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Karma Doesn’t Need My Help

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For most of my career, I believed that being a good leader meant fixing things: fixing problems, fixing people, and fixing situations that felt unfair, inefficient, or out of my control. If something went wrong, my instinct was to step in, straighten it out, and make sure it didn’t happen again.

That approach served me well in some moments, but over time, I learned a hard truth: Not everything needs to be solved, and not everything needs my intervention. That realization is at the heart of Karma Doesn’t Need My Help: 11 Weekly Lessons to Leadership Success and Peace.

This book isn’t about leadership theory or best practices you can find in any classroom. It’s a collection of lessons I learned the hard way over more than three decades in healthcare leadership—often through mistakes, setbacks, and moments when my instincts worked against me rather than for me.

Here are a few takeaways:

Leadership Starts on the Inside

I didn’t want to write another leadership book focused on tactics alone. What interested me more was the inner work: the mindset, emotional discipline, and self-awareness that shape how leaders show up every day.

Early in my career, I was driven, passionate, and emotionally invested in the outcomes around me. I cared deeply. But caring deeply without emotional control comes at a cost. While my words set the direction for my teams, my reactions—especially the nonverbal ones—set the cultural tone. Often, that impact was bigger.

One of the earliest lessons in the book is simple but uncomfortable: Negative emotions are, well…negative. That doesn’t mean we suppress them or pretend they don’t exist. It means we learn to manage them. Our teams don’t need our frustration, our anger, or our anxiety. They need clarity, calm, and consistency—especially when things go wrong.

Not Everything Needs to Be Solved

Another lesson that took me far too long to learn: Solving every problem for others doesn’t make you indispensable. It makes you exhausted, and it prevents others from growing.

For years, I prided myself on being the “go-to” problem solver. If there was an issue, I handled it. What I didn’t realize was that I was training people to bring me their problems instead of developing their own solutions.

Sometimes the best leadership move is to pause and wait, then let someone else step into the discomfort and figure it out. That shift changed my leadership and my energy more than any productivity system ever could.

The Most Dangerous Phrase a Leader Can Use

One chapter is built around what I believe may be the dumbest phrase ever uttered by a leader: “I already knew that.”

I used it often early on, usually as a defense mechanism. I didn’t want to appear inexperienced or uninformed, so I shut down conversations without realizing it. The unintended message was clear: Don’t bother bringing me information—I’ve got it covered.

That phrase kills communication. It shuts down learning. And over time, it isolates leaders from the very insights they need most. Don’t make the mistake of believing that leadership is about proving how much you know. Instead, it’s about creating an environment where information flows freely—even when it’s repetitive, uncomfortable, or inconvenient.

Karma Doesn’t Need My Help

The title lesson is the one everything else builds toward.

Over time, I learned that holding grudges, keeping score, or hoping for “karma” to take care of people who disappointed me was draining and unproductive. Life and leadership aren’t fair. People will let you down. Situations won’t always resolve the way you think they should.

Trying to control outcomes—or people—only creates more frustration.

That’s where the concept of E + R = O comes in: Event + Response = Outcome. We don’t control every event. We do control our response. And our response often determines whether the outcome becomes a lesson, a setback, or a turning point.

How to Read This Book

This isn’t a book to race through. I designed it as 11 weekly lessons, each followed by reflection questions. My suggestion is simple: Read one lesson per week, put the book down, and think. Journal if you’re willing. Decide what you agree with, what you don’t, and how each lesson applies to your own leadership. Reading the words is an important starting point, but the really meaningful work is in the reflection that follows.

Leadership is hard. Life is harder. None of us get it right all the time. But we can get better.

As I often say, don’t be sorry; be better.

Tom McDougal
Speaker
Dr. Tom McDougal retired from hospital leadership in 2024 after serving as a hospital CEO for 23 years over a 33-year career. His book, Karma Doesn’t Need My Help, was conceptualized for more than a decade as he wanted to write it after his hospital CEO career was completed to ensure its honesty and authenticity. Dr. McDougal holds a doctorate in healthcare leadership, a master of science in healthcare administration, a master of business administration, and a bachelor of business management. He is also a life fellow of ACHE. Tom and his wife, Wendy, just celebrated their 32nd wedding anniversary and are the proud parents of Mary Ann and Madden.