Early in my healthcare leadership career, I received a call that many leaders hope for, despite the trepidation that follows. I was asked to step into an interim executive role. At first, I felt honored. Someone believed I was capable of leading at the next level. But I’d be lying if I said it didn’t also rattle me.
The questions came fast: Was I being tested? Was I simply holding the seat until someone else arrived? Did I have the authority to make real decisions? How would my peers respond now that I was suddenly their leader?
Years later, after coaching many healthcare leaders through similar transitions, I’ve learned that those questions are nearly universal. An interim assignment is one of the most challenging and developmental leadership experiences an organization can offer. It’s designed to maintain stability while a search is underway, but it also gives organizations a chance to assess whether a leader can operate effectively at the next level. The challenge is that most leaders receive very little guidance on how to navigate that transition well.
It’s also a lonely journey. As an interim leader, you often can’t process your concerns openly with direct reports, peers, or supervisors. Every conversation carries weight, and there’s no obvious thought partner. That isolation is one of the most consistent things I hear from leaders in this situation.
Why you were chosen as an interim leader
Organizations typically place someone in an interim role for one (or all) of three reasons:
- To provide stability while a permanent search is conducted
- To create continuity during a planned or unexpected transition
- To evaluate whether an internal leader is ready for a permanent appointment
Many interim leaders focus exclusively on proving they deserve the job. Ironically, that can be the very thing that works against them. If you’re in this role, your primary responsibility isn’t to campaign for the title. It’s to lead well, create stability, and advance the work of the organization. When you do that consistently, others begin to envision you in the permanent seat. The results do the campaigning.
One thing worth noting: If an organization isn’t genuinely considering someone for the permanent role, it shouldn’t place them in an official interim capacity. I’ve seen leaders pour everything into an assignment they were never actually being considered for. That’s a disservice to the leader and to the team they’re asked to stabilize.
The challenges that catch most interim leaders off guard
- Leading without complete authority
One of the most frustrating aspects of an interim role is ambiguity. You may carry the title, but not everyone is sure what authority comes with it. Team members may hesitate to follow your direction. Peers may keep treating you as they did before the transition.
Many interim leaders spend significant energy trying to establish authority. A more effective approach is to establish credibility. Credibility comes from clarity, consistency, and follow-through. Over time, credibility creates influence, and influence creates authority.
- Balancing “business as usual” with future vision
As an interim leader, you’re managing two competing objectives at once: maintaining operational stability and demonstrating strategic leadership. Some leaders become caretakers, avoiding important decisions. Others attempt to launch major transformations before they understand the landscape. Neither serves the organization well.
Your goal is to balance continuity with thoughtful progress, solving today’s problems while helping others see tomorrow’s possibilities.
- Managing relationships that have suddenly shifted
Yesterday, you may have been a peer. Today, you may be supervising former colleagues. This shift can create tension for everyone. Interim leaders often discover that relationship management becomes just as important as operational performance.
Conversations that were once informal now require greater intentionality. Boundaries must be established. Expectations must be clarified. Leading with transparency, humility, and consistency is what gets you through it.
- Performing under a microscope
During an interim assignment, everyone is watching. Your team. Your peers. Senior executives. And every decision can feel like an evaluation. That visibility often breeds self-doubt and perfectionism — and for many leaders, a creeping sense of imposter syndrome that no amount of preparation fully inoculates against.
You don’t have to have all the answers. You’ll come out stronger by staying grounded, learning quickly, seeking feedback, and moving forward despite uncertainty.
What to focus on during your interim assignment
When I coach leaders through interim transitions, I encourage them to anchor to five priorities.
⇢ Build trust relentlessly
Trust becomes your leadership currency. This requires a lot of listening, consistent communication, and following through on commitments. Your team is experiencing their own version of uncertainty. Creating psychological safety for them is your most important early job.
⇢ Think like the next-level leader
Many leaders continue operating from the perspective of their previous role, struggling to let go of their prior responsibilities entirely. An interim assignment is an invitation to expand your executive lens.
Ask yourself: What decisions should I be making at this level? What conversations belong here? What enterprise issues should I be developing a deeper understanding of? Start acting like the leader the organization needs, not simply the leader you used to be.
⇢ Seek feedback continuously
One of the most common mistakes interim leaders make is waiting for formal evaluations. Don’t wait. Seek feedback from trusted stakeholders throughout the assignment.
What’s working? What am I not seeing? What would make me more effective in this role?
The willingness to learn often matters as much as performance itself.
⇢ Resist the urge to prove yourself
When you’re trying to “win the job,” it’s easy to overextend — taking on too much, becoming reactive, and attempting to demonstrate value through constant activity. Focus on creating impact instead. The results will speak. At the same time, watch the burnout risk that comes with over-achievement tendencies in high-stakes situations.
⇢ Lead the team you have
Don’t spend your energy ruminating on whether you’ll receive the permanent position. Your team deserves real leadership today, regardless of what happens tomorrow. Serve them well. That’s the job.
How executive coaching can help you deliver your best as an interim leader
An interim assignment can be professionally exciting and personally exhausting — sometimes in the same afternoon. Because you often can’t speak candidly with the people around you, it’s easy to end up processing everything alone. A leadership coach changes that.
Coaching begins with self-awareness, helping you understand the mindsets and patterns you’re bringing to the assignment, and builds from there. A coach provides a confidential space to think, reflect, and make sense of what’s happening in real time.
During interim assignments, that work often centers on:
- Executive presence
- Strategic thinking
- Stakeholder management
- Communication during uncertainty
- Building confidence and resilience
- Navigating organizational politics
- Preparing for promotion interviews and selection processes
One of the most valuable things coaching does during this period is help you separate your identity from the outcome. Not every interim assignment ends in a permanent promotion. And that’s okay. Success isn’t defined solely by receiving the title, but by how you show up, how you lead others, and how much you grow through the experience.
Teams benefit from coaching during this period, too. Organizations often hold off on team coaching while waiting for a “permanent” leader to be named, but that process can take months, and the team is absorbing real disruption in the meantime. Waiting isn’t neutral. A team that works on its collective effectiveness during a leadership transition is better positioned to receive whoever comes next.
What the interim seat taught me
Looking back, my own interim experience taught me things I couldn’t have learned any other way. It forced me to think bigger. It challenged me to lead through ambiguity. It pushed me to build trust and influence in ways I hadn’t been tested on before. It accelerated my growth more than any role I had held to that point.
If you’ve been asked to serve in an interim capacity, take that seriously — and take it as a compliment. Someone sees potential in you. Treat this as more than a temporary responsibility. It may turn out to be one of the most valuable leadership development experiences of your career. Whether or not the role becomes permanent, the leader you become during the process may be the greatest outcome of all.
