Listen on the record
Spend the first month asking every clinician and every member of staff the same three questions: what wastes your time, what worries you clinically, and what would you change if it were free. Write the answers down and count the repeats.
Doing it systematically rather than casually gives you something rare — a documented, shared account of the problem that nobody can later claim you invented.
Pick one visible fix
Choose the most frequently repeated irritation that is genuinely within your authority, fix it completely, and tell people it is fixed and why. The size matters less than the completion.
Credibility in clinical leadership is not granted by title. It is accumulated by finishing things, and the first finished thing is worth more than the next five started ones.
Decide how you will decide
Say publicly which decisions you will make alone, which you will consult on, and which belong to the group. Ambiguity here produces more resentment than any individual decision does.
Then hold the line when it is inconvenient. A leader who follows a stated process on an unpopular decision is trusted on the next one.
Key takeaways
- Ask everyone the same three questions and count the repeats.
- Finish one visible fix completely before starting anything else.
- Publish how decisions get made, then follow it when it costs you.
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How to cite
Vejayan PD. Your First Hundred Days as Medical Director. On The Beat MD. Published July 29, 2026. Available at: https://www.onthebeatmd.com/insights/first-hundred-days-medical-director
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This material is educational and is not medical, legal, or financial advice. It does not create a physician-patient or attorney-client relationship.
© 2026 Priya D. Vejayan. All Rights Reserved. Except as permitted by applicable copyright law, reproduction, distribution, or commercial use of original content requires written permission.