Posted July 31, 2026

I recently sat down on my podcast with Neil Marshall and Kurt Mosley from Health Search Partners, and the whole conversation kept circling back to one idea: the first 90 to 100 days in a new leadership role are the most critical days you will ever have in that job. Not the most critical days of the year. Not the most critical days of the assignment. The most critical days, period. And once I really sat with that, I realized it applies far beyond hospital C-suites. It applies to a new commander taking over a battalion, a new pastor taking over a congregation, a new manager taking over a team that has been running just fine without them, thank you very much.

Ninety days is enough time for an organization to form an opinion of you. And here's the part that should make every new leader a little uncomfortable: it is enough time to form either a really good opinion or a really bad one that follows you for the rest of your tenure. There is no neutral. People are watching, deciding whether to trust you, and they are deciding fast.

So what separates the leaders who gain traction from the ones who stumble out of the gate? Kurt said something that stuck with me — the ones who win are willing to listen first. Not perform confidence. Not walk in with a plan already built in their head from their last job. Listen first. Learn the culture before you try to change it. Earn the right to lead before you exercise the authority you were just handed. That is a distinction I learned the hard way in the military. You can be given command, but command and trust are not the same thing, and trust is the one that actually gets things done. Nobody expects you to be perfect in the first 90 days. They are just watching to see if you can be trusted.

What really got me, though, were the stories. Neil told me about a hospital CEO named Richard Parks who, on his very first night on the job, moved into the resident dorm instead of a hotel. He asked the young doctors sleeping there how they slept, and one of them told him the mattresses were terrible. Before he had even officially started, he had five pickup trucks at Costco buying thirty new mattresses. That one act, replacing mattresses on day one, traveled through that entire organization for the rest of his tenure. Not a memo. Not a town hall. A mattress.

That is the power of what Neil and Kurt call a symbolic act — something visible, practical, and immediate, with no fanfare, just action. I think we overcomplicate leadership sometimes. We think we need the grand strategic plan on day one to prove we belong. But there was another story about a CEO whose board kept pushing him for a new strategic plan in his first weeks, and he kept telling them, I'm listening first. Then late one night on rounds, a nurse told him flat out, we don't need a new strategic plan, we need working IV pumps. He fixed that in a day. That single fix earned him more trust than any strategic plan could have in that moment, because he showed them he was actually listening, not just saying it.

There is a rule Kurt shared from a CEO he worked with, Jim Decker, called the 25-50-25 rule. When you walk in, 25 percent of people will support you simply because you are the leader now. Another 25 percent will probably never fully be on your side. The middle 50 percent, though, is where the game is won or lost. You earn that middle 50 through listening, through actually acting on what you hear, through consistency between what you say and what you do. Kurt called it making sure your audio matches your video. I loved that phrase. In the military we called it a different thing entirely, but the idea is the same. People are not listening to your words nearly as much as they are watching your actions, and the gap between the two is where leaders lose credibility fastest.

One story stopped me for a second, about a CEO who, within days of arriving, let go of one of the most popular executives in the organization. Neil said it was probably the right decision, but the wrong timing, and it caused a serious ruckus that took a long time to recover from. That is the lesson underneath all of this. Speed and haste are not the same thing. John Wooden used to tell his players, be quick, but don't hurry. Act quickly to learn. Move deliberately to change. You can move fast to understand a problem while still being patient and graceful about how you correct it.

What I keep coming back to, though, is something Neil said near the end, about wishing he had been more intentional earlier in his career about one specific question: who do I want them to see? Not can I do the job, because almost anyone qualified can do the job. The real question is who you choose to be in front of people when you do not have to be anyone in particular yet. That is the work of the first 90 days. It is not about proving you were the right hire. It is about becoming, in front of everyone watching, the leader they can actually trust.

I have walked into new organizations more times than I can count over sixteen years in uniform, across combat deployments and operational assignments where I had exactly zero built-in credibility on day one. I earned it, or I did not, in those first few months every single time. Listening first never once cost me anything. Moving too fast, even when I was right, cost me plenty. If you are stepping into something new right now, whatever it is, do the mattresses before you do the memo.

If you have a story of your own about the first 90 days in a new role, something you did that earned trust fast or a mistake that taught you the hard way, I would love to hear it in the comments. Neil and Kurt at Health Search Partners are collecting these stories for an upcoming book on defining your leadership legacy in the first 90 days, so your story might end up doing more good than you think.