The CEO role is widely seen as one of the most demanding positions in business, often marked by isolation and constant pressure. For women, those challenges can be more pronounced due to underrepresentation, heightened scrutiny and narrower room for missteps, according to a March 20 McKinsey article.
In healthcare, the growth rate of women in CEO roles has risen steadily over the past decade but still lags behind other industries, according to a summer 2025 report from executive search firm Crist Kolder Associates. Women hold most entry-level positions in healthcare, but comprised just 35% of C-suite leaders in 2024, up from 29% in 2020.
Hospital and health system leaders told Becker’s in October that boosting women’s representation in the C-suite requires greater focus and investment in succession planning, sponsorship opportunities and affinity groups.
Drawing on conversations with experienced women CEOs across industries, McKinsey identified five leadership principles that help sustain performance over time: anchoring decisions in purpose, demonstrating principled courage, building strong support systems, understanding organizational dynamics and designing a sustainable approach to the role.
1. Anchor decisions in purpose, not pressure. Effective CEOs prioritize mission over optics or personal positioning. Leaders emphasized using their authority to advance what the organization truly needs — even when those decisions are difficult or unpopular. A clear sense of purpose helps reduce ambiguity, align teams and sustain momentum over time, McKinsey wrote.
2. Demonstrate courage grounded in principles. Leaders highlighted the importance of making difficult calls when values and evidence are clear. This form of courage strengthens trust and decision-making quality. By contrast, surface-level displays of boldness may appear decisive but can erode credibility if not rooted in conviction, according to McKinsey.
3. Build and rely on support systems. Rather than operating in isolation, successful CEOs actively seek input and surround themselves with advisers, mentors and coaches. Expanding perspectives — and being willing to ask for help — enables stronger decision-making and reduces the risks of overreliance on individual judgment, the leaders said.
4. Understand and navigate the full system. Top leaders look beyond individual outcomes to see the broader organizational and stakeholder landscape. This includes anticipating resistance, recognizing competing priorities and approaching challenges with curiosity rather than defensiveness.
5. Make the role sustainable. Sustained performance requires intentional management of time and energy. CEOs described treating energy as a finite resource, focusing it where it makes the greatest difference and avoiding a constant state of intensity. Designing the role in a way that supports longevity — not just short-term performance — is critical to staying effective, according to the report.
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
