not worthy to be in a room, and yet they wouldn't be there if they weren't selected, had applied, volunteered. I mean, like, it's happening. And so it's interesting how we don't focus just on being in the present moment and just capitalizing on what we have in front of us, and I have to admit, I am guilty of it just as much as anybody else. But we'll save that for a later date. I'm curious, have walked through a time when either yourself or a coachee, where certainty just wasn't available, and you have to just act anyway. You just need to do. And so what's happening underneath, all of that to be able just to activate the confidence that's necessary?

Vicki Landers: I see it a lot, which again, you touched on it just a minute ago, that, when people, they get in the room, and then they don't feel like they're worthy of being in the room. And so there's this distraction. but it's really fun to like have people walk through or talk through, "How'd you get in the room? How'd you get here? What all did you do, and how did you show up that got you where you are?" And then we can use that for a conversation about how to get where you wanna go. 'Cause a lot of p- times people will come, and they'll be like, I don't like where I am. I'm uncomfortable. There's some sort of friction with my values and the organization I'm in. but I don't know. I can't do anything else." And so that's one of the things that I see is that this belief of, "I can't do anything else." So we really do focus on, who are you that got here? And really helping people understand that the person that got them there is a really special person. it's once in an all eternity event. but that they are special and unique because they got where they are, and that they can use the skills that got them where they are to take them to whether it's the next career, whether it's the next role. that it's really going back and thinking about who they are and reflecting on that and giving themselves the chance to really honor who they are that got there, and the choices that they've made. ' Cause we tend to discount our skills. Once we've like done something, it's like, big- I did that. This has happened this..." Okay, this is something that's I have lived through. I'm like, "Well, if I could do it, then clearly it's no big deal."

Lillian Liang Emlet: Yeah

Vicki Landers: that's a sentence I've said to myself. But the truth is, it is a big deal. Wherever you are or wherever people are, they got to that point, whether they got through medical school and residency and fellowship. they get through all of their clinical rotations. that's a big deal. And the person that you are that got through all of that to decide where you wanna go next.

Lillian Liang Emlet: I love that. And, you're right, it happens to me as well, in terms of as soon as, like, the thing is done, I'm like, I've already, moving ahead. And so you don't even take a second to just savor or be proud of for a hot one second, all the things that you've accomplished is definitely a problem we all have, I think just the way our brains are built

Vicki Landers: Yeah, we don't celebrate. It's like, "Okay, check. Next." that, that moment of celebration can become that thing that turns into that underground confidence that just can show up all of the time. we've got to celebrate what we've done, what we've accomplished when we reach those milestones. what we... I don't want to celebrate the milestone. I want to celebrate everything that went into it and reflect on that to use that to get to the next whatever that might be. So you've got to take that space and really celebrate who you are, so that you can springboard to whatever's next

Lillian Liang Emlet: Really great point. And it's one of those things where I do think this is why mentors and tutors and teachers, and coaches, people who are in your corner to be able to notice and celebrate and pause, reflect, and give it back to you. Because I think by natural tendency, each individual human doesn't want to do that, doesn't feel like they have the time to do that. But that's actually how confidence is built, is to actually acknowledge what is it, what's the formula, because then you create the system to keep on doing all the right things. Because then it becomes not negotiable to do all the things, like the, mistakes to not lend you towards success, right? So whether you look at an Olympic athlete or you look at a, a well-performing team, it takes multiple compounded actions in favor of where you wanna go to g- finally get, whatever trophy you want, whatever sporting, championship we're currently going through whenever this gets released, or personal, win that you want. It's through that process of noticing what's working, acknowledging it, and that catapults you to being willing to do the next gritty hard work to be able to get to the next level

Vicki Landers: Yeah. And so much of it is recognizing within ourselves what derails us. I have this goal that I want to meet, whatever it might be, whether it's the, the non-clinical role, the administrative role, or it's just your next level of education, that getting to that goal isn't the goal, which sounds a little weird, but it's recognizing, yeah, I got the goal, and then setting the goal over there. What does it take to get there? Who do I have to be to get there? 'cause most of the time who you have to be you already know. You just need to sit back and think into it you can actually do the day-to-day stuff and not get distracted by the things that are happening around you,

Lillian Liang Emlet: Right.

Vicki Landers: is easy to have happen

Lillian Liang Emlet: Right. So if confidence is the belief that you can handle what comes, where do you think that belief is built? Like, inside the who. You've described a little bit about unpacking that with other coachees or clients, but where is that raw material sort of coming from as each, for each individual person?

Vicki Landers: I think it kind of-- some of it starts with values really thinking about what's important to you, and then living in congruency with that, because that eliminates a distractor. You can get distracted by, by those incongruencies in your lives, in our lives. it comes from being aware of how your environment derails you, how the people around you might derail you. so awareness is a big part of being able to step into your own confidence, and recognizing, the influencers on who you're being, and then choosing those influencers. Because influencers can be, detractors, and can be enhancers. I find that some of the most confident leaders that I work with are people who are around other confident leaders. Not arrogance, not ego, but just understated confidence, and it influences. So one of the things that I like to encourage people to do is to really think about who they're spending time around. who feeds their soul? Who raises their level? keeps them steady? who might be pulling them away from their goals and their purpose? So yeah, really thinking about the influencers can make a big difference, in whether somebody is developing confidence or they're losing confidence in their own self

Lillian Liang Emlet: That I, it's really interesting 'cause I do feel like in the healthcare sector there is so much, negative vortex energy. And what you've described is what I call embodiment. Where it is interesting that the, the most highly successful leaders, business people, influencers, coaches, they're embodied, meaning They exude sort of their philosophy and their being, and they feel confident they're gonna be able to step up to the situation, in the moment. and so I think what you're describing is, something that you sense intuitively when you meet them. When you talk with them, there's not an agenda, there's not a lot of trying, they're just being

Vicki Landers: Trying. I think that's the difference. It's like, are we trying or are we being? sometimes there's a pretty big chasm between the two. We're trying so hard that we forget who we are. And when you can let go of the trying, um, that becomes confidence in and of itself. it's really very powerful to just be and to be present, it takes a lot of letting go of the trying to get there

Lillian Liang Emlet: Yeah, it's a really great point. And I think the reality is also just recognizing that, you have everything you need, like, right here, right now, just with yourself. You may not need anything else really, Like, you just, as long as you have your own personal, your mind, your body, your spirit, this is all you're really going to need to be able to face things. when I think about, like, when we faced the pandemic, it's like, you know what? we have what we know. Whatever equipment we have, we'll use it but we have what we have. And it's like, it's just gonna be the way it's gonna need to be. And that when you have confidence, rather than having the anxiety and the worries, when those creep in, I do feel like so much of, I know that a lot of people talk about, I always think, people love or hate Tony Robbins, I suppose. But for me, I actually am in favor of the fact that it is your mindset. If you don't have the good physiology inside your mind, and your body, and your spirit to be able to, like, carry forth what it is you want to do, the rest will get to you. I mean, you'll get pushed around by other people's agendas. Other things will, like you said, influence how you wanna show up. But the more you can ground in what's right and true for you, you'll know how to show up. You'll know how to show up when the ethical challenges come, you'll know how to show up when the budgetary problems come. And also, like, whenever there may be needed a decision that how do you retrospectively want to remember yourself? Like, "This is how I handled it."

Vicki Landers: I, there's so many things that you said that I really love in there. taking care of yourself and knowing who you are helps you show up, like you said, in those challenging moments where you are the one creating the budget and you know that not everything is gonna get funded. You have a basis for how you make decisions, and you're not following and getting swung by everybody else's agenda. and sometimes as early leaders, we're learning, we're growing, and that's why getting yourself in a position where you're around people who you feel have integrity, are leaders, that you want to be, will really make a difference in how you develop and being able to have your own grounding. Because it really is easy to get distracted by somebody else's agenda and having that awareness that can be possible is like the first step towards being like, "No, who do I wanna be? How do I wanna make decisions? What's my framework for this?" And then you always have that to stand on regardless of whether you're dealing with family situations, work situations, or patient interactions

Lillian Liang Emlet: Yeah. it's, interesting too when, you had talked about, like, there's all these different people you should surround yourself with, and, like, think about categorizing, like, where you wanna go. I also find, like, a lot of people just like, "Well, I have what I have," but the, the world is kind of amazing, I have to admit. This day and age now with, with the internet and the hybrid world, and just looking for the communities. So I just joined because, as some of you have seen if you follow me on LinkedIn, I've begun to talk a bit much more about my AI interests and my vibe coding and products and things. And I suppose I probably should share here on the podcast, so you know, for our clients and for our coachees, we do have supports that are technological in addition to if we're in between our sessions. Because AI is something where we shouldn't be afraid of, and so I've taken a deep dive for the last three years even as I've grown this coaching business and practice and podcast, to also take a deep dive into AI and coding. And then as I enter into all kinds of new founder worlds and ed tech, it's kinda amazing. There are just many more people out there that you need to meet. And so for those of you who are listening and you feel like you're stuck, you're in a career p- transition and you don't know where to find your people, there are tons of communities out there, by interest, by future passions, by learning interest, where you can go find your potential new people. And you'll still know who you are, but you're gonna be surrounding yourself with those who might elevate you to a different place

Vicki Landers: I love that you said this because it's so amazing to me. So I worked in a very narrow world of healthcare for, 18 years, very focused on my organization, the people that I worked with, my patients, my staff. and then when I left that organization, I've had this really interesting opportunity to see the whole world in a completely different way. meeting people by putting myself into different communities, coaching communities, other healthcare organizations that I hadn't been a part of, entrepreneurship organizations, all of these places where you meet people who are outside of healthcare, but who can contribute to making things better in the world. I think it's really amazing. And one of the things that I think is really cool, I had a conversation on LinkedIn not too long ago with somebody who, they were talking about how clinicians are lamenting the fact, "Ugh, my patients, they went on AI, and they came in with all this ChatGPT stuff." So I think it's great, and the reason I think it's great is that That's a great way to start the conversation and

Lillian Liang Emlet: Great

Vicki Landers: " What did you put into ChatGPT? Tell me what your questions were." Because that, it's like that tells you where your patient is. What are they thinking? what are they needing? What are their challenges? And it gives you this beautiful inroad to start a real conversation. And same thing with leadership. You can, when somebody says, "Well, I was looking on chat," or, People are building these things, and I'm afraid of them." No. Use them as a jumping-off point to create deeper connections that are more meaningful that may just be created initially by something that was automatic.

Lillian Liang Emlet: It is really interesting because I think AI has really, has exposed, the fact that there is, I hate to say this, maybe less volume of critical thinking and curiosity than the world needs right now, I think those who are thriving right now in AI are those who are probably the early adopters, who wanna push the limits, ask questions, think analytically, are always willing to, wonder about what we can do and what we should or should not do, right? So whether you're coming from governance or ethics or building, guardrails, I mean, no matter wherever you are, you're sitting on that utilization of AI implementation. those are things you all wonder and ask about. But there's a whole, I think, larger part of the population who really doesn't, one, like change, and then two, is a little bit anxious about actually asking any questions, which is why I think there, us even for this podcast, we've had it- to educate so many people on what in the world is coaching. which is still shocking to me because, I mean, there's an entire institute, the Institute of Coaching. There's bodies of positive psychological literature. There is wide implementation in Fortune 500 and Fortune 100 companies. it's normalized with, in terms of efficacy and outcomes, and yet in healthcare, I think my first response whenever we talk about either systemic team coaching or individual coaching is either, " Oh yeah, I've heard of that." It's like, like, like they pull back and they're like, yeah," right? Or,

Vicki Landers: evidence there

Lillian Liang Emlet: right. Or they're like, "Did I do something wrong?" And I think that's the saddest part for me, that they don't assume that they deserve to have it, just like an athletic team, just like an Olympic athlete. They don't identify as that they are something special, and I find that to be the saddest part about any frontline clinician who's been offered coaching and declined it because they're afraid to one, either do the work, become curious, and also have accepted a societal, culture that maybe this is punitive. Maybe they think I'm not good in some way. so I don't know. I'm curious whether you've had the, some of the similar, or maybe it's just I've been talking to maybe some of the wrong, the, like, not the right people.

Vicki Landers: No, this is-- there is still within healthcare and with actually a lot of or-- just organizations in general, coaching initially was used as something that was like, "Oh, you're on a performance improvement plan. We're gonna give you a coach." And that was... That's too late. That's not when you give somebody a coach. coaching can be developed early in somebody's career. So I believe, like through my heart and soul, that anybody who has just been moved into a supervisory or a coordinator position where you are directing staff or you are supervising staff, those are the people who need to be provided with a coach. ' Cause those are the people who have just gone from, "You're a rock star clinician. Here, do this leadership thing. Oh, no, we're not gonna teach you about it. You spent 15 years learning your clinical skills, so clearly you can just go be a leader." It doesn't work that way. So those are the people who I really believe should be getting coaching. I actually, I work, I'm on the board of a local hospital, and they are starting to do some shifts in that direction so that people earlier are getting true leadership support so that they can actually do those jobs well not waiting until they fail and put them on a performance improvement plan. And I'm really excited to see that more within the world of healthcare. We've got a ways to go, but coaching is all about support and learning and creating. Let's go back to the confidence thing. Creating situations where people can develop their own personal confidence and go out and support their staff, their peers, their patients, and their organizations better. Wow, that was a little bit of a soapbox.

Lillian Liang Emlet: I went on my own, little soapbox. And I just, I'll argue also that I think for new leaders, new, you need probably two people in your court. One is definitely the coach. sometimes they're just, in little inflection points or for, like, bursts of support. But then you also do need at least a year or two long mentor, 'cause I think the reality is, I think once we take on a new position, there should be a strategy. And I think the reality is most of, us get put in the position, and then we're like, "Let's go figure it out," for figuring out, like, how it's gonna fit in for our own selves. And so I think having the mentor-coach combination, one, because it's internal to the organization, so all of the HR and directors out there, these are advice from, two people who see lots of different leadership, situations from different angles. one is the long-term mentor, and also, targeted coaching interventions. maybe, like, six months here, things are probably moving pretty well, could probably take a break for a little bit, and there's gonna be other shifts. So depending how volatile your organization is, obviously tech being a little more volatile compared to other industries. But some people argue that healthcare in many places is also very volatile because the margins are always shifting in particular regions.

Vicki Landers: Yeah. Healthcare has a lot of challenges right now from a staffing, from a funding. the actually the direct care providers are the people who are getting squeezed, while other people are making all of the decisions. And so I think h- that's one of the people that I really like to work with, are those people who are like, "I don't feel like I can affect anything," and they're going to work feeling very, and like they don't have any power, and helping them recognize where their power really is start to like refocus on who they want to be, doing their direct clinical care. 'cause tho- those people need support, and need to like refocus into their values and refocus into where they do have power. and that power comes internally, by recognizing the impact that they actually have every single day.

Lillian Liang Emlet: Yeah. And the nice thing for s- those who are listening is that syst- at, here at Transforming, we have systemic team products, packages, and also individual, like Vicki is talking about, because you need s- a combination of both, where each person, when they're well and whole and confident and empowered themselves, they function together better when we are together as a team. And so both to synergistically, help stabilize when there's a lot of change. I mean, let's get real. There's some organizations right now that, a good 50% of their leaders are turning over in any given year. So I know a lot of times we look at retention, and we look at engagement metrics, but the other question is, how much of your leadership is actually turning over? That is a very unstable, moment to be in compared to like, oh, maybe 10% per year, only a few people change over, or, and then you have a pipeline, right? But I don't know that people really think more granularly deep into that because it's happening all across the organization in multiple disciplines and specialties, that, having the idea that it does affect each other. Like, so if nursing turns over, and the physicians turn over, they are gonna affect each other, even if one is, seems more stable than the other

Vicki Landers: You lose institutional knowledge, you lose camaraderie, you lose, informal communication systems, when people turn over and then when the higher level leadership turns over, you create some instability. So whatever you can do in order to maintain longevity and, succession planning, I'm a... Succession planning is something that should start... discharge planning. Succession planning should start when somebody starts their job. I've got this gig. I don't know how long I'm gonna have this gig. Let's make sure that we set the next person up to, for success." that might not be a popular statement, but I do believe succession planning starts on day one of your job

Lillian Liang Emlet: yeah. so I think for the people who are still listening to all the way to the end, let's give them something concrete. And so before a hard shift or a difficult case or a conversation, and you just don't feel confident, in that moment, what's one practice you can do that builds self-trust in the moment?

Vicki Landers: I like to have people ask themselves the question, how did I get here?" And, just because if they answer that question, it takes you into the space of knowing that you have the skills. "I'm here because I got here because of this." So, "How did I get here?" is a nice one to use

Lillian Liang Emlet: I like that. For me, I just think that just taking some deep breaths and steadying and grounding yourself to recognize that you wouldn't be having this conversation or you wouldn't be in this moment if you couldn't handle it, that you have everything inside you right now to be able to do what you need to do with it, to figure out what it is you need to learn from this experience. And so to just ground yourself and to know that you are enough and what you have is what you have, and that in the moment you do have the ability to be able to respond, to whatever you've been given. Because I have to admit, I, in general, I'll bet on myself, more than I will bet on how other people may or may not either fail me in the situation, not know how to do something, and then that can be good and bad, right? In terms of that learning to delegate. But I can almost always bet on myself that if there's a situation, I will respond in the way that I hope to, in the way that I can be given the knowledge and the skills in that present moment

Vicki Landers: What we need tends to show up for us

Lillian Liang Emlet: Yeah. Well, so this concludes our episode for today, and thank you so much if you've been listening all the way to the end. And so, feel free to please leave in the comments below, what questions you have or situations where, or tips for others in terms of relation to confidence and how that can help us either as leaders, healthcare professionals, in how we live our life. And so for future topics, please email us at podcast@transforminghealthcarecoaching.com. We want to begin to give you the skills, tools, tips, tricks that we see, use in our, clients, in our own lives, and bring the evidence back to you in terms of what we're seeing out there in the real world. So thanks so much for listening. We'll talk to you next time