An Essential Leadership Vehicle: Your Relational Lens
In healthcare, where lives are on the line and the margin for error is slim, relational fluency isn’t a luxury—it’s a necessity.
In a compelling TED Talk, Dr. Atul Gawande compares a medical team to a car. Only slightly tongue-in-cheek, he suggests that a typical team today might have the engine of a Ferrari, the body of a Volvo, the chassis of a BMW, the brakes from a Mercedes, and so forth.
The result is one very expensive vehicle . . . that doesn’t function well.
A healthcare team can have the very best diagnostician, surgeon, anesthesiologist, nurse, and so on, but if they don’t communicate with one another, they may falter. In our work with physician leaders, what surprises many of them is this: technical skills and clinical acumen alone won’t carry them through the leadership journey. What’s needed—especially in today’s complex environment—is relational fluency: the ability to lead through connection, trust, and collaborative strength.
Relational leadership—a practice that emphasizes the importance of relationships, anchored in trust, collaboration, and human connection to achieve shared objectives—has emerged as a defining capability for healthcare leaders. Amidst burnout, system strain, and organizational change, it’s the relationally fluent leaders who bring stability, cohesion, and progress to teams.
Why Relationships Matter More Than Ever
The modern clinical environment is more complex and emotionally taxing than ever before. Reimbursement pressures, physician burnout and shortages, and mounting patient needs have left many teams stretched thin. The dynamism of this context makes strategizing a moving target—as one seasoned department chair put it, his solution is “just keep your head down, take care of patients, and this will all work out.” His words reflect a calm exterior but also reveal a sense of isolation that is too often a part of leadership roles. Today’s physician leaders need to be more than steady—they must be connectors.
One reason for this shift is the evolution of interprofessional, team-based care. Advanced Practice Providers (APPs)—including nurse practitioners, physician associates, and others—now play an essential role in frontline care delivery. These teams often operate across traditional hierarchies and silos. Effective coordination requires more than aligned workflow—it demands intentional relationship-building, empathy, and cultural competence. Yet too often, leaders are promoted based on clinical or academic excellence, not relational strength. This leaves a critical gap.
How Relational Leadership Develops
Relational leadership isn’t simply about being personable. It’s about presence, trust, and follow-through. It’s a discipline that can be taught, practiced, and improved—often through shared reflection and experience.
Many have noted that these relational skills are rarely taught in formal medical training (medical school, residency, fellowship). Now, more than ever, modern healthcare must support and develop physician leaders to take on today’s challenges.
In our Physician Leadership LABS, we help physician leaders build their relational muscles in the same way you would refine any skill—through intentional practice. Our preferred venue for this work is in small, facilitated peer groups that we call Learning Circles, which provide a supportive, confidential space explore real-time challenges, uncover blind spots, and strengthen connection. Within the Circles, leaders reflect not only on what they’re doing—but how they’re doing it, with whom, and receive guidance from colleagues on ways they could try other approaches.
Through structured dialogue, case-based learning, and—it must be acknowledged—genuine, shared vulnerability, our participants examine three key relational dimensions of leadership and what they mean for them:
- Leading Up: Are they building credibility and alignment with senior executives? Are they offering insight, not just updates?
- Leading Across: Are they fostering productive collaboration with peers—across specialties, disciplines, and functions?
- Leading Down: Are they supporting the growth and cohesion of those they supervise, through feedback, clarity, and presence?
This three-dimensional view of relational influence helps leaders see where they’re strong—and where they may be unintentionally creating distance or confusion. Over time, these insights lead to deeper trust and better performance, both for the individual and their team.
Relational Teams Create Real Impact
Some may still dismiss relational leadership as “soft.” The evidence tells a different story. Research shows that teams built on strong relational foundations—psychological safety, shared purpose, and mutual respect—are more innovative, more engaged, and better equipped to handle stress. In a recent study published in The Journal of Management Inquiry, organizations with high-trust leadership cultures reported better staff retention, higher patient satisfaction, and improved quality outcomes.
We’ve seen this firsthand.
In one organization, Circles helped nurture a sense of “systemness” in a regional hospital system. Having endured a difficult merger, physician leaders were isolated from their colleagues at other sites and felt great pressure to achieve more with less. While the regular Circle meetings offered an opportunity for the participating providers to know each other better, they provided much more—in this case, the opportunity to intentionally seek feedback and initiate relationships across the organization, while comparing experiences and benefitting from the lessons of others.
None of these changes were driven by a new strategic plan or operating model. They were driven by human connection, one relationship at a time.
Conclusion: In a Storm, It’s the People Who Hold the Line
Relational leadership doesn’t mean avoiding hard conversations. It means committing to them. It means showing up with consistency, clarity, and care. And it means holding yourself accountable for how you make others feel—even when the pressure is on.
As one physician executive reflected, “I used to think leadership was about vision. Now I know it’s also about making it safe for others to bring their best forward.”
In healthcare, where lives are on the line and the margin for error is slim, relational fluency isn’t a luxury—it’s a necessity. Relationships make the unique parts of the car work together so the whole vehicle runs smoothly. And the leaders who invest in them will not only hold their teams together—they’ll move them forward.
