In this episode of the Lead Up Podcast, host Mike Harbour sits down with Tom Dahlborg, healthcare executive and author of From Heart to Head and Back Again, to examine what happens when leadership becomes overly transactional in a system that depends on human connection. Drawing from his experience as both a leader and a patient, Tom challenges the assumption that better outcomes come from better metrics—and instead points to the standard of leadership underneath them.
They discuss why healthcare has seen limited progress in patient safety and experience despite decades of focus, and how an overreliance on measurement, incentives, and control has shifted leadership away from its core responsibility. Tom explains how well-intended systems can unintentionally strip away intrinsic motivation, turning meaningful work into transactional activity—and why that shift shows up as Burnout, disengagement, and moral injury across teams.
The conversation also explores the difference between managing outcomes and leading people, and why many leaders default to fixing systems without first examining their own role within them. Tom emphasizes the need for courage, self-reflection, and a willingness to make decisions that prioritize what is right—not just what is rewarded.
One of the key takeaways: organizations don’t get better results from new strategies alone—they get them from leaders who are willing to operate at a higher standard, especially when it’s difficult.
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You can learn more about Tom here and find his book on Amazon.
