Promoting leadership from within: 11 pros and cons

The majority of hospital leaders are wary of internal leadership promotions because of the strain they put on existing employee relationships and changes in authority, according to a recent survey of hospital leaders published by The HealthCare Initiative, an affiliate of MRINetwork.

According to the survey, two-thirds of respondents reported they believe promoting from within an organization is a bad idea, while one-third of respondents believe it is a good idea but only if the employee being promoted would have a great mentorship program within the organization.

Four hundred hospital leaders responded to the THC survey and their responses were used to generate a comprehensive list of pros and cons of promoting employees to leadership positions from within a hospital.


1. Promoting from within an organization will help increase loyalty and retention.

2. Internal promotions can improve morale among other if they see there is potential for career growth within the organization.

3. Internal candidates already understand the different elements of the department.

4. A newly promoted manager already has staff relationships (although these relationships do require certain restructurings).


5. It is difficult to transition from a peer to managerial position.

6. A new, outside perspective is better equipped to recognize issues and implement change.

7. Being a good clinician does not mean he or she will make a good leader.

8. It is often difficult for a newly promoted manager to deliver criticism or negative evaluations to former peers.

9. Former peers will always see the newly promoted leader as their "old self," and have a hard time accepting his or her authority.

10. The old peer network will hold animosity toward their new boss.

11. It could be hard for a newly promoted leader to remain objective in matters with staff when they are friends.

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