One of the most common patterns I’ve observed in healthcare operations, and frankly,
across most industries, is what I call the Promotion Echo.
It goes like this:

• A front-line employee shows up on time, follows the rules, avoids conflict, and executes tasks reliably.
• Leadership takes notice.
• The employee is promoted to supervisor.
• A few years later, they’re managing a team (and struggling).

Not because they aren’t capable.
But because the only leadership model they’ve ever known… is the one they were promoted
under.

The Problem with Promotion
In many systems, promotions aren’t based on strategic thinking, empathy, or the ability to grow others. They’re based on tenure and consistency.
“Good employee” becomes “manager”—with no training on how to lead.
The result?
People don’t develop new thinking. They replicate old habits.
And those habits?

They cascade.

• If the supervisor they worked for was rigid, they became rigid as well.
• If the manager never explained why, they don’t either.
• If they were taught to stay in their lane, that’s the behavior they pass down.

What you end up with is a leadership layer that’s managing by memory, not by mission.

What This Looks Like on the Ground

I’ve seen it firsthand. Bright, well-intentioned managers are struggling to get their teams
engaged, but unknowingly reinforcing transactional, siloed, and reactive behaviors. Not
because they’re poor leaders, but because they were never given a new model to work from.

They use the only playbook they know:
Follow the task list. Hit the quota. Avoid mistakes. Keep your head down.

• Innovation stalls.
• Strategic initiatives get lost in translation.
• And leaders wonder why nothing seems to change, despite promoting from within.
• Front-line staff don’t get coached
  

How We Rewrote the Script

Throughout my military career leading supply chain teams, leadership development wasn’t an afterthought, it was embedded in our culture. The military is designed with intentional gates for growth, blending structured leadership courses with ongoing mentorship and performance counseling.

When I transitioned into the healthcare industry, I quickly recognized a gap: the same developmental rigor was missing. So, I brought that military mindset with me. I made it a personal mission to break the cycle. We need to cultivate leaders, not simply promote high-performing doers.

We asked:
“Which of the three virtues—Hungry, Humble, Smart—do you lead with?”
“Which one do you struggle with most?”
“Which one do you tend to overlook in others?”

What followed were some of the most honest conversations I’ve had as a leader.

We didn’t stop there.
I designed a Leadership Interview Scorecard and Question Guide to evaluate future
candidates through the same lens. We standardized what we looked for in potential leaders
and built a shared language around those expectations.

Slowly, a new culture emerged.

One where feedback was normalized.
Where curiosity wasn’t punished.
Where leadership meant something more than tenure.

And most importantly, where promotions started to reflect potential, not just past
performance.

Final Thought

The culture you allow is the culture you promote.

The people you promote today will shape your culture tomorrow.
If you’re not intentional about what they carry with them, don’t be surprised when they
echo what they inherited.

Leadership isn’t just about moving up.
It’s about leveling up, and helping others do the same.

Field Notes from the Author
I’ve seen what happens when we promote without developing. It’s not sabotage, it’s inertia.
But inertia can be broken. With tools, with coaching, and with intentionality. Start with the
leaders you have, and help them become the leaders they wish they’d had.