Leadership Lessons They Don't Teach in Medical School
Leadership Lessons They Don't Teach in Medical School
In Part 1, I shared the story of a night call schedule that failed because my team didn’t warn me…because I didn’t really ask them. This follow-up explores what that silence actually means: not agreement, but resignation. Drawing again on Ed and Peter Schein's Humble Inquiry, we see why physician leaders find humble inquiry especially difficult because it feels slow, vulnerable, and out of their control and how we can start practicing it today.
Once, when a Chief Medical Officer, I rolled out a night call schedule that failed three weeks in. The team had seen what was coming; they just didn't tell me. The reason wasn't a communication failure — it was an asking failure. Drawing on Ed and Peter Schein's Humble Inquiry, this post explores why physicians, trained to be the person in the room with the answer, struggle to ask real questions when they move into leadership. It introduces the Scheins' four types of inquiry — humble, diagnostic, confrontive, and process-oriented — and shows how most physician leaders unknowingly default to confrontive questions that teach their teams to confirm a hypothesis rather than share what they actually see.
A nurse once told me the truth only when the doctor in charge was away. That is what a lack of psychological safety looks like in healthcare: not loud fear, but quiet calculation. When people cannot say what needs to be said in the room, truth starts traveling through hallways and whispers. And when that happens, leaders are not hearing reality. They are hearing what feels safe.
Every leader wears armor. Most don't realize they're wearing it. Over-reliance on data. Excessive use of jargon and buzzwords. Cynicism disguised as realism. These forms of armor often punish the very behaviors that build trust. Your armor may have served you at some point. The question is whether it's still serving you now — or whether it's keeping your team from trusting you enough to follow where you're trying to lead.
Medical training teaches many things directly, but it also teaches a lot without ever saying it out loud. One of the unspoken lessons is: never look uncertain. So doctors develop habits that help them succeed in clinical work. They project confidence before they fully feel it. They hide uncertainty while they think. They sound clear, even when the situation is not. But when doctors move into leadership roles, these same habits can quietly undermine trust. Patients want reassurance, but teams want honesty. Patients look for confidence, while teams need openness. They need a different kind of trust.
If you're a physician leader who believes in servant leadership, at some point someone in a boardroom will say, "That's nice, but what are the results?" This post gives you the answer. And if you're an executive thinking about physician leadership development, this is why servant leadership isn't a personality trait. It's an operating system you can support or undermine. Which choice you make will determine your organization's culture.