In recognition of Women’s History Month, the MGMA Insights Podcast, hosted by Daniel Williams, senior editor at MGMA, brings together three leaders behind one of MGMA’s most active member communities: the MGMA Women Healthcare Leaders Resource Group. Facilitators Cheryl Mangiello, Dolores McNair, and Paola Turchi share insights on the realities facing women in healthcare leadership today, including mentorship gaps, leadership isolation, work-life integration, and the need for stronger peer networks.

The discussion highlights practical strategies for building leadership pipelines, improving organizational culture and creating environments where leaders can grow without burning out.

The Expanding Complexity of Healthcare Leadership

Healthcare leadership roles — particularly in independent and private practices — have evolved significantly, requiring a broader and more sophisticated skill set than ever before.

Cheryl Mangiello, an administrator focused on family and independent practices, emphasized how dramatically expectations have shifted: “We've moved from the part of a manager [checking] somebody in and sending a bill off to needing to know what population health is, what care management is, and all of those pieces.”

This creates a pressing workforce challenge: The traditional “learn on the job” pathway is no longer sufficient. Staff who are promoted into leadership roles may be strong operationally but lack training in areas like population health, financial strategy, or regulatory compliance. 

Without intentional development, practices risk bottlenecks, burnout and costly errors.

Mangiello pointed to the downstream impact on independent practices, which are already under pressure from consolidation and changing reimbursement structures. When leadership capacity is stretched or underdeveloped, it becomes even harder for these practices to remain competitive and deliver high-quality, personalized care.

Takeaway: Investing in leadership capability is no longer a “nice to have” — it is directly tied to operational stability, financial performance, and the long-term sustainability of independent practices.

Bridging Clinical and Administrative Perspectives

One of the recurring themes in the conversation was the importance of leaders who understand both clinical care and business operations.

Dolores McNair, who transitioned from clinical roles into administration, described how this dual perspective shapes her leadership approach: “I can empathize with the nurses because I've been clinical, but I can empathize with the administrators and the business managers because I've managed physician contracts, compensation, overall business, financial planning, strategic planning.”

She also emphasized the breadth of operational knowledge required in today’s healthcare environment, noting that leaders must be able to connect clinical needs to business realities. “When we're looking at operation, we're looking at facilities… we're looking at how do we take all of what we know clinically and justify the means for why we need more space, why we need a radio protective wall, why we need certain shields, why we have to meet a whole different range of compliance demands.”

That ability to translate clinical insight into operational and financial decisions is critical — and often underdeveloped. McNair highlighted how her experience allows her to support others navigating that transition: “When I come to the table… I can bring a perspective and hopefully some words that lets that woman know, I see you, I hear you.”

Organizations that invest in mentorship, cross-training, and real-world exposure to financial and operational decision-making can better prepare emerging leaders — and build stronger, more resilient leadership pipelines in the process.

Leadership Isolation and the Need for Trusted Networks

As leaders move up within organizations, many experience increasing isolation — a challenge that can impact both decision-making and well-being.

Paola Turchi explained, “The higher you go, you feel more lonely as you go through that process.” She expressed that this isn’t just a personal feeling — it’s a structural reality of leadership, where fewer peers exist internally to provide perspective or support.

To counter that isolation, she emphasized the importance of building external support systems. “Having a group of individuals — kind of like a board of directors that you trust, that you can turn to — is really important for you to be able to thrive.” 

These networks can provide a space to ask questions, test ideas, and navigate challenges that may be difficult to address within one’s own organization. 

Rethinking Work-Life Balance as Integration

Work-life balance remains one of the most persistent challenges discussed among women leaders — but the group reframed the concept in a more practical and sustainable way.

Mangiello noted that many leaders feel pressure to be everything to everyone. “We need to realize that we don't need to do it all… if we handled our careers and our home life [as] a balancing act as opposed to an all-or-nothing act, I think we would be much better.” 

She pointed out that many women feel forced to choose between competing priorities, when in reality, success often comes from adjusting expectations and pacing over time rather than trying to meet every demand simultaneously.

McNair added a powerful reframe that resonated deeply with the group: “We don't have to be I'm every woman. We just have to be the woman we need to be today in this moment.” Her perspective shifted the focus away from perfection and toward presence — encouraging leaders to make intentional choices about where to invest their time and energy on any given day.

Turchi reinforced that idea by challenging the concept of balance altogether: “Work-life balance is a myth… it's the integration… it's a matter of setting the boundaries so you can be successful and happy at what you do.” She emphasized that those boundaries are not fixed, adding that what works one day may not work the next — and that flexibility is part of effective leadership, not a failure of it.

Together, these perspectives highlight the concept that leaders are more effective when they are supported in setting realistic boundaries and adapting to shifting demands. 

The Missing Piece: Time to Reflect and Improve

A key operational takeaway from the discussion was the lack of intentional reflection time for leaders — a gap that directly impacts performance, efficiency, and long-term strategy.

Turchi pointed to a critical gap in how leaders operate day to day, noting that the pace of healthcare leadership often prevents meaningful connection or reflection. “We are constantly fighting fires — because the provider was upset or because a patient was upset or because the insurance didn't pay us — and because of that, we [are] consumed with troubleshooting.”

McNair reinforced the importance of reflection as part of leadership growth, noting that time alone — when used intentionally — can be a powerful tool: “It's okay to be alone long enough for you to know you.” 

She connected that reflection to long-term development, adding that leaders need space not only to process challenges but to think about who they are becoming and how they want to lead.

Reflection should be treated as a leadership responsibility, not a luxury. Leaders who carve out time to evaluate processes, identify patterns, and plan proactively are better positioned to reduce inefficiencies, improve team performance, and create more sustainable operations.

Creating Cultures That Support Vulnerability

The group also addressed the role of vulnerability in leadership and how it contributes to stronger organizational culture — particularly in high-pressure healthcare environments.

Mangiello emphasized the importance of separating feedback from personal identity: “When we stop making it personal… I can grow with it.” She noted that many leaders instinctively move into self-protection mode when challenged, which can limit growth and collaboration. Instead, she encouraged a shift toward openness and validation, adding, “We need to be able to say, 'that was a great idea… and I'm so glad you [told me]'.”

She also acknowledged that this kind of cultural shift is not easy, particularly in fast-paced environments where stress levels are high: “We're doing 15,000 things in this executive level, and if somebody comes and asks me something, perhaps I do snip a little bit," she said. "But we need to recognize that this is work, and it's not personal.” 

Turchi connected vulnerability to the broader theme of leadership development, noting that it requires intentional effort and trust. “You have to take the steps to participate… to be vulnerable… to accept the fact that you don't know the answer — and it's okay and you can ask somebody else.” 

McNair highlighted how creating safe environments allows leaders to speak honestly about challenges and receive meaningful support. Describing the dynamic within the resource group, she said participants are able to share openly and be supported by peers who understand their experiences, helping them move forward rather than stay stuck.

Safe Spaces and the Power of Peer Support

The Women Healthcare Leaders Resource Group provides a model for creating safe, productive professional communities.

McNair described the dynamic within the group: “We talk about what you want to talk about, what you don't want to talk about, and everything in between.” She highlighted the collaborative nature of the space, noting, “People don't vent out, they vent up," she quipped. "And another woman in the group will vet them by saying, 'I know where you can go to get that answer.'”

Importantly, the group is designed to foster trust:

• Sessions are not recorded.
• Participants can engage in ways that feel comfortable — whether speaking, listening or contributing in chat.

Creating spaces like these reinforces the value of staff being able to share challenges openly and learn from peers without fear of judgment.

Moving Forward: Empowerment, Risk-Taking and Mentorship

Even when opportunities exist, hesitation and competing demands can prevent leaders from stepping forward.

The group’s message moving forward was clear:

• McNair summarized her hope for participants: “You were seen. You were heard. You thought it, you spoke it, and you did it.”
• Mangiello added that leaders should feel “comfortable taking risks, and step out of their comfort zone knowing that there's a support system available.”
• Turchi emphasized the importance of connection and shared growth, noting the goal is “creating a space where there is a sense of connection and confidence… that you feel supported and encouraged.” 

She added that leaders should be able to take practical insights from these interactions and apply them, saying participants can “take things from those conversations and then share it with others and elevate others as you are being elevated.”

Together, their perspectives point to a leadership model built not just on individual advancement, but on collective growth. Empowerment is not a one-time achievement — it is reinforced through mentorship, community, and a willingness to take risks.

For healthcare organizations, the takeaway is both cultural and operational: Building mentorship pipelines, encouraging thoughtful risk-taking, and creating environments where leaders feel supported can strengthen leadership capacity across the organization. When leaders are empowered to grow — and to help others grow alongside them — the impact extends far beyond the individual to the entire practice.


Related Resources

• MGMA Member Resource Groups — overview of MGMA’s live member resource groups, including the Women Healthcare Leaders community. 
• MGMA Community — MGMA’s member community hub for peer connection and discussion. 
• MGMA Mentor Program —  Connects experienced healthcare leaders with members seeking guidance, mentorship, and professional growth. 
• MGMA Book Club — monthly MGMA member book discussion led by Daniel Williams. 
•  "Is Your Practice Ready for its Next Chapter of Leadership?" — MGMA on-demand webinar focused on succession planning, leadership transitions, and mentoring future leaders.