How to Lead a Team You Didn't Choose

A practical guide for new clinical directors navigating the challenge of inherited teams

When I stepped into the CEO role at a community health center, I inherited a staff and a board of directors. I didn't get to choose them. I didn't get to build my team from the ground up. And I certainly didn't get to personally vet every person to make sure we shared the same vision, values, and work ethic.

Some of my inherited staff were absolute all-stars—double booking, creating more access, championing outcomes, and carrying the weight of the health center on their backs.

And others… were quietly doing the bare minimum. Drifting. Letting the all-stars shoulder the responsibility while they kept their heads down.

If you've ever inherited a team, you know both sides of this dynamic.

The Pressure New Leaders Face

Here's what I see happen with clinical directors all the time—especially those new to leadership or new to the organization:

You step into a role expecting to lead, but instead you're handed a team with:

• Their own deeply ingrained habits
• A complicated history you weren't part of
• Unspoken frustrations and loyalties
• Expectations you didn't set

And then you're told: "Okay, now make this work."

If that's you right now, I want you to hear this clearly: You are not behind. You're not inadequate. You're just leading in a situation you didn't get to design.

And honestly? That takes tremendous courage.

The Mistake Most New Directors Make

The biggest mistake I see new directors make is trying to prove themselves immediately. They jump right into:

• Setting aggressive goals
• Announcing new expectations
• Making sweeping changes
• Trying to "fix" everything at once

Not because they're pushy or micromanagers, but because they're scared of failing.

But here's what I learned through my own experience and years of coaching leaders: Your inherited team doesn't need you to prove yourself first. They need to understand you—and you can't lead people you don't yet know or understand.

My First 90 Days Strategy

So I spent my first 90 days doing something that felt counterintuitive at the time:

I slowed down.

I met with each person. I listened more than I talked. I watched. I observed. I built trust before I tried to change anything.

Those first 90 days were not about radical transformation. They were about earning credibility—so the real work could begin later.

And it worked.

Your Path to Building Trust Quickly

Let me walk you through the exact strategy I used—and now teach my coaching clients—to quickly build trust and create stability with an inherited team.

Step 1: Learn the Story Before You Lead the Story

Every inherited team has a story. There are:

• Old wounds and old expectations (or no expectations)
• Unspoken frustrations and unwritten rules
• Loyalties between team members or to previous supervisors
• People who've carried the weight too long
• People who've hidden from responsibility too long

Your job isn't to fix the story on day one. Your job for the first 30-90 days is to understand it.

How to do this:

Schedule a simple 20-minute "get to know you" conversation with each team member. Not about goals. Not about performance. Just four questions:

1. What's working well here? (Start positive)
2. What's one thing you wish would change? (I love using the "magic wand" question—if you had a magic wand, what's one thing you'd change?)
3. What do you need from me to do your best work? (This is where you'll discover technology gaps, resource needs, workflow bottlenecks)
4. What's one thing you never want to lose about this team? (End positive)

Important: Go into these conversations with an open mind and a closed mouth. Don't defend. Don't justify. Don't make promises. Just listen and take notes.

Listening and being quiet while they talk will build way more credibility in your first 30 days than any heroic team makeover ever will.

Step 2: Identify Your Carriers, Coasters, and Question Marks

Every inherited team has three types of people:

The Carriers – These are the people holding everything together. They come in early, leave late, double book, take clinical data seriously, and are facing imminent burnout because they've taken on so much.

What they need: Recognition and support. Help them delegate and get things off their plate. They don't need supervision—they need relief.

The Coasters – These are the people doing the bare minimum. They're not doing anything outside their job description, they call out frequently, and they're not interested in providing better patient care.

What they need: Clarity and accountability. Observe them more frequently to see where improvements can be made and what help they need to get there. Ignoring this dynamic is how high performers burn out and underperformers stay under the radar.

The Question Marks – These are people showing up and doing their job, but you're not sure where they stand yet. They don't seem happy, but they're not outwardly expressing dissatisfaction either.

What they need: Connection and consistency. They need time to feel safe before they'll show you where they stand.

Step 3: Stabilize Before You Optimize

I see new directors try to improve productivity, change workflows, and reset culture in week one. That never works.

When a team is inherited, the first thing you need is stability.

Here's what stabilizing looks like:

• Make your communication schedule predictable – Every Monday we'll have a 15-minute huddle. Every other Friday we'll have a 30-minute team meeting. Whatever it is, make it consistent.
• Ensure providers have what they need for patient flow – Fix the broken printer. Establish pre-visit planning huddles. Address chaotic communication patterns.
• Address safety issues and glaring workflow problems – These can't wait.
• Clarify what success looks like right now – Remember, you're stabilizing. What does a stable work environment look like?

When you stabilize the environment, your team relaxes. When your team relaxes, they perform better. Then you can start to optimize.

Step 4: Create One Quick Win

Nothing builds trust like one simple improvement. Not something monumental—something small that says, "I see what's not working and I'm going to make it better."

Examples:

• Fix the schedule template
• Clean up how tasks are triaged or delegated
• Eliminate an unnecessary meeting
• Improve the morning huddle communication
• Create a checkout process so providers aren't constantly interrupted

One quick win creates psychological safety. Your team will think, "Okay, they get it. I can follow this person."

Step 5: Set Expectations with Compassion

Underperformance is one of the hardest parts of inheriting a team. But here's the truth: You can be compassionate and still hold a clear line.

Try saying this:

"My job is to help this team succeed. And part of that is making sure everyone has clarity and support, including you. So let's talk honestly about what's working and what's not."

Then ask questions like:

• "What gets in the way of you seeing more patients?"
• "What's one thing that would help you show up at your highest level?"
• "Where do you think you're doing well?"

You're not attacking them—you're partnering with them.

So many times, underperformance is caused by:

• Outdated tools and technology
• Personal life challenges they're trying to manage
• Lack of clarity about expectations
• Feeling unseen or unsupported

When you address underperformance as a partner instead of a critic, you build trust exponentially faster.

You're Already Doing Better Than You Think

Inheriting a team is not easy. Balancing productivity, morale, and your own learning curve is not easy.

But you don't need perfection. You just need:

• Presence
• Clarity
• The right next step

And by reading this far, you've already taken that step.

What's Next

If this resonates with you—if you're nodding along because you've inherited chaos, inherited burnout, or inherited a team you didn't choose—I want you to know I'm working on something just for you.

It's called The New Clinical Director's First 90 Days Survival Guide.

This short, practical guidebook will help you:

• Lower your anxiety
• Get a clear roadmap
• Lead with confidence
• Avoid hidden pitfalls
• Stabilize your team
• Build credibility fast

It's coming in January, and I'll share more details soon.

For now, just know: You're not alone. And you're already doing better than you think.

If this post helped you, please share it with another community health leader who might need to hear this message today.

Checkout my Community Health Collective podcast episode on this topic. You can listen to the full episode here or find it on your podcast app.

Listen here:

• Spotify - https://open.spotify.com/show/408mftHJU9NsCSkbx4HgjK?si=d4cef1e26b5e4c0c
• Amazon Music - https://music.amazon.com/podcasts/2e90ebcd-46bb-450a-a293-7310640c8997/community-health-collective
• Apple Podcast - https://podcasts.apple.com/qa/podcast/community-health-collective/id1850646195