Hello Reader,
What If the Real Prescription Is Caring About the People You Lead?
Think about the best leader you've ever worked with. Picture them clearly.
Now ask yourself: did they care about you — not just professionally, but personally?
I'd be willing to bet the answer is yes. And Dr. Josh Hartzell, retired Army Colonel, faculty physician, certified executive coach, and author of A Prescription for Caring, has asked that question of hundreds of healthcare leaders across the country. He hasn't met a single person who said no.
That's the foundation of everything we talked about in this episode — and honestly, it's the foundation of good leadership, full stop.
Clinical excellence is necessary. It's not sufficient.
Josh came to this realization early in his career. Even as a resident, he noticed that patient care wasn't just about clinical decision-making. It required teamwork, communication, system awareness, and the ability to bring people together around a shared mission. His program director gave him and his co-residents real agency — and that experience shaped everything that followed.
In the decades since, Josh has watched healthcare organizations consistently underinvest in one thing: the longitudinal development of leaders. Not a one-time course, not a weekend retreat, but a sustained, career-long approach to building leadership capacity alongside clinical expertise. We learn leadership primarily through three channels — on the job, through mentoring and coaching, and through formal education. Most of us only get the first one.
The "prescription" that changes how you lead
Josh's book, A Prescription for Caring, started with a simple question a podcast host asked him years ago: "What did you learn from medicine that carries over to leadership?"
His answer: we take care of people. That's our job in healthcare. And it's our job as leaders, too.
This isn't softness. It's strategy. When people feel valued, respected, and genuinely cared for, they do more. They take feedback more readily. They don't want to let their team down. They show up differently. And when leaders approach every act — delegation, feedback, a difficult conversation — from a place of caring, the entire texture of the work changes.
"When I delegate to someone, part of the reason I do it is to give them the opportunity to grow. I can be explicit about that. I label it as caring."
This reframe matters more than it might sound. How many times have we withheld feedback because it felt unkind, only to deprive someone of exactly the information they needed? How often have we delegated a task without explaining why — and accidentally communicated that we didn't trust or value the person we were handing it to? Josh's point is that caring doesn't soften leadership. It makes it more precise.
The patterns Josh sees in unhealthy cultures
When Josh steps into organizations as a coach, two things show up consistently: unrealistic workload demands paired with inadequate support. The "do more with less" dynamic that so many of us know intimately. What gets lost in that equation isn't just energy — it's the margin to actually care for the people around us.
He's also watching AI tools with cautious optimism. Anything that reduces "pajama time" — notes written at midnight because there was no space to finish them during the day — creates more room for the human work of leadership. That's worth paying attention to.
Breaking the cycle of inherited culture
One of the most honest parts of our conversation was about this: how do you lead differently when you've only ever experienced one way of being led?
Josh offers a few practical approaches. One is coaching, which helps people think outside their own frame and see what's actually possible. Another is exposure — visiting other organizations, talking to peers in different systems, asking the new people on your team what seems strange or inefficient about the way you do things. Sometimes the intern from a different medical school is the one who spots what everyone else stopped noticing.
And then there's intentionality. Culture doesn't change through big pronouncements. It changes through small, daily, deliberate acts that model what you actually want the culture to look like. Something as specific as the tone you use when you take a consult call. That's not a system problem. That's a choice.
Feedback: the underused tool
Josh uses the Leadership Challenge 360 as a coaching tool, and his observation about how people typically respond surprised me — in the best way. Most leaders, when they see their data, feel appreciation first. The gift of finally knowing how they're actually landing, not just how they intend to land.
The gap between intent and impact is where so much leadership friction lives. We assume our positive intentions are visible to our teams. Often, they're not. Getting data on that gap is genuinely useful — not as a punishment, but as information.
He also pointed out something worth sitting with: most of us, once we leave formal training, almost never receive meaningful feedback. That drought of input means we're often flying blind. Tools like 360s, even informal branding exercises where you ask colleagues for two or three words that describe you, give us something concrete to work with.
What the best leaders have in common
When Josh distills decades of developing physicians, residents, students, and faculty, one thing rises to the top: a genuine passion for investing in other people. Not soft, not easy — in fact, it often means challenging people, raising the standard, delegating to stretch them.
But it all comes from the same starting question: what can I do to help this person grow?
Imagine if that was the question every leader carried into their one-on-ones. Not "how is this project going" or "are we on track" — but "what does this person need from me right now to become more of who they're capable of being?"
That single shift, Josh believes, would move cultures in a significant way.
You don't need to change the whole system
Here's the piece I keep coming back to from this conversation. Josh closed with it, and I think it's worth sitting with.
Every single one of us has multiple interactions during the day. Every one of those is a chance to positively impact the life in front of us. A piece of feedback to a student. A career conversation with a resident. A quick acknowledgment to the nurse who is doing exceptional work. These micro-moments are the building blocks of culture — and they are entirely within our reach, regardless of our title, our system's dysfunction, or how limited our time feels.
"We can start from the bottom and make a difference in that life in front of us."
You don't have to wait for leadership permission to lead with care.
Connect + Continue the Conversation
If this resonated, I'd love to hear what stood out for you. Reply to this email, drop a note in medTHRIVE Connect, or share this with a colleague who is working through a leadership transition right now.
🎧 Listen to the podcast sneak peek episode below and listen to the full episode on YouTube, Apple, Spotify, Podbean, or Amazon Music.
What's inspiring us this week:
Teamwork. In the small moments in the middle of night with critically ill patient getting admitted to the ICU needing emergent BiPAP, Swan-Ganz catheter, arterial monitoring and emergent dialysis, grateful for my nursing colleagues and other professions (shout out to Renal and Surgery) for being great supportive consultants. When healthcare happens smoothly, it's a win!
The Practice: Celebrating Wins
We get more of what we focus on. The practice of gratitude and celebrating the goodness of life is the first step in changing our brains, mindsets, and circumstances for the better.
I had the opportunity to lead our Society of Critical Care Medicine (SCCM) LEAD leadership pre-congress workshop with Dr. Mojdev Heavner and we were delighted by the participation and contributions of all the attendees and faculty. Grateful for the opportunity!
Stay mindful and keep leading,
Lillian
Founder & CEO
| We are planning workshops for the fall: What would you be most interested in attending?? |
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