At Family Care Center, we believe strong clinical leadership comes from ongoing learning, shared values, and the courage to lead with purpose, especially during tough times. Recently, as part of our Clinical Leadership series, we welcomed Major General (Ret.) Jimmie Keenan to speak with our clinical leaders.
Keenan brings more than 30 years of experience in health care operations and military service. She is the founder of Keenan Leadership Consulting and previously served as Senior Vice President of Enterprise Clinical Operations for WellMed, overseeing more than 300 clinics across Texas and Florida. As a retired U.S. Army Major General, she served as Deputy Commanding General for the Army Medical Command and Chief of the Army Nurse Corps. She is a Fellow of both the American College of Healthcare Executives and the American Academy of Nursing.
Her message to our clinical leaders was clear and practical: leadership is not about having all the answers. It is about knowing your values, acting with integrity, and building teams that can handle uncertainty together.
What shadow will you cast?
One of the most powerful questions Keenan posed was simple: What shadow are you casting?
How leaders show up — their tone, their actions, their consistency — creates a ripple effect across their entire team. Leadership is not just what you say. It is whether you walk the walk, set an example, and create a kind of environment where feedback flows in both directions.
Keenan challenged leaders to consider if they truly seek feedback from their teams, not just give it. Psychological safety, which means team members feel safe to speak honestly without fear of negative consequences, does not happen by accident. It is built over time by how a leader listens and responds.
She also brought up the importance of succession planning. “A successful organization always looks ahead,” she shared. “If your team cannot function without you, that is not a strength; it is a weakness. Leaders who help develop those around them are building something lasting.”
What kind of team are we on?
Keenan drew a clear contrast between individual performers and true team players. A golfer competes alone. A basketball team wins or loses together, with every role mattering, and no single person is more important than another.
The teams that achieve the best results, in health care and elsewhere, are those where each member knows their role, feels valued, and works toward a shared goal. At Family Care Center, we build clinical teams where everyone belongs and contributes, because this directly affects the quality of behavioral health care our patients receive.
The power of curiosity
Keenan encouraged leaders to approach their teams with genuine curiosity, particularly when things are not going well. Instead of assuming, ask. Instead of judging, explore.
She shared a simple but effective way to give feedback: start with what is working, then ask if there is another way to approach things next time. Avoiding the word “but” is more important than it seems. When feedback includes “but” that is often all the listener remembers.
Being curious also means asking the right questions in moments of struggle. If someone is consistently falling short, do not assume the problem is performance. Ask: Is there something going on that we need to talk about? That one question can change everything.
Climate vs. culture
Keenan made an important distinction between climate and culture. These terms are often used interchangeably, but they are not the same.
Climate is what people see and feel immediately. It can shift quickly with new policies, new leadership, or a single difficult conversation. Culture is deeper. It is built over time and shapes the identity of an organization.
Leaders shape culture by their actions and by what they allow. If a leader ignores dysfunction, disrespect, or disengagement, they are indirectly supporting it. Doing the right thing, even when it is difficult or uncomfortable, is part of the job. Everyone is watching.
When team members do not feel heard, it creates confusion and distrust throughout an organization. At Family Care Center, creating regular opportunities for honest feedback is not just a management practice — it is foundational to who we are.
Thriving in a VUCA environment
Keenan introduced the concept of “VUCA” — a framework originally developed for military contexts that is equally relevant in health care leadership. VUCA stands for Volatile, Uncertain, Complex, and Ambiguous. These are the conditions clinical leaders navigate every single day.
The antidote to VUCA, she explained, is not eliminating uncertainty. It is developing the capacity to lead through it. That means:
- Vision to replace volatility — knowing where you are headed even when conditions shift
- Understanding to replace uncertainty — staying informed and keeping your team informed
- Clarity to replace complexity — slowing down to explain the why, not just the what
- Agility to replace ambiguity — staying flexible and ready to adapt
When change is happening, Keenan emphasizes the importance of transparency. Explain what is going on. Ask for your team’s input. Slow down long enough to give people clarity about why something is changing and what it makes possible. Then trust them to move forward with you.
If a door closes, keep looking forward. Leaders set the tone for whether a team responds to adversity with panic or with purpose.
Succession, identity, and the courage to let go
One of the more candid moments in Keenan’s talk came when she addressed succession planning. It is common for leaders to struggle with the idea of someone stepping into a role they have poured themselves into. When identity becomes tied to a position, it can be hard to imagine anyone else carrying the mission forward.
But Keenan’s message was direct: if you do not have someone ready to continue the mission, the patients pay the price. Working through personal feelings around succession is important, but it should not get in the way of doing what is right for the organization. Building a strong succession plan is not an act of letting go — it is an act of commitment to the mission you care about most.
Giving people grace
Keenan closed with a reminder that leadership is not pass/fail. People make mistakes. Life gets complicated. The role of a leader is not to judge, but to develop.
Praise publicly and counsel privately. When a team member continues to struggle, do not fill in the blanks with assumptions. Ask. Create space for honesty. Use tools like job shadowing and peer mentorship to help people understand what their roles really require and feel supported as they grow into them.
She also encouraged leaders to empower their teams daily rather than micromanage. Set clear intentions. Hold huddles. Share information in a way that builds understanding, not just compliance. When a policy changes, explain it — do not just send it. When a challenge arises, bring it to your team in a way that prepares them rather than waiting until it lands on your doorstep.
A final thought
Major General Keenan’s message was a reminder that the most effective leaders are not the ones who hold everything together alone. They are the ones who build teams strong enough to hold together on their own.
This conversation is part of our Clinical Leadership Series, created to equip FCC clinical leaders with practical insights from experienced voices across healthcare, military service, and organizational leadership. It reflects our ongoing commitment to strengthening leadership at every level through shared learning, reflection, and growth.
This is the standard we hold ourselves to at Family Care Center, grounded in values, shaped by curiosity, and committed to developing leaders who can navigate complexity with clarity and purpose.
