What Healthcare Leaders Can Learn from Lead Like It Ends

How urgency, clarity, and presence become the difference between drifting through leadership and actually leading

There is a moment in every leader’s career when they realize the position is temporary. The seat will change. The responsibility will pass to someone else. The work will continue long after they leave. When leaders understand this simple fact, everything shifts. This truth is the foundation of my book Lead Like It Ends, and it is the mindset that shaped every chapter of my thirty-plus years in military and healthcare leadership.

You do not need a command position at a major medical center or a federal agency to learn this lesson. You simply need to understand what most leaders miss. Leadership is not about the role. Leadership is about the impact you make while you are occupying it. And the time you have to make that impact is far shorter than most leaders want to admit.

The problem is that healthcare leaders often lead like the position is permanent. They delay decisions. They avoid conflict. They let dysfunctional patterns run without interruption. They assume there will always be more time. More chances. A calmer season. A better moment.

There is never a better moment.
There is only the moment you are in right now.

The day I learned nothing about leadership is guaranteed to last

My first day as Commander of Landstuhl Regional Medical Center in Germany was not ceremonial or smooth. I walked into an environment dealing with personnel reductions and budget pressures. The decisions that needed to be made were not popular. They weren’t even clear yet. I knew from the moment I sat in the chair that the organization did not need a caretaker. They needed a leader willing to make decisions that mattered, even if the cost was personal. That is the essence of leading like it ends. You act with urgency because leadership is borrowed time.

Healthcare leaders today face a similar reality. Crisis, turnover, financial pressure, regulatory demands, and cultural fatigue all collide at once. If you assume your time is unlimited, you will make slow, safe decisions that keep the peace and preserve your own comfort. If you lead like it ends, your mindset sharpens. You become decisive. You set expectations clearly. You focus on what will matter two years from now, not what will win applause today.

Leadership is not about maintaining calm. It is about creating clarity.

Clarity is the oxygen your team runs on

One of the biggest themes from Lead Like It Ends is this: leaders communicate either clarity or confusion, and teams quickly reflect whichever they receive. In the emergency department, where I spent decades, clarity was non-negotiable. You either communicated effectively or you created chaos. In combat zones and crisis environments, clarity kept people alive. Later in large federal systems like the VA and IHS, clarity kept massive, complex projects from collapsing under their own weight.

What does this mean for healthcare executives, nurse managers, department directors, and mid-career clinicians who want to step into leadership?

It means your team responds to the environment you create. If you avoid difficult conversations, your team will do the same. If you hesitate when decisions need to be made, your team will sense the gap. If your expectations shift week to week, your team will stop trusting the process.

But when you communicate directly, consistently, and without apology, your team begins to settle. The room gets calmer. People understand where they stand. They know what matters. They begin to believe the situation is navigable because you are showing them how to navigate it.

Leadership is not about charisma. It is about consistency.

Why urgency is not panic

When leaders hear the word urgency, they often assume it means speed or intensity. Urgency is neither. Urgency is clarity with a clock on it. It is the understanding that your actions today shape the organization you leave behind tomorrow.

In Lead Like It Ends, I describe urgency as the disciplined awareness that leadership is temporary. Urgency prevents stagnation. It keeps leaders from falling into the trap of “someday.” Someday becomes the excuse for every unmade decision, every avoided conversation, and every delay that slowly erodes team trust.

Urgency means:

• you address problems when they emerge
• you communicate expectations early and often
• you develop the people who will replace you
• you remove barriers rather than tolerate them
• you set direction even when the direction is uncomfortable

Healthcare leaders do not have the luxury of drifting. Too much is at stake. Staff morale. Patient outcomes. Financial survival. Team culture. If you want to lead effectively, you must live with urgency but operate with calm.

Panic is emotional.
Urgency is intentional.

What leading like it ends looks like in real life

When I coach healthcare executives, rising leaders, and mid-career clinicians, I see the same patterns repeating across organizations of every size. Leaders are overwhelmed not because the work is too complex, but because they are carrying unnecessary weight. They have not clarified their priorities. They are dealing with symptoms instead of addressing causes. They are managing around conflict rather than confronting it.

Leading like it ends changes that.

Here are the shifts I see when leaders adopt this mindset:

• They simplify their priorities down to what actually matters
• They stop tolerating behaviors that drain the team
• They delegate with real trust instead of hidden control
• They communicate with authority instead of apology
• They lead meetings with intention instead of habit
• They take responsibility for the culture instead of blaming circumstances

These are not abstract improvements. These are behavioral changes that teams immediately feel.

One leader I coached recently shifted from being reactive and scattered to being clear, firm, and calm in her communication. Within sixty days her staff reported higher confidence in direction and better communication across the department. Her own stress dropped dramatically. Nothing changed in her environment. Everything changed in her leadership.

That is what leading like it ends produces.

Your leadership legacy begins now

The purpose of leadership is not to preserve your position. The purpose of leadership is to strengthen the people and systems you are responsible for. When you embrace the reality that your time in the seat is limited, you start to make decisions that outlast you. You lead with clarity. You act with purpose. You communicate with intention. You build teams that can withstand uncertainty because they trust your direction.

This is what healthcare needs today.
Not more policies.
Not more committees.
Better leaders.

Leaders who understand that their time matters.
Leaders who act like the work is urgent.
Leaders who lead like it ends.

Call to Action: Coaching for Leaders Ready to Make the Shift

If you are a healthcare executive, rising leader, or clinicians stepping into leadership and you want to build clarity, confidence, and calm under pressure, I coach leaders one-on-one to do exactly that.

You do not have to guess your way through leadership.
You can become the leader your team needs.
It starts with a single session.

Book a leadership coaching session today.