A colleague recently told me, “I never would’ve known you didn’t come from healthcare.” I took it as a compliment—and as a reminder of how narrowly we still define who “belongs” in leadership roles across this field, despite the complexity of the work before us.
Like many leaders now shaping healthcare systems, I didn’t begin my career inside a hospital or clinic. I spent nearly two decades in journalism, followed by enterprise operations work at the University of Texas at Austin supporting a large and complex portfolio that included finance, IT, HR, safety, real estate and capital planning. Those experiences helped me become fluent in systems, governance, accountability and human behavior—capabilities that translate directly to modern healthcare leadership.
When I transitioned into healthcare in 2021, I was not yet experienced in the language of care teams, reimbursement policy or clinical workflows. I couldn’t explain a 340B pharmacy program or the nuances of prior authorization, chronic disease registries or coverage redetermination cycles. But I understood how systems fail, how incentives shape outcomes, and how decisions ripple through organizations and communities. Those competencies proved essential in today’s environment.
Seeing What Insiders Can Miss
Leaders who arrive from outside healthcare can bring a useful distance from “the way things have always been done.” Without inherited assumptions, they are more likely to ask fundamental questions, surface blind spots and challenge norms that may no longer serve patients or staff.
At the same time, healthcare depends deeply on leaders who are steeped in its clinical knowledge, regulatory history and hard-earned lessons. Caution in this field is not inertia—it is shaped by patient safety, regulatory accountability and the reality that failures carry real human consequences. Experience inside the system carries wisdom about what has failed before, what protects patients and where shortcuts create harm.
The strongest leadership teams hold both truths—and know when to lean on each. Fresh perspectives are additive when paired with deep experience. When leaders with outside lenses work alongside those grounded in healthcare’s history and craft, distance becomes clarity.
Reframing Imposter Syndrome
Imposter syndrome is often framed as a personal weakness. In practice, it can function as situational awareness. Feeling like an outsider encourages deeper listening, stronger preparation and clearer translation of complex issues. Successful leaders with nontraditional backgrounds draw directly on prior training rather than attempting to shed it.
Operationally, that posture strengthens them as leaders by providing them with:
- A focus on clarity over jargon
- A willingness to question normalized dysfunction
- An ability to make grounded decisions in lived experience, not just metrics
Over time, confidence grows; curiosity and humility remain.
What Nontraditional Leaders Contribute
Across healthcare, leaders who arrive through unconventional paths often bring skills the field urgently needs, particularly when paired with clinical and operational expertise:
- Pattern recognition from outside the sector
Experience in other industries can sharpen the ability to anticipate risk and identify system-level connections, complementing the clinical insight that identifies consequences at the bedside. - Translation as a leadership competency
Making complexity understandable for clinicians, boards, policymakers and staff is not ancillary work. It is core leadership work. - Systems thinking anchored in community impact
Leaders trained to listen to people first tend to keep human outcomes at the center of operational and policy decisions. - Humility and learning orientation
Nontraditional leaders often arrive with deep respect for clinical expertise and institutional memory, coupled with a disciplined commitment to learning from those who have built, tested and sustained care delivery over decades.
Why This Matters Now
Healthcare is navigating shrinking coverage, sustained financial pressure, rising demand, workforce burnout and operational complexity. The leaders best positioned to guide organizations through this moment are those who can bridge domains—policy and operations, care delivery and governance, community need and financial reality.
Many of those leaders did not begin their careers in healthcare and in an era of compounding risk and volatility, their ability to navigate governance complexity while keeping patients at the center reflects it.
Rethinking the Leadership Pipeline
Rather than treating nontraditional experience as an exception, health systems should treat it as a strategic asset—intentionally built into leadership pipelines through succession planning, executive hiring and board development, not tolerated at the margins.
These include the communicator who can translate complexity, the educator who understands behavior change, the public-sector leader fluent in governance and accountability, and the technologist who sees infrastructure differently.
These leaders are not outsiders to healthcare’s mission. They are increasingly central to its future.
The Bottom Line
Imposter syndrome often signals attentiveness, not inadequacy. In a field as complex and consequential as healthcare, that attentiveness is a strength, especially when paired with deep institutional knowledge earned through years of care delivery and hard lessons learned.
The most effective health systems are led by people who bring different starting points, shared accountability and mutual respect for what each background contributes. Progress doesn’t come from discarding healthcare’s history, nor from clinging to it unchanged. It comes from integrating lessons learned with fresh ways of seeing.
If health systems are to become more equitable and patient-centered, leadership pipelines must expand—not replace—the mold.
Healthcare doesn’t need one kind of leader. It needs leadership teams strong enough to hold complexity, history and change at the same time — because patients and our communities depend on it.
Tara Trower is deputy CEO/chief strategy officer, CommUnityCare Health Centers, Austin, Texas, the second largest FQHC system in Texas. She is an ACHE member.