Healthcare leadership can be a high-wire act: visible, relentless, and stressful in a way that often feels personal. In a new episode of the Healthcare Plus Podcast, Dan Collard sits down with former hospital CEO Tom McDougal to discuss why Tom’s book, Karma Doesn’t Need My Help matters now: it gives leaders from the C-suite to early careerists a simple operating system to make better decisions under pressure—and keep their peace while they do it.

From learning how to manage negative emotions and stop over-functioning, to embracing humility, reflection, and trust, the book offers a weekly path toward transformation from the inside out. Each lesson builds on the last, guiding readers to think differently, lead intentionally, and show up with presence and peace.

A few insights from the podcast:

When churn becomes the norm, creates a leadership environment where emotions run hot. The problem is, reactivity is costly. The solution is not to outrun the noise, but to create habits that keep you steady inside it.   

Start with the outcome; design the response. The backbone of Tom’s book is a discipline you can use in any tense conversation, escalation, or crisis: E+R=O, which is short for Event + Response = Outcome. Leaders have zero control over the events,” says McDougal. “But 100% control over their response, and your response is what drives outcome.”  

Practically, that means beginning with the outcome you want (safety, trust, a clean handoff, the right long-term decision) and then choosing the response that gets you there. Over time, that shift—from managing the event to managing your move—reduces drama, rework, and regret.

Let karma take the night shift. Spending time and energy wishing karma on someone else comes at a cost. It pulls attention away from personal happiness, deepens disappointment, and crowds out opportunities to enjoy and invest in better things. The idea is simple: set it aside and let it go. This isn’t philosophy for philosophy’s sake—it’s conservation. When leaders stop doing karmic bookkeeping, they reclaim hours of mental bandwidth and can reinvest that energy in coaching, clarity, and outcomes that actually matter.

Know that it’s okay to feel what you’re feeling—and you’re not alone. Leadership is a very hard job. McDougal wants readers to find peace in what they do and to feel good about it. And keep it in perspective:  “If things go south on you and you do end up with an unfortunate event of losing a job or something else, it’s not the end of you as a person,” he shares. “It’s just a new chapter in your role as a leader.” 

Put it to work on Monday. A few actionable tips for putting Tom’s  system into practice:

• In a contentious meeting, write the outcome you want first, then pick the response that serves it.
• When a grievance shows up in your head, name it, drop it, and spend those minutes clarifying expectations with your team.
• Use the weekly cadence: one lesson, one behavior, one place to practice; debrief it in your next one-on-one or huddle.
• Model steadiness out loud. People learn how to respond by watching you respond.

Leaders can’t control the event stream—budget shocks, staffing gaps, public scrutiny—but they can control the operating system they bring to it. The tips and tools in Karma Doesn’t Need My Help are valuable because they’re small enough to use in super stressful times. They help you replace reactivity with response, score-settling with focus, and isolation with solidarity.

Karma Doesn’t Need My Help: Practical Tools for Leading with Peace shares more tips, tools, and insights on how leaders can manage their emotions (and why they should). Click here to listen! 

About the Author:

Dr. Tom McDougal, author of Karma Doesn’t Need My Help: 11 Weekly Lessons to Leadership Success and Peace, retired in 2024 after operating hospitals for 23 years over a 33-year career. He conceptualized this book more than a decade ago but had to wait for early retirement to publish it to assure its honesty and authenticity. Dr. McDougal holds a doctorate in healthcare leadership, a master’s of science in healthcare administration, a master’s of business administration, and a bachelor’s in 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.