Interim and on-demand leadership represents a critical response to the increasing complexity and dynamism of today’s healthcare landscape. The traditional model of hiring full-time executives may not always be the optimal approach for organizations navigating transformation, constant disruptions, unexpected challenges, or rapid expansion. Interim and on-demand leaders offer a flexible and agile solution to these challenges, providing specialized skillsets, rapid ramp-up times, and the expertise to drive change and innovation effectively.
The significance of on-demand leaders, working either full-time or on a part-time (fractional) basis, is particularly pronounced in the project economy, where work is structured around specific deliverables or outcomes rather than traditional job roles. As the project economy takes center stage (Harvard Business Review, 2021), organizations can easily integrate on-demand talent into this environment, leveraging them to access specific skills, enhance agility, and optimize costs. This is especially relevant in healthcare, where projects such as implementing new technologies, restructuring facilities, offering new services, or expanding or launching community health programs can greatly benefit from this flexible approach.
Organizations seeking to navigate today’s rapidly changing healthcare landscape require a different mindset and approach to leadership, one that embraces the value of interim and on-demand leaders as significant contributors to progress. Organizations that proactively orchestrate their leadership needs in this way exhibit five key characteristics: close coordination of cross-functional management of in-house and interim and on-demand leaders, strategic hiring and engagement of necessary in-house and interim and on-demand talent, support for managers in the recruitment of interim and on-demand leaders, effective allocation of work among in-house and interim and on-demand team members, and alignment of talent strategies with overarching organizational objectives (MIT Sloan Management Review and Deloitte, 2022).
Interim and on-demand leaders can be particularly effective in healthcare and academic medicine organizations. The complexity of these fields is magnified by the convergence of economic pressures, skilled talent shortages, workforce wellbeing and safety concerns, and intensification of public pressure and scrutiny. These and other factors demand continuous leadership evolution and agility. Interim and on-demand leaders can drive innovation and efficiency, addressing the unique challenges of care delivery by aligning their roles and projects with the organization’s mission, critical objectives, and community needs. They play an important role in navigating the dynamic healthcare landscape, fostering cultures that accelerate change and transformation while maintaining high standards of care delivery and patient safety.
Creating Value through Interim and On-Demand Leadership
Interim and on-demand leaders commonly are enlisted to:
- Boost flexibility: Interim and on-demand leaders enhance flexibility, particularly during periods of transition. Whether prompted by team adjustments or deliberate initiatives (e.g., new service line development, facility expansions, mergers and acquisitions, functional and operational projects), healthcare organizations require flexibility to navigate uncertainties and establish options based on insights and experiences gained from immediate situations that inform long-term strategic and associated leadership needs.
- Accelerate speed: Interim and on-demand leaders can expedite time-sensitive projects, such as transforming processes and systems, conducting functional turnarounds, integrating functions or organizations, and driving expansion initiatives, while also cultivating innovation through fresh perspectives and skillsets. Equipped with clear directives and authority tailored to the specific situational context and strategic framework, these leaders are primed to make an immediate impact upon arrival.
- Cultivate embedded leadership: Unlike traditional consulting firms, interim and on-demand leaders integrate deeply within client organizations. This direct involvement demonstrates accountability for results and a profound understanding of organizational culture — the synergy that acts as a catalyst for success, aligning leadership actions with the organization’s mission, core values, and norms. They create roadmaps, repeatable processes, and ongoing capabilities that survive their engagements — and ultimately contribute to improving healthcare outcomes and enhancing the patient experience.
- Access specialized skills: Interim and on-demand leaders provide quick access to specialized skills and expertise that may be lacking within an organization’s current team. As healthcare organizations reimagine their business models through technology-driven innovation, such as digital technologies, telehealth, and AI tools, these leaders offer an exceptionally compelling value proposition — many experts in these fields are simply inaccessible otherwise.
- Provide capable, hands-on transitional leadership: Interim and on-demand leaders embody a blend of strategic thinking and practical execution. They excel in devising intelligent strategies and ensuring their timely and precise execution. This helps incumbent executives minimize the opportunity cost associated with delaying critical initiatives due to competing priorities, budget and capital constraints, and limited talent availability, while sidestepping more expensive consulting engagements.
The Strategic Imperative of Interim and On-Demand Leadership
In the current environment, normalcy remains elusive, with constant change and challenges defining the new status quo. Within healthcare and academic medicine, a multitude of factors — ranging from technological advancements and the imperative for AI literacy to a shift towards consumerism and patient-centered care, regulatory changes, economic fluctuations, rising healthcare costs, skilled workforce shortages, and rapid industry consolidation — converge to present organizations with a mix of unprecedented challenges and transformative opportunities.
Interim leaders are executives who are temporarily employed to fill a specific leadership role in an organization. They are often experienced executives with a track record of success in similar roles and can quickly provide leadership and direction to the team. Interim leaders make critical decisions, drive results, and ensure business continuity during periods of change. The KPIs for interim leader assignments typically revolve around role-based responsibilities.
On-demand leaders are executives and/or former consultants who are available to provide leadership and expertise on a project-by-project basis. They are often subject matter experts with deep knowledge and experience in particular areas, retained to provide hands-on work, guidance, advice, and support to a team for specific projects or initiatives. The KPIs for on-demand leader engagements are typically defined by specific deliverables.
Interim and on-demand leaders can be retained to work either full-time or on a fractional/part-time basis to meet the needs of a specific leadership or advisory role. They may work onsite, in a hybrid model, or remotely, depending on the client’s needs for the specific project.
Leveraging Interim and On-Demand Leaders for Success
Top Trends leading to an increased demand for interim and on-demand talent:
- Trend 01: Business imperatives, by their very nature, cannot wait on the possibility that talent scarcity may give way to greater availability.
- Trend 02: Budget constraints require healthcare organizations to assess consulting spend, which can be significantly reduced via on-demand leaders.
- Trend 03: Successful strategy execution requires flexible access to skilled leaders and optimized use of resources to manage intricate challenges.
- Trend 04: Remote work enables the integration of top talent from various locations, creating a seamless blend of permanent and interim team members.
Within healthcare, there is a well-documented scarcity of skilled talent, with the shortage of nursing staff, physicians, and other frontline healthcare professionals reaching critical levels. During and after the pandemic, one in five healthcare professionals have exited their jobs, and up to 47% were contemplating leaving their roles within the next two years (Definitive Healthcare, 2023). Although the talent shortage today shows signs of stabilization compared to the pandemic years, projections suggest continued strains. By 2028, the U.S. is anticipated to have a national shortage of 100,000 healthcare professionals, with some states projected to have surpluses and others with deficits of up to 14,000 (Advisory Board, 2024). Critically, turnover among nursing staff, who are pivotal to maintaining high standards of patient care, persisted at a significant rate of 18% (Becker’s Hospital Review, 2024).
Similarly, executive turnover is a pressing concern, with hospital CEO positions turning over at a rate of 16% for the third consecutive year in 2022 (American College of Healthcare Executives, 2023). Additionally, an impending wave of retirements looms, as 33% of the leading 200 health system CEOs are currently aged 65 and above. According to our analysis of community health providers, 46% of key C-suite roles, such as Chief Operating Officers, Chief Financial Officers, Chief Medical Officers, and Chief Nursing Officers, were appointed in the last three years. This underscores the ongoing challenges in maintaining leadership stability amidst a talent shortage.
Turnover and burnout, although reduced from their peak pandemic levels, continue to exacerbate these shortages, contributing to clinician burnout and poorer health outcomes. Additionally, there is a growing concern about new clinical graduates’ readiness for bedside care, as many who began practicing during the pandemic may have missed important learning experiences and now face increased workloads, often with limited mentorship. Given the limited support, it becomes difficult for new nurses to learn on the job (American Hospital Association, 2024).
The financial implications of these shortages are also significant. According to PwC’s 26th annual global CEO survey, 67% of healthcare CEOs highlighted labor and skill shortages as significantly impacting profitability, exceeding the global average of 52% among all CEOs (PwC, 2023). This underscores the necessity for a profound reinvention of the healthcare delivery model, leveraging technology to improve both patient and employee experience. However, given the already alarming rates of burnout among healthcare leaders, adding more responsibilities to their already full plates is a risky proposition.
To address these challenges, healthcare organizations must look beyond their current resources. The capacity and skills required to define and implement this essential reinvention are simply not widely available in-house. In such an environment, interim and on-demand leaders are becoming essential assets for healthcare organizations. These leaders provide the flexibility and specialized expertise needed to navigate complex strategic priorities and address immediate operational challenges.
The AI in healthcare market is poised for explosive growth, projected to surge from $21.7 billion in 2025 to $110.6 billion in 2030, at a CAGR of 39% (Markets and Markets, 2025), and some estimates suggesting it could reach as high as $187.7 billion by 2030 (Grand Research, 2025). This growth highlights the escalating demand for AI expertise as healthcare organizations strive to enhance operational efficiency, treatment and medication precision, and patient outcomes. AI and automation are being deployed in critical areas such as medical imaging analysis, predictive diagnostics, personalized treatment planning, claims processing, workflow optimization, machine integration, and cybersecurity. Additionally, exponential growth in healthcare data from electronic health records, medical imaging scans, wearable devices, and genomic sequencing presents significant opportunities for AI-powered solutions to extract actionable insights and support clinical decision-making.
Moreover, AI, automation, and ambient listening technologies can reduce or eliminate low-value administrative tasks for clinical and operational teams. This allows them to focus on high-value accountabilities and human-to-human interactions, which are vital to healthcare delivery and require a high level of thinking and input. To maintain a competitive edge, healthcare organizations are rapidly immersing themselves in AI experimentation; nevertheless, they face particularly significant talent shortages in AI-related roles. On-demand talent serves as a cost-effective way to explore, implement, and scale AI capabilities across different facets of the enterprise. This strategic approach enables healthcare organizations to harness the power of AI, driving innovation and improving patient outcomes.
Meanwhile, consumerism is reshaping healthcare delivery, compelling hospitals to evolve towards more convenient, patient-centered care models. Health systems are expanding their reach by opening new satellite locations, extending operational hours, and offering virtual care options to better accommodate patients’ schedules. They are embracing virtual nursing, allowing for self-scheduling, and customizing communication to support whole-person care. This shift not only enhances patient satisfaction but also aligns with the broader industry trend towards more accessible and consumer-friendly healthcare services.
Interim and on-demand leaders play a pivotal role in this transformation. They bring specialized expertise and flexibility, crucial for navigating the complexities of integrating technologies, processes, services, and facilities to adapt to consumer-driven models. These leaders help bridge talent gaps and skills shortages, offering insights and skills. By leveraging interim and on-demand talent, healthcare organizations can maintain operational continuity and drive transformative change, ensuring they remain competitive and responsive to the demands of the modern healthcare landscape.
Historically, the consulting industry witnessed significant growth, reaching $300 billion in the U.S. market in recent years (Forbes, 2023). However, while organizations traditionally relied on management consulting services, a shift is now occurring as organizations seek alternatives to have value-added work done at a lower cost. In 2023, consulting growth slowed to a modest 5%, accompanied by reductions in consulting staff and project delays.
Currently, 86% of U.S. clients plan to decrease spending on consulting this year (The Wall Street Journal, 2024). The slowdown in consulting growth is causing top-tier firms to trim their most senior consultants, resulting in a greater availability of experienced on-demand leaders.
Enter the realm of on-demand leaders. Whether it involves conducting a new service line evaluation, developing a patient-centric care strategy, advancing the next phase of healthcare technology implementation, executing AI-driven clinical decision support, or supporting an internal quality improvement initiative, on-demand consultants typically cost one-third to one-half less than larger consulting firms, based on our experience. This cost efficiency not only saves significant amounts of money but also ensures high impact and credibility due to their strong expertise in the industry, service line, or function.
Healthcare organizations astutely utilize on-demand leaders for targeted projects or to execute recommendations from traditional consulting firms, which would otherwise entail substantial costs and potentially require a different or new team for implementation. Following through with on-demand leaders post-project is cost-effective and impactful, as these leaders often possess prior experience and insights into implementation needs. Moreover, the affordability of engaging experienced independent consultants with operations expertise enables smaller health systems and hospitals to access valuable insights without incurring exorbitant costs, effectively managing expenses while benefiting from specialized expertise.
Healthcare and academic medicine organizations frequently encounter periods of specialized needs, particularly during strategic or operational transitions. To address these needs effectively, interim or on-demand leaders provide essential support during critical phases, helping establish and scale vital functions, ensuring the organization can adapt to evolving needs and maintain operational excellence.
In today’s dynamic healthcare landscape, successful strategy execution hinges on flexible access to skilled leaders and optimized use of resources. By leveraging interim and on-demand leadership, healthcare organizations can:
- Rapidly respond to market changes: Interim leaders bring fresh perspectives and specialized expertise, enabling organizations to pivot quickly in response to regulatory changes, market complexities, or competitive pressures.
- Optimize resource allocation: In challenging budget environments, healthcare organizations must reassess capital allocation and spending priorities. Interim leaders can help identify cost-saving opportunities and make informed decisions that align with strategic and financial objectives.
- Facilitate strategic transitions: Interim leaders can provide continuity and stability during leadership changes, mergers, or acquisitions, ensuring that strategic priorities remain on track.
- Support rapid growth and integration: As healthcare organizations expand their service lines, enter new regional markets, or integrate acquired entities, interim leaders can help scale operations and drive successful integration.
By embracing this flexible approach to leadership, healthcare organizations can better navigate uncertainties, optimize resource use, and execute their strategic priorities effectively. This adaptability is essential for maintaining high-quality patient care, improving operational efficiency, and achieving long-term success and financial viability.
In the past, healthcare organizations often relied on interim and on-demand leaders to work onsite. However, this dynamic shifted significantly since the onset of the COVID-19 pandemic. Recent data indicates that approximately 40% of healthcare and social assistance organizations now operate fully remote or in hybrid setups (U.S. Chamber of Commerce, 2024).
This shift to remote work broadens access to specialized skills without travel limitations and enables health systems, hospitals, academic medical centers, and other healthcare organizations to engage with previously inaccessible talent, whether for interim leadership or on-demand consulting. Remote work empowers organizations to leverage talent from various locations and seamlessly integrate them within the team, particularly as remote or hybrid work gains traction among both permanent and interim team members.
In summary, healthcare organizations are grappling with mounting demands amid resource constraints. The imperative to deliver value for patients, communities, clinical staff, boards of directors, and external partners, while maintaining high-quality care and operational efficiency, is urgent and cannot be postponed.
The Rise of Independent Leadership Talent
Fortunately, a growing pool of available leadership talent with relevant expertise is filled by elite industry executives and experienced consultants choosing to work on an independent project basis, providing a critical resource for organizations to stay on track and progress their strategic, financial, and operational paths. Full-time independent workers increased from 13 million in 2017 to 26 million in 2023, with high-earning independents accounting for over 20% (compared to 12.5% a decade ago), now the fastest-growing segment (Statista Research Department, 2025). Another study estimates that 36% of employed Americans worked independently in 2022 compared to 27% in 2016, with a significant portion, one-third, earning over $150,000 a year (McKinsey, 2022).
Many of these independent workers bring advanced degrees from leading universities and/or executive-level experience gained at top organizations and management consultancies, boasting track records of performance and specialized skillsets to make a fast impact. And they are increasingly opting to continue working independently.
Healthcare organizations can now deploy well-qualified interim leaders to hit the ground running and address their talent shortages. Organizations that dynamically allocate talent to opportunities achieve returns to shareholders 2.2 times higher than their competitors (McKinsey, 2021). Leveraging interim and on-demand leaders is an essential component of an agile leadership strategy, enabling organizations to innovate, scale, and transform in a cost- and capital-efficient, flexible manner.
The Interim and On-Demand Deployment Journey: A Strategic Framework
In the quest for accessing and effectively deploying interim and on-demand leaders, healthcare organizations face critical decisions. When instant organizational or project leadership and adaptability are imperative, how can organizations successfully navigate this terrain? Drawing from the extensive experience of WittKieffer’s consultants in thousands of interim and on-demand engagements, we identify four essential steps to increase the efficacy and success of this important resource.
The initial key to success with interim and on-demand leaders lies in understanding how, when, and where to effectively utilize their expertise. Healthcare and academic medicine organizations can proactively tap into this important resource during pivotal phases to bolster performance agility.
The diversity of potential applications of interim and on-demand leadership aligns with the varied needs of healthcare organizations when implementing vital programs.
- A mid-sized hospital appoints an interim CEO to navigate a political backlash sparked by the former CEO’s controversial statements, with a mandate to stabilize operations, rebuild community trust, and secure critical funding — all under heightened scrutiny.
- A teaching hospital engages an interim Chief Clinical Officer to provide leadership during the search for a permanent hire, ensuring seamless continuity in clinical operations and upholding the highest standards of patient care throughout the transition period.
- A regional health system partners with an on-demand Nurse Advisor to counsel the Chief Nursing Officer on defining and prioritizing transformation efforts and priority projects, catalyzing advancements in patient care delivery.
- A national health system discreetly appoints an interim Senior Perioperative Leader to spearhead turnaround efforts, reporting directly to the Chief Operating Officer; this leader’s adeptness in managing complex organizations proves to be instrumental in optimizing surgical service efficiency.
- An independent regional medical center secures an interim leader to temporarily fill the Oncology Program Director role, ensuring uninterrupted oncology services and patient care continuity while a permanent candidate is sought.
- Following the acquisition of three hospitals, a health system engages an on-demand Integration Officer to accelerate the integration of acquired entities; this leader reports directly to the CEO and serves on the executive cabinet, freeing up executive capacity for strategic initiatives.
- A large health system engages an interim fractional Chief Financial Officer with expertise in divestitures to guide the finance team through the complexities of system dissolution.
- To counter a decline in research funding and adapt to new healthcare regulations, an academic medical center appoints an interim Chief Transformation Officer, tasked with realigning the institution’s strategic priorities, initiating a comprehensive review of existing partnerships, and securing new funding sources.
- An academic medical center engages an on-demand Chief AI Officer to prepare and initiate the ethical and effective integration of AI, including the latest advancements in agentic AI, to enhance patient care, optimize clinical workflows, and contribute to the research and development of new healthcare practices and strategies.
Within the interim and on-demand talent space, both traditional and startup talent firms now operate. A critical factor for success is selecting a talent access partner who can effectively align organizational requirements with client needs and has access to a comprehensive network of highly skilled, established interim and on-demand leadership talent.
As the interim and on-demand talent market evolves, talent access partners typically fall within two tiers.
- Premier leadership networks: These leadership advisors offer comprehensive advice and guidance on the most suitable solution for each opportunity. They focus on specific markets relevant to the client, possess a robust and distinctive network, pre-select and vet leadership candidates, and deploy trusted client and delivery advisors who genuinely understand client requirements and tailor solutions accordingly. Their success metrics encompass outcomes, impact, as well as the quality, range, and depth of talent they represent. Moreover, they emphasize a caliber of talent that acknowledges the distinction between leadership and technical proficiency, capable of leveraging both for the client’s success.
- Marketplace and staff augmentation services: These platforms are designed to provide independent talent in large quantities. Their key performance indicators (KPIs) focus on speed, volume, and cost, lacking the strategic perspective needed to assist executives in making informed decisions about talent strategies. These services are more suitable for roles requiring easily identifiable technical skills and individual contributors.
In specialized industries like healthcare and academic medicine, premier leadership networks are better equipped to assist organizations in achieving success with interim and on-demand leadership. The top firms maintain a strong focus on these fields and are aligned with the mission of improving patient outcomes. Healthcare organizations that seamlessly integrate interim and on-demand services with executive search and leadership advisory capabilities are particularly well-positioned. By leveraging their expertise, networks, and comprehensive understanding of the leadership landscape, they can effectively match leaders with roles and/or projects that align with their strengths and clients’ cultures. These firms stay actively engaged throughout each project to minimize challenges and maximize results.
In collaboration with their talent access partner, the client will define the project or role and identify the necessary leader requirements. They will also decide whether the role should be filled on a full-time or a functional basis.
The client’s advisors will leverage their networks and proprietary search methods to identify potential interim and on-demand leaders. They will promptly provide the client with two to three carefully selected candidates tailored to the engagement, giving the client the opportunity to assess and select. The client may engage in multiple discussions with the chosen leader to ensure alignment with desired outcomes, cultural values, and soft skills. The client’s talent access firm will handle the necessary reference and background checks.
Once the leader and the project deliverables or role are defined, the client will collaborate with their talent access partner to streamline the contracting process for a quick start. This often requires coordination among management, human resources, and finance to finalize contracts efficiently. Leading talent access firms offer transparent budget guidelines early in the scoping phase and concurrently manage the contract alongside talent selection.
For large healthcare organizations, establishing a dedicated category for high-end interim and on-demand leaders can optimize the utilization of this talent pool, distinct from traditional consulting and staff augmentation services. In small to mid-sized health systems and hospitals, contracts can progress quickly with support from finance, legal, and human resources in finalizing agreements. Fast contracting allows for quick starts and accelerates impact as a result.
Interim and on-demand leaders excel at integrating into internal teams and workflows, but there are several actions that the client — and their talent access partner — can take to maximize the value of their expertise.
- Define success and stay focused on deliverables: Collaborate with your talent access partner to scope the role and establish meaningful goals, deliverables, and measurable KPIs for each interim and on-demand engagement. Interim leader assignments typically revolve around specific responsibilities, whereas the work of an on-demand consultant is guided by defined deliverables.
- Plan for a strong kick-off: Introduce the interim or on-demand leader to key constituents and involve them in meetings while sharing relevant parts of their background that are pertinent to the project. Introduce them in a manner similar to how a regular employee would be introduced to support their success. Ensure they have the executive mandate and access necessary for success, and provide clarity to them and the broader teams with whom they will interact regarding decision-making processes and authorities. Ensure they understand the organization’s mandate and compliance requirements.
- Schedule regular check-ins: Once goals have been established, schedule time with the interim and on-demand leader to ensure alignment to the intended path (and troubleshoot as needed). The talent access partner should also arrange regular check-ins with both the interim or on-demand leader and the internal client sponsors to ensure performance and alignment.
- Make the interim leader part of the team: Foster communication and transparency by encouraging the interim and on-demand leader to familiarize themselves with internal executives, ensuring alignment around a common mission and goals; integrate the interim leader as a valued team member. “The role of traditional contractors is staff augmentation: They add capacity on a temporary basis … But when the purpose is not augmentation but innovation, firms need a different approach — one that fully integrates expert freelancers into a highly cohesive team. To that end, forward-looking companies are starting to develop new practices.” (Harvard Business Review, 2024).
- Map out what happens next: Consider the future of the interim or on-demand leader’s work post-engagement completion. Strategize to ensure readiness for the upcoming phases. Role transition and post-engagement operational plans should form part of the scope of work assigned to the interim or on-demand leader. Share secure collaboration, document-sharing, and knowledge management systems that the interim leader can use. A key deliverable for on-demand leaders should be a transition plan that ensures the seamless transfer of knowledge, processes, and future program steps to the relevant ongoing resources.
An Integral Part of Leadership Strategies
Interim and on-demand leaders play a pivotal role in the healthcare industry, offering rapid access and specialized expertise across the entire care continuum. The significance of these leaders will continue to grow as organizations recognize their contributions to strategic agility and positive leadership impact.
Leadership advisory firms like WittKieffer, which blend industry expertise with seasoned talent advisors, are well-positioned to connect client organizations with effective interim and on-demand leaders, enabling them to leverage this evolving resource to the fullest. WittKieffer takes pride in exclusively serving clients within the Quality of Life Ecosystem, dedicated to improving quality of life through impactful leadership deployed through executive search, interim and on-demand leadership, and leadership advisory solutions. For more information, please visit our Interim Leadership website or reach out to Interim Leadership Solutions Leaders.
