101: Why Leadership Training Fails (and How to Fix It): Healthcare Executive Keith Repko on Building Strong Managers
Tue Feb 03 2026
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Leadership problems rarely start at the top. They start in the middle.
In this episode of Business Origin Stories, I sit down with Keith Repko, a former healthcare executive who spent decades leading one of the largest VA medical systems in a five-state region. Over his career, Keith oversaw thousands of employees, multiple hospital campuses, and complex operational systems, and what he learned is simple and uncomfortable: most organizations promote people into leadership roles without teaching them how to lead.
We talk about why bad managers drive great people out the door, why younger generations are increasingly opting out of leadership roles altogether, and what actually works when it comes to developing strong, relational leaders inside complex organizations.
Keith shares real-world stories from healthcare, practical frameworks leaders can use immediately, and why relationship-first leadership is not “soft,” but operationally essential.
In this episode, we explore:
Why most leadership training comes too lateThe real cost of promoting high performers who aren’t ready to leadHow poor management accelerates burnout and turnoverPractical ways leaders can build trust and cohesion across teamsHow organizations can create leadership pathways without forcing people into managementWhether you lead a hospital system, a growing company, or a small team, this conversation will change how you think about leadership development and what it truly takes to build teams that last.
Connect with Keith: https://www.linkedin.com/in/keith-repko-a0b80684/
Instagram:
@amyschutte_
Work with us: www.hudsonandco.co
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Send us a text Leadership problems rarely start at the top. They start in the middle. In this episode of Business Origin Stories, I sit down with Keith Repko, a former healthcare executive who spent decades leading one of the largest VA medical systems in a five-state region. Over his career, Keith oversaw thousands of employees, multiple hospital campuses, and complex operational systems, and what he learned is simple and uncomfortable: most organizations promote people into leadership roles without teaching them how to lead. We talk about why bad managers drive great people out the door, why younger generations are increasingly opting out of leadership roles altogether, and what actually works when it comes to developing strong, relational leaders inside complex organizations. Keith shares real-world stories from healthcare, practical frameworks leaders can use immediately, and why relationship-first leadership is not “soft,” but operationally essential. In this episode, we explore: Why most leadership training comes too lateThe real cost of promoting high performers who aren’t ready to leadHow poor management accelerates burnout and turnoverPractical ways leaders can build trust and cohesion across teamsHow organizations can create leadership pathways without forcing people into managementWhether you lead a hospital system, a growing company, or a small team, this conversation will change how you think about leadership development and what it truly takes to build teams that last. Connect with Keith: https://www.linkedin.com/in/keith-repko-a0b80684/ Instagram: @amyschutte_ Work with us: www.hudsonandco.co