Live well. Lead well. Grow Together. Weekly conversations to help you stay human in healthcare. We share practical ideas, podcast pearls, and curated reads that help you grow. Together, we can transform healthcare, one person at a time.®
Share
No one's asking questions. Is that good?
Published about 12 hours ago • 3 min read
Hello Reader,
After a change in administration and a government shutdown, Dr. Jess Bunin's institution rewrote policy after policy. At a meeting afterward, a senior leader said no one was coming to them with questions anymore, so everything must be okay.
Jess was hearing the opposite. As dean of community, she had become an unofficial ombuds, and the complaints were coming to her instead.
This week on the podcast I spoke with Jess, a retired Army colonel and West Point graduate trained in both psychiatry and critical care medicine. She has served as a critical care fellowship program director at Walter Reed and assistant dean of faculty development at the Uniformed Services University. Her new book is Self-Awareness and Trust.
Jess describes two costs of staying quiet. A team member who holds back in meetings gives up influence, and she does not believe anyone needs a title to have influence. Silence also wears down confidence, as "leadership" turns into a separate group people no longer feel allowed to approach.
Rank plays a larger role than most senior people remember. As a lieutenant colonel, Jess asked a struggling student why they hadn't come to her. The answer: you're a lieutenant colonel, I would never. Her other trainees said the same. She had believed she was open and available, and her open-door policy meant little to people afraid of her rank. She sees the same fear in civilian medicine, between students and attendings.
When two student groups at her institution stopped speaking to each other, Jess first built a student curriculum. It did not move much. At a deans' staff meeting, her colleagues stopped her: this isn't a student problem, it's us. So they built a full day for faculty and staff, half on restorative practices and community building, half on civil discourse. Participants reported more belonging and more hope, and 97% called it an effective use of their time. One associate dean realized he had passed a colleague on his own hallway about 100 times without ever saying hello.
For the moment you freeze, Jess teaches from her CLEAR framework: create psychological safety, listen actively, establish common ground, adjust your thinking, and respond skillfully and respectfully. "Tell me a little more about what you meant" gives the other person the floor while you think. When a conversation stalls, return to the goal you share. When something lands badly, "Ouch" or "Can we take a pause?" keeps you from saying what you don't mean.
The teaching point: a lack of questions is not evidence that things are fine. It can be evidence that trust is gone.
"I think the second people stop coming to you with questions, you've stopped being a leader. They don't trust you anymore."
Jess's book begins with self-awareness, and she does not believe anyone builds it alone. It takes a coach, peer, or partner to point out blind spots, including the positive impact you may not see in yourself.
Here's my question for you this week: who used to bring you their questions and has stopped?
You can find Jess and her book at jessbuninmd.com, and her team's workshops at alllevelsleadership.com.
Stay mindful and keep leading, Lillian Founder & CEO
It's not too late to join us this Sunday September 20, 2026 6-7pm EST in our medTHRIVE® Connect Book Rounds, featuring author Rebecca Thompson, MD book Held Together
Join us even if you haven't finished the book.
We are going to talk about how life, parenthood, careers, leadership, and medicine intertwine.
Bring your favorite bevvy, sit out on the deck, and join us video on or off. All are welcome and it's free! Register here to join us!
By Transforming Healthcare Coaching® Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, Founder & CEO
Live well. Lead well. Grow Together. Weekly conversations to help you stay human in healthcare. We share practical ideas, podcast pearls, and curated reads that help you grow. Together, we can transform healthcare, one person at a time.®
Hello Reader, Suppose I give you directions to my house. From my front door, go one block down and turn left. At the light, go right, past Target, then left again, and you're there. You will never arrive. The directions start where I am, not where you are. Salvatore Manzi uses that example to explain the principle his new book, Clear and Compelling, is built on. He calls it "you then me." Before your agenda, your data, or your talking points, you start with the listener's world: their...
Hello Reader, "Just wait." It is one of the most common pieces of career advice in medicine, and most of the time it is offered kindly. Wait until you have more experience. Wait until your kids are older. Wait for the next cycle, when the timing will be better for you. Dr. Shikha Jain has been given that advice for most of her career. Pregnant with twins, she was told she had ruined her chances at leadership. Interviewing for her first job with one child at home, she was advised to go...
Hello Reader, Alison Conklin was 42 years old when her doctor told her she had six months to live without a new heart. It was the same age her mother had been when she died of the same disease — hypertrophic cardiomyopathy — right in front of her. Alison was 14. Months later, she was living inside an NYU hospital room with floor-to-ceiling windows, watching the Empire State Building change colors every night. She had no idea if a matching heart would come in time. She had no idea if she'd...
