I recently had the privilege of meeting with several CFOs navigating one of the most challenging financial environments our industry has ever faced. What healthcare executives are grappling with today goes far beyond spreadsheets and margins. They’re often wrestling with impossible choices that will ripple through entire organizations and communities for years to come. Close a service line or restructure a department, and you’re not just adjusting a P&L statement. You’re affecting people’s livelihoods, patient access, and the fabric of care delivery itself.
Here’s the thing that doesn’t get talked about enough: the profound loneliness that comes with making these calls. One executive who recently spoke to one of our coaches described it as “dealing with Monopoly money”—the cuts they have to make are so large, that kind of money just doesn’t exist within the organization. They’re responding to demands for drastic reductions, setting the course for stronger operating margins so they can continue their mission. When you’re the one who has to decide which programs to cut, which investments to defer, and how to do more with perpetually less—all while keeping physicians aligned, employees engaged, and patients safe—where do you turn?
Your board wants answers. Your team looks to you for reassurance. And late at night, your inner critic starts asking the questions you can’t say out loud: Do I actually know what I’m doing? Am I making the right decisions? Some of you are laying off large groups of people and shutting down services—decisions that carry an enormous emotional toll. It’s hard to articulate how difficult this is.
For healthcare leaders, this isn’t a temporary storm you’re weathering. This is a crucible—high heat, high pressure—that will either refine you as a leader or potentially burn you out entirely. The difference between those two outcomes often comes down to whether you have the right support in place to navigate it.
Why a Thought Partner Makes All the Difference in Healthcare Leadership
When you’re facing decisions of this magnitude and complexity, you need thought partners: people who can help you think through the impossible without adding their own agendas to an already overwhelming load. Someone who understands the market conditions well enough to ask the right questions. Someone who can help you examine challenges from multiple perspectives and develop strategies that honor both the financial realities and the human ones.
But here’s what matters even more: You need space to be human. To vent. To process. To acknowledge the weight of what you’re carrying. To remember that taking care of yourself isn’t selfish—it’s essential to your effectiveness as a leader. In my experience, most healthcare leaders tend to be exceptionally giving. Many will give of themselves without consideration for their own wellbeing, and that’s precisely what can diminish their ability to lead through crises.
The relationships you invest in as you navigate these difficult decisions—all while providing the best patient care possible—are what will carry you through. This is how many healthcare executives are surviving these challenging times: not alone, but with trusted thought partners who understand what’s at stake.
The Burnout Risk You Can’t Ignore
Leaders operating in a crucible face real burnout that can impact their career trajectory, reputation and impact as leaders. There’s something called the Maslach Burnout Inventory that identifies eight stages or levels of burnout. One dimension of burnout is called depersonalization: a feeling of detachment from others. That means you no longer see or experience the people you’re leading as people. You’re just surviving, and you lose a humanness to how you engage.
Losing your humanness as a leader can be extremely damaging, to you and others. Keeping burnout at bay by having an outlet and validator to help you take care of yourself—that’s critical.
Harvesting the Opportunity in the Pressure
Back to the crucible example: the heat and pressure of the crucible can refine you or burn you out. The question isn’t whether you’re in the fire—you are. The question is what support you have in place to ensure you’re harvesting the opportunity that the crucible presents rather than being consumed by it.
Have you ever heard the expression, “We’ve been in a foxhole together”? It refers to a time when you faced danger with a close partner, fighting whatever was out there. Executive teams often say, “We need one of those moments where we grow together.” Well, you’re in one. How will you take advantage of it?
Times of pressure also force changes in teams. Teams go through specific, unavoidable stages of development. Each time change is introduced—new leader, roles, participants, structures—your team returns to the earliest stage of development to some degree. Getting a team back up to interdependence (the highest level of performance) during a crisis requires intentional effort. It requires investing in the relationships and structures that help people work through complexity together.
What This Moment Requires
Here’s what I’ve learned from decades in healthcare: When leaders grow stronger, organizations grow stronger. And when organizations grow stronger, patients, employees, and communities benefit.
Investment in leadership during financial crises isn’t about “fixing” something that’s broken. It’s about equipping leaders to navigate the financial and human challenges of this moment with strength, clarity, and their humanity intact. It’s about ensuring that the crucible refines you rather than burns you out. It’s about making sure you’re not just surviving, but actually leading: seeing the people around you as people, making decisions with both courage and compassion, and building the kind of resilient leadership teams that can weather what’s ahead.
These are difficult times for healthcare executives like you. The cuts are real. The pressure is relentless. The decisions you’re making will shape the future of your organization and your community. You don’t have to navigate this alone. Healthcare leaders who are making it through aren’t toughing it out in isolation. Rather, they recognize that having thought partners, trusted advisors, and space to be human isn’t a luxury. It’s how you survive the crucible and emerge as the leader your organization needs you to be.
