If you’ve been following along, you know we’ve been addressing the challenges Health Centers across the country continue to face with attracting and retaining qualified staff and leadership. Leadership positions are becoming increasingly difficult to fill as experienced executives retire, competition for talent intensifies, and organizations struggle to find candidates who truly understand the unique complexities of community health.
Earlier this month Beth Little-Terry, THRIVE’s Director of Healthcare Compliance & Strategy and a former Health Center CEO, shared her insights around finding and growing the right leaders outside of typical hiring norms in the blog “Grow Your Own.”
Additionally, Beth pointed out that many Health Centers already employ talented individuals who have the potential to lead. They understand the organization’s mission, know the communities they serve, and have built valuable institutional knowledge. Yet too often, there is no intentional process for identifying these employees, helping them develop new skills, or determining whether they are ready for greater responsibility. In the second of our “Grow Your Own” blog series, we suggest ways Health Centers can more intentionally expand their leadership pipeline from within.
Today, the need for stronger leadership development has never been greater. According to the U.S. Bureau of Labor Statistics, healthcare is expected to add approximately 1.9 million job openings each year between 2024 and 2034, while employment of medical and health services managers is projected to grow 23 percent during that period. At the same time, the National Association of Community Health Centers (NACHC) continues to report workforce shortages and increasing difficulty recruiting qualified talent.
Health Centers simply cannot recruit their way out of every workforce and leadership challenge. They also need to recognize and invest in the talent already within their organizations.
Today we’re adding an important layer to the discussion of growing leaders from within: how to build a pipeline that develops internal potential into effective leadership talent.
One of the most common mistakes organizations make is assuming that exceptional employees are automatically prepared to become exceptional leaders.
Technical expertise, strong work ethic, and years of experience are valuable, but leadership requires an entirely different set of skills. Managing people, making difficult decisions, balancing competing priorities, communicating across departments, and thinking strategically all require experience that many employees have never had the opportunity to develop.
Conversely, organizations sometimes overlook internal candidates because they have never held a formal leadership title before, assuming the best candidate must come from outside.
Neither approach builds a sustainable leadership pipeline.
A successful Grow Your Own strategy begins long before a position becomes vacant. Future leaders need opportunities to stretch beyond their current roles by:
These experiences help the employee grow while giving the organization a better understanding of their strengths, judgment, and readiness.
While external recruitment is sometimes necessary, especially when an organization requires expertise that cannot be developed internally, Health Centers should always look inward first. Relying on outside hiring as the default strategy carries significant costs, including:
Gallup estimates that replacing a manager or leader can cost approximately twice that individual’s annual salary once recruitment, onboarding, lost productivity, and organizational disruption are considered.
For Health Centers already operating with limited resources, these costs can quickly become substantial.
Leadership development should therefore be viewed not simply as an employee benefit, but as a strategic investment that reduces organizational risk while strengthening long-term stability.
Health Centers have part of the answer within their own organization.
Internal employees often already understand:
These aren’t lessons that can be learned during orientation.
An external candidate may bring valuable expertise, but developing an understanding of the Health Center model, organizational culture, and community relationships takes time.
Internal employees often already possess that foundation. What they may need is greater exposure, broader experiences, and intentional development opportunities.
Grow Your Own is about giving capable people the opportunity to develop the knowledge, judgment, and leadership skills necessary to meet higher expectations.
Improving the leadership pipeline from within doesn’t require a complicated program. It requires creating intentional pathways.
Leadership teams should regularly talk about employees who may be ready to take on more responsibility, not only when someone resigns. Rather than focusing solely on tenure or technical performance, leaders should look for employees who consistently demonstrate qualities such as:
Potential often appears long before someone is ready for a promotion.
Leadership isn’t developed in a classroom alone. Emerging leaders need opportunities to solve real problems, navigate uncertainty, and make decisions that matter. An effective Grow Your Own strategy provides opportunities to high-potential candidates regularly and intentionally.
These experiences might include:
These experiences help employees build confidence while giving executives valuable insight into how they think, communicate, and respond under pressure.
Developing a leader should not depend on one mentor.
A supervisor or CEO may open doors, provide guidance, and create opportunities, but other people will play important roles as well. That may include colleagues, educators, outside mentors, coaches, subject-matter experts, board members, and professional peers.
No one person has every perspective or area of expertise an emerging leader will need. The strongest development approach is built around that individual, delivering the right support at the right time.
Leadership development should never guarantee a promotion.
Instead, employees should have a clear understanding of:
This transparency benefits both the individual and the organization by creating realistic expectations while encouraging continuous growth. That clarity helps the employee focus their development and allows the organization to make better decisions about readiness.
Building future leaders isn’t solely the responsibility of Human Resources.
Executives and supervisors need to identify potential, create opportunities, provide honest feedback, and make time for development. Boards should understand where the organization may be vulnerable and whether there is a plan for leadership continuity.
Over time, employees who have benefited from this approach should also be expected to carry it forward by helping develop others.
Health Centers do not need a complicated dashboard, but they should know whether their leadership pipeline is getting stronger.
Useful metrics include:
Ultimately, the most important question isn’t whether your organization has a formal leadership program.
It’s whether you’re building leadership capacity faster than you’re losing it.
Most Health Centers will need to recruit externally at times, and there will be situations where an outside candidate is the right choice. But waiting until a key leader resigns before thinking about succession leaves organizations reacting rather than preparing.
Leadership capacity is built over time through intentional experiences, coaching, constructive feedback, and increasing responsibility. It creates continuity, preserves institutional knowledge, and ensures that future leaders are ready when opportunities arise.
The strongest organizations don’t wait for vacancies to begin developing leaders. They build the pipeline long before they need it.
Developing future leaders requires intentional planning, practical tools, and ongoing support.
THRIVE is hosting a webinar for healthcare leaders focused on the development of your internal pipeline. Please join us!
