Patrick Lencioni, president of The Table Group and a bestselling author, will be the featured speaker at the MacEachern Address and Luncheon, Tuesday, March 3, during ACHE’s 2026 Congress on Healthcare Leadership. He recently shared a preview of his address, which includes insights about leadership, navigating rapid transformation and creating healthy organizations.
Your work has shaped leadership thinking across industries. What aspects of your leadership philosophy do you believe are most essential for today’s healthcare executives, given the unique pressures they face?
The pressures facing healthcare executives today only reinforce what I’ve believed for years: clarity, trust and courage matter more than sophistication. Leaders must be willing to slow down long enough to ensure their teams are aligned around a common purpose, even when the environment feels, and is, chaotic.
In healthcare, where the stakes are particularly high, only leaders who prioritize human dynamics over ego and politics can create organizations that actually sustain high levels of performance.
The concepts of trust and team cohesion are central to your work. How can healthcare leaders—who often oversee multidisciplinary, high-stress environments—intentionally build trust across clinical, administrative and operational teams?
Trust is built when leaders model vulnerability and consistency, not when they rely on authority or expertise alone. In healthcare, that means intentionally creating space for honest dialogue and collaboration across different disciplines, encouraging healthy conflict and resisting the temptation to operate within silos.
When leaders are willing to invite input, have difficult conversations and resolve conflict directly, they send a powerful message that the success of the entire organization matters more than the results of any individual team.
Healthcare organizations are navigating significant change—workforce shortages, financial pressures and rapid technological transformation. What leadership behaviors differentiate those who lead effectively through uncertainty from those who struggle?
The leaders who thrive in uncertainty are the ones who are uncomfortably clear and relentlessly human. They communicate priorities simply and repeatedly, even when answers are incomplete. Those who struggle tend to hide behind complexity, delay hard decisions or hope stability will return before they act.
What role does vulnerability play in effective leadership, especially for healthcare executives who may feel pressure to appear infallible in high-stakes environments?
Vulnerability is not weakness; it’s the foundation of trust. For healthcare executives, this means acknowledging what they don’t know, asking for help and admitting when decisions don’t work out as planned.
Ironically, the more leaders try to appear infallible, the more distance they create between themselves and their teams.
You often speak about “healthy organizations” being more important than simply “smart” ones. How does this distinction manifest in healthcare, and what practical steps can leaders take to move toward organizational health?
A healthy healthcare organization is one where people trust one another, engage in productive conflict and commit to decisions … even difficult ones. Too many organizations focus on intelligence, credentials and strategy while ignoring problems within their culture that are actually creating more strategic issues.
Leaders can move toward organizational health by clarifying values, reinforcing behaviors and holding one another accountable with compassion and resolve.
Many healthcare leaders feel pulled between operational pressures and fostering culture. How do you recommend they balance these demands?
Operational pressure will never go away, especially in a field like healthcare, so waiting for some sort of extra time to focus on culture is a mistake. Culture is built in how leaders handle meetings, make decisions and respond to stress.
The most effective leaders understand that operational results and culture are not competing priorities—they are inseparable. As leaders, we absolutely cannot wait for the waves to die down or for pressure to subside before dedicating appropriate attention to fostering a healthy culture and achieving higher levels of clarity.
Looking back on your own journey in leadership and consulting, what experiences or lessons have had the greatest impact on your thinking—and what might healthcare leaders learn from those moments?
The most influential moments in my career came from watching talented leaders fail because they underestimated the impact of team dysfunction. I learned that even the smartest strategy or the most airtight business model truly cannot overcome politics, fear or lack of trust. Healthcare leaders can learn from this by recognizing that investing in team health is not a soft luxury … it’s a hard necessity.
If you could give one piece of advice to a healthcare executive stepping into a senior leadership role today, what would you want them to understand on day one?
On day one, I’d want a healthcare executive to understand that their primary job is not to be the smartest person in the room. Their job is to build a team that trusts one another enough to disagree, decide on a path forward and move toward goals together. If they get that right, everything else, from outcomes to innovation, becomes far more achievable.