Leading When You Don't Have All the Answers

Update: 2025-12-03

Description

Episode 30: Leading When You Don’t Have All the Answers

In this episode of Medical Mentor Coaching for Physicians in Their First 10 Years of Practice, Dr. Stacey Ishman explores one of the most underrated leadership skills in academic medicine: leading through uncertainty. Physicians are trained to know the answers—yet real leadership often requires navigating ambiguity, modeling vulnerability, and creating psychological safety for your team.

Drawing from her own experience building a hospital Utilization Management Group with no blueprint, Dr. Ishman shows listeners how to reframe vulnerability as strength training, cultivate trust, and guide teams even when the path isn’t clear.

No need to take notes—just check out the Blog for a full summary of these insights.

If you’re interested in the Academic Physician Kickstarter Course—designed for physicians in their first five years to set up practice systems, learn finances 101, build a research program, grow a national reputation, and map your personalized promotion pathway—DM @sishmancoach on Instagram or email staceyishmancoach@gmail.com .

Key Points

1. Why Uncertainty Feels So Hard (00:00 – 01:07 )

Physicians are conditioned to have answers, expertise, and confidence.

Leadership often requires the opposite: navigating situations with no clear roadmap.

2. A Story From the Field: Building a Team With No Blueprint (01:07 – 03:00 )

Dr. Ishman shares how she stepped into an administrative leader role with minimal prior knowledge.

Instead of pretending, she named what she knew, identified gaps, and asked the right questions.

3. The Power of Vulnerability in Leadership (03:00 – 04:20 )

Being open about what you don’t know builds trust—not doubt.

Expertise culture in medicine makes vulnerability feel risky, but it’s essential for innovation.

4. Rethinking Failure: Pivoting Quickly Instead of Perfecting (04:20 – 05:20 )

“Fail quickly” ≠ failure—it means testing, learning, refining.

Model the practice of identifying when something isn’t working and adjusting early.

5. Reframing Vulnerability as Strength Training (05:20 – 06:30 )

Treat uncertainty like reps at the gym—each moment builds the muscle.

Examples across clinical, research, and education settings where transparency accelerates progress.

6. A Three-Step Structure for Leading Through the Unknown (06:30 – 07:30 )

Acknowledge the gap

Frame the opportunity

Engage the team

Inviting participation sparks creativity, problem-solving, and ownership.

7. Avoiding the Over-Preparation Trap (07:30 – 08:30 )

Early leaders often over-control, over-explain, or over-analyze to feel safe.

Start with solid data—but don’t let perfectionism block action.

8. Pause, Breathe, and Reframe (08:30 – 09:20 )

Silence isn’t danger—it’s space for thinking.

Shift from “I should know this” to “I’m leading us through discovery.”

9. Final Leadership Lessons (09:20 – End)

Leadership is about creating clarity—not certainty.

Psychological safety unlocks stronger teams, better ideas, and true collaboration.

Say: “I don’t know, but we’ll figure it out together.”

Summary

You don’t need all the answers to lead effectively—especially in the early years of practice where new roles, new systems, and new responsibilities often come without clear instructions. Dr. Ishman illustrates how vulnerability, curiosity, honesty, and quick pivots create strong, innovative teams. Leadership isn’t about perfection. It’s about modeling the courage to explore, refine, and grow—together.

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