Many of us reach a plateau in our careers where improvement seems to stall. Despite our best efforts, we may find ourselves unable to identify the barriers holding us back or the specific changes needed to overcome them. This phenomenon is precisely what renowned surgeon and public health innovator Dr. Atul Gawande explores in his insightful presentation on the profound impact of professional coaching.

Dr. Gawande shares a compelling personal narrative about his journey as a surgeon who, after years of practice, found his improvement curve flattening. Like many accomplished professionals, he initially experienced steady progress in his early career, watching his complication rates drop year after year. But after about five years, this improvement plateaued, leading him to question: "Is this as good as I'm going to get?"

What follows is a remarkable testament to the power of external perspective. Dr. Gawande invited a retired professor to observe his surgical technique—a practice uncommon in his field but standard in others like music and sports. Despite believing his performance was flawless, he received a page full of observations about small but significant details he had missed: suboptimal lighting, improper elbow positioning, and other subtle inefficiencies that affected his performance.

In leadership and governance, individuals often face a profound dilemma: the choice between upholding principles and pursuing conventional success. This question cuts to the core of what it means to lead with integrity in the face of complex ethical challenges. While the allure of pragmatism and compromise can be strong, the long-term consequences of sacrificing one's principles for short-term gains can be severe.

At the heart of this dilemma lies a fundamental question about the nature of success itself. Too often, success is defined by narrow metrics such as promotions, recognition, or financial gain. However, true success—the kind that leaves a lasting impact and inspires others—is rooted in something more profound: the courage to stand firm in one's convictions, even when it's difficult.

Leaders who prioritize principled decision-making understand that their choices have ramifications that extend far beyond the immediate situation. Each compromise, however small, sets a precedent and shifts the baseline for future decisions. Over time, these incremental concessions can lead to a gradual erosion of ethical standards and a loss of moral authority.

The final hours of 2024 are ticking away, and across the globe, millions are penning their New Year's resolutions with fresh hope and determination. Yet beneath the sparkle of champagne and the glow of fireworks lies a sobering truth: most of these well-intentioned promises will fade before the winter snow melts.

But what if we've been approaching change all wrong? What if the secret to transformation isn't in grand declarations but in the quiet power of tiny actions? This is the revolutionary premise of James Clear's "Atomic Habits," a book that arrives at the perfect moment as we step into 2025.

The essence of Clear's philosophy is deceptively simple: success isn't about dramatic transformations but about the steady accumulation of small improvements. He calls these "atomic habits" – minute changes that, like atoms, are the fundamental building blocks of remarkable results. Just as compound interest transforms modest savings into wealth over time, these atomic habits compound into extraordinary changes.

Evidence-based research demonstrates that systematic competency development serves as the cornerstone of healthcare organizational success. The ACHE Healthcare Executive Competencies Assessment Tool (available here) provides the essential framework for this development process.

At the foundation of executive competency lies effective communication. Organizations that implement structured leadership rounds with documented learning systems consistently report significant improvements in staff engagement within six months. Beyond basic rounds, leading healthcare institutions have found success through communication laboratories that focus on real-world scenarios. These programs have demonstrated marked improvements in leader confidence, conflict resolution, and overall staff-leader communication effectiveness.

Leadership development builds naturally upon this communication foundation. The most successful healthcare organizations emphasize cross-departmental project management as a key development tool. By managing initiatives outside their primary expertise, leaders develop broader organizational understanding and enhanced collaborative capabilities. This approach pairs effectively with systematic case review programs, where actual organizational challenges become learning opportunities. Regular crisis simulation exercises round out this aspect of development, consistently improving emergency response capabilities and team coordination.

Not long ago, I found myself facing an unexpected job transition. It was a shift I hadn’t planned for, and it has brought with it a complex mix of emotions—some I expected, others I didn’t. Moving out of a role I’d known well, even without a new position lined up, carries both excitement and apprehension. I realized that this transition was not just about finding a new job; it was an invitation to pause and reflect on where I’ve been, where I want to go, and what truly matters to me in my career.

Going through this experience has made me deeply appreciate the power of reflection and the value of support during a job transition. Many of us will face these changes, yet they’re rarely easy. Today’s professional landscape doesn’t offer the clear, structured paths it once did. Instead, we often have to define our own milestones, successes, and markers of progress, relying on our networks—our friends, mentors, and colleagues—to help us fill in the gaps. As I continue to navigate this phase, I’ve realized that one of the most meaningful ways we can move through job transitions is by reflecting on our journey and supporting one another.