Working Genius in Healthcare Leadership: Building Healthier, High-Performing Teams
At the recent ACHE Congress 2026, I had the opportunity to meet and listen to Patrick Lencioni’s keynote on Six Types of Working Genius.
In this article, I will attempt to distill that keynote and translate it into practical insight for healthcare leaders.
Smart vs. Healthy: The Two Requirements for Organizational Success
Lencioni described two foundational requirements for any successful organization:
- Smart
- Strategy
- Finance
- Operations
- Technology
- Decision science and analytics
These are the “hard” capabilities we typically emphasize in business schools, consulting, and management literature. They’re critical — especially in healthcare, where the “smart” side is extraordinarily complex and ever‑changing.
- Healthy
- Minimal politics
- Minimal confusion
- High morale (in a real, not “touchy‑feely” sense)
- High productivity
- Low turnover of good people
Healthy organizations are places where people are energized to come to work, know what’s going on, trust each other, and want to stay.
Lencioni pointed out that most CEOs will admit, if pressed, that what keeps them up at night is not strategy or finance but the “soft stuff” — culture, conflict, politics, disengagement. And yet, because it’s harder to measure, they often focus where the “light is better”: on the smart side.
His central claim: Healthy organizations get smarter over time. Smart but unhealthy organizations lose their way.
In healthcare, where complexity is high and stakeholders are many, organizational health is a competitive and moral imperative.
The Six Types of Working Genius
The Working Genius model describes six types of work that show up in any endeavor — from opening a new hospital, to launching a program, to redesigning a care pathway, to planning a family vacation.
1. Wonder (W) – The Genius of Questioning
People with the genius of Wonder:
- Ask big, foundational questions: “Is this the best we can do?” “Why are we doing it this way?”
- Reflect on whether the current reality is good, right, or complete.
- Notice gaps, possibilities, and areas for improvement.
They are often misunderstood as:
- Distracted
- Not “on board”
- “Overthinking” or “daydreaming”
Yet every meaningful improvement begins with Wonder. In healthcare, this might be:
- “I wonder if our patient experience could be much better.”
- “I wonder if these readmissions are really inevitable.”
Suppressing Wonder means silencing the earliest signal that change is needed.
2. Invention (I) – The Genius of Creating
People with the genius of Invention:
- Love to solve problems from scratch.
- Generate new ideas, models, tools, and approaches.
- Thrive when given a blank slate and a challenge: “How might we…?”
These are your natural innovators. For Lencioni, this is a core genius; he wakes up inventing new frameworks, books, and ideas.
In healthcare, Invention might show up as:
- Designing a new care model
- Creating a novel staffing approach
- Reimagining patient flow or communication processes
Wonder and Invention together form Ideation – seeing what could be and designing potential solutions.
3. Discernment (D) – The Genius of Judgment
People with the genius of Discernment:
- Have strong instincts and intuition about ideas and decisions.
- Quickly “sense” whether something will work or not, often without being able to fully explain why.
- See patterns in complex, multi‑variable situations.
This is not mystical; it is fast, holistic judgment developed through experience and a particular kind of wiring.
In healthcare, Discernment often appears in:
- Clinicians or leaders who can rapidly prioritize, triage, or diagnose situations beyond what data alone shows.
- Team members whose feedback on proposed strategies or initiatives is almost uncannily accurate.
Discernment is crucial for vetting ideas before large investments of time and money.
4. Galvanizing (G) – The Genius of Rallying
People with the genius of Galvanizing:
- Love to rally, inspire, and push others to action.
- Are energized by getting people moving and keeping momentum alive.
- Naturally take the microphone, call the meeting, send the follow‑up, and say, “Let’s go!”
Without Galvanizing:
- Great ideas stall.
- Teams get excited once, then drift back into old patterns.
- Change efforts struggle to sustain energy.
In healthcare, Galvanizing is critical when:
- Rolling out new clinical protocols
- Driving adoption of a new EMR feature
- Leading culture or safety initiatives
Lencioni shared that repeatedly having to galvanize, when it was not his natural genius, left him drained and grumpy. When he identified someone on his team who loved galvanizing and shifted that responsibility, both of them — and the organization — benefited.
5. Enablement (E) – The Genius of Supporting
People with the genius of Enablement:
- Love to help others succeed.
- Say “yes” easily, often before the request is even fully stated.
- Provide assistance, resources, presence, and encouragement at just the right time.
They are not simply “nice.” Enablement is a true work genius:
- Responding to others’ needs
- Making others’ work possible
- Being the “glue” that holds execution together
In a hospital, this looks like the nurse who answers the call light with genuine joy for the third time in 15 minutes, or the colleague who instinctively steps in to help another department under pressure.
Without Enablement:
- People feel alone and unsupported.
- Initiatives die in the gap between intention and execution.
6. Tenacity (T) – The Genius of Finishing
People with the genius of Tenacity:
- Are determined to drive tasks to completion.
- Love clear outcomes, measurable results, and finished checklists.
- Are dissatisfied when things remain half‑done or ambiguous.
Tenacity is vital in healthcare, where:
- Regulatory requirements must be fully met.
- Projects have hard deadlines.
- Quality and safety improvements must be not just designed, but implemented, audited, and sustained.
Without Tenacity:
- Projects linger “80% complete.”
- Strategic plans never fully materialize.
- People start many things and finish few.
The Three Stages of Work
The six types organize naturally into three stages that appear in every initiative:
- Ideation (W + I) – Asking big questions and creating solutions
- Activation (D + G) – Judging ideas and rallying people behind the best ones
- Implementation (E + T) – Supporting and driving work to completion
Breakdowns happen when:
- A team is strong in one stage and weak in others.
- For example, a team may have great designers (W + I) and strong executors (E + T), but no one to discern and galvanize (D + G), so ideas don’t get properly vetted or sustained.
One global brand Lencioni mentioned had plenty of design talent but lacked D and G — so excellent product ideas stalled in the gap between concept and market.
For healthcare leaders, the question becomes:
Where in this chain is my team consistently struggling? Is it ideation, activation, or implementation?
Why This Matters So Much in Healthcare
Healthcare is not just another industry. It is, as Lencioni emphasized, a vocation.
Leaders and teams are:
- Navigating relentless complexity and change.
- Serving vulnerable patients and families.
- Operating under intense regulatory, financial, and emotional pressures.
In such an environment:
- Organizational health is not a luxury — it is a necessity.
- Misalignment between people’s wiring and their roles accelerates burnout, turnover, and moral injury.
- Aligning work with Working Genius is both a performance strategy and an act of dignity and stewardship.
By intentionally designing roles, teams, and expectations around how people are naturally wired to contribute, healthcare leaders can:
- Increase productivity and innovation
- Reduce frustration and attrition
- Create cultures where people feel seen, valued, and energized in their calling
In other words, we can build organizations that are both smart enough to handle the complexity of modern healthcare, and healthy enough to sustain the people who make care possible.
Conclusion
Patrick Lencioni’s Working Genius model offers healthcare leaders:
- A simple, memorable framework
- A shared language for different types of work
- A practical way to improve organizational health quickly
By understanding and applying the six types of Working Genius — Wonder, Invention, Discernment, Galvanizing, Enablement, and Tenacity — we can better align our people to the work they were made to do, and in doing so, better serve our patients, communities, and each other.
In a field where the stakes are human lives, putting people in the right roles and building truly healthy organizations is not optional — it is part of our vocation.
Ready to build a healthier, higher-performing leadership team?
The difference between burnout and breakthrough often comes down to how well your people are aligned to the work they are meant to do.
At CTI, we partner with healthcare organizations to apply frameworks like Working Genius to real-world leadership challenges—improving team performance, strengthening culture, and reducing friction across the system.
👉 Schedule a complimentary 30-minute discovery call to explore how this could apply within your organization.
