There is a pattern that plays out with enough regularity in healthcare organizations that it has become almost predictable. A critical executive seat opens. The timeline is compressed, the pressure is high, and the search begins in earnest. And somewhere in the early conversations, it becomes clear that the urgency was years in the making.
The role didn’t suddenly become important. It was always important. What was missing was the pipeline that should have been built alongside it.
Shannon Libbert, Senior Partner at Kingsley Gate, is direct about what this pattern reveals:
“The organizations that find themselves in reactive hiring mode are often the ones that maybe haven’t done as good a job in succession planning.”
It’s not a judgment — it’s a structural reality. When succession planning is treated as a future priority rather than a present practice, organizations surrender their optionality precisely when they need it most.
What Strong Succession Planning Actually Produces
The counterexample is instructive. Some of the most talent-stable healthcare organizations fill the vast majority of their leadership roles from within. This isn’t a function of luck or an unusually deep talent pool. It is the direct result of sustained, deliberate investment in identifying and developing internal talent — well before any specific seat becomes vacant.
The returns on that investment compound in ways that aren’t always visible until you compare them against the alternative. Internal promotions move faster because the candidate already knows the organization. Cultural continuity is preserved because leadership transitions don’t require a new executive to spend twelve months learning the ecosystem before they can lead effectively within it. And the signal it sends to the broader workforce — that growth is possible here, that investment in people is real — is one of the most powerful retention mechanisms an organization can deploy.
Organizations that build this kind of bench don’t eliminate the need for external search. New capabilities, fresh perspective, and deliberate diversification of leadership background all have genuine value. But they enter external searches from a position of choice, not desperation. That changes everything about the process — the timeline, the leverage, and ultimately the quality of the outcome.
Why Organizations Deprioritize It Anyway
If the case for succession planning is this clear, why do so many organizations treat it as a perennial back-burner item?
The honest answer is that it requires organizations to make significant investments in people for roles that may not open for two, three, or more years. In environments where leadership attention is consumed by quarterly performance, regulatory pressure, and operational complexity, that kind of long-horizon commitment is genuinely difficult to sustain. The urgency simply isn’t there — until, suddenly, it is.
There’s also a subtler challenge. Effective succession planning requires organizations to have candid conversations about current leaders’ long-term trajectories — conversations that touch on performance, potential, and in some cases, timeline to exit. These are uncomfortable conversations in any organization. In healthcare, where leadership teams are often deeply mission-driven and personally invested, they can be especially fraught.
But the discomfort of having those conversations now is considerably smaller than the cost of not having them. When a key leadership departure happens without a succession plan in place, organizations don’t just lose a leader — they lose time, momentum, and often talent, as uncertainty ripples through the team left behind.
Building a Succession Practice, Not Just a Succession Plan
The distinction matters. A succession plan is a document — a list of names against roles, produced in response to a board request or a governance requirement, and then filed until the next annual review. A succession practice is something different: an ongoing discipline of talent identification, deliberate development, and honest assessment that is integrated into how the organization runs.
The organizations that do this well approach succession as a leadership responsibility, not an HR deliverable. Senior leaders are expected to know who on their team has the potential to step into a broader role, what development that person needs to be ready, and what the realistic timeline looks like. That information is surfaced regularly, not annually. And it informs both internal development decisions and external hiring strategy — because knowing where your internal gaps are helps you make smarter choices about when and what to hire from outside.
Libbert frames this as a business imperative, not a talent nicety.
“It’s a business imperative to be able to cultivate that talent within. And if we’re doing promotions from within, we need to be certain that those leaders have the foundational skills they need to take the organization to the next level.”
That last point is worth sitting with. Promoting from within is not inherently risk-free. If internal candidates haven’t been systematically developed — given coaching, exposure, and feedback that builds genuine readiness — then an internal promotion can carry as much risk as an external hire, with less of the fresh perspective. Succession planning done well includes an honest assessment of internal candidates, not just identification of them.
The Question That Exposes the Gap
There is a question worth posing to any leadership team: if your top three executives left tomorrow, do you have a pipeline or a problem?
Most organizations, when they answer honestly, know which one it is. The ones with a pipeline built it intentionally, over time, before the pressure was on. The ones with a problem tend to wish they had started earlier.
The best time to build a succession practice is when you don’t need it.
The second-best time is now.
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