October 30, 2025: After 25 years leading transformational change in healthcare IT, Erik Howell, VP and Head of Technology at Callen-Lorde Community Health Center, made an unconventional decision that most leaders only dream about: he took a sabbatical. Following major EHR implementations, enterprise PMO leadership, and scaling a Silicon Valley AI startup's delivery team, Erik stepped away to travel, reflect, and rediscover what truly mattered in his career. The result? A complete reframing of success, renewed energy, and a mission-driven role leading technology at an LGBTQ-focused community health center in New York City. Join as Erik shares the lessons from his intentional career pause and why stepping away might be the secret to stepping forward with clarity and purpose.

Key Points:

• 07:08 Erik's Pivot to a Silicon Valley Startup
• 12:46 Lessons from the Sabbatical
• 19:23 Finding the Right Career Fit
• 25:26 Speed Round and Final Thoughts

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Flourish Sound Bytes: Stepping Away to Step Forward - Lessons From Sabbatical with Erik Howell

Sarah Richardson: I'm Sarah Richardson, a principal here at this week Health where our mission is healthcare transformation, powered by community. This is Flourish Soundbites, unfiltered Conversations with healthcare leaders. Let's get real,

Welcome back to Flourish. I am Sarah Richardson and today's soundbite features a seasoned and purpose driven leader, Erik Howell.

With 25 years of experience leading transformational change in healthcare, Erik has done it all from EHR implementations and guiding multimillion dollar enterprise projects as a consultant to working for a Silicon Valley AI software startup to scale its delivery and client success teams. But Erik's story takes a unique turn.

Erik, welcome to the show. Thank

Erik Howell: you, Sarah. I love that tagline. stepping away might be the secret to stepping forward. I'm really excited to be here and I'm really looking forward to having this conversation with you today.

Sarah Richardson: I am too, and for those of you listening, we wrote an article, or Erik wrote an article and I gotta throw some quotes in a while back About that sabbatical and that journey and why it was so formative. In his career. I'm gonna start by asking you about being a transformational leader, especially in the consulting space because you have led some of the most complex and large scale transformations in healthcare, EHR implementations, enterprise PMOs, and even scaling a digital startup.

Looking back, what are the common threads that make these efforts succeed?

Is one, leadership alignment and consistent messaging. being able to have organizational focus. and I'll add a fourth one that is fun to talk about, which is change management. I love talking about change management, but starting with planning, I'm curious, Sarah, have you ever been talking about an upcoming project with someone saying that kickoff is in two or three months and the person you were talking to thought kickoff meant go live?

Sarah Richardson: Oh, it's actually a common theme when you're like educating the organization about how to get stuff done. Yes.

Erik Howell: It's crazy. If I had a dime for every dime that happened, I'd easily have like three or four bucks. so now I make sure to make clear, like kickoff is the start of the project after that planning phase is complete.

That requires decades of planning because the cost of failure is just catastrophic, right? And on the other end, you have a small project, like a workflow tweak in a clinic where. It doesn't make sense to, to spend more time planning than doing the work. And in the middle sits something like a big EHR implementation, which is a big transformation for a health system.

Sarah Richardson: I had that conversation with a CIO this morning. Yes.

Erik Howell: and you know what, if they involve different teams, then maybe you can pull it off like construction of a new hospital and a new ERP system.

Lots of tools you can layer on top of that framework. But at the very least, when I'm doing a big transformational project, ACAR how I design communications, training, and support and even if it's applied in imperfectly, which often is the case, I [00:06:00] don't think I've ever done it perfectly.

It just, it makes the difference between a thoughtful project that sticks in one that struggles.

Sarah Richardson: I love that you bring up a car, because I've been such a fan of Prosci for years. I actually had a previous team, 20 people. All the EPMO and all the major leaders in it get their Prosci certification so that the conversation was a common vocabulary. and we made the investment of actually utilizing the Prosci tool set, which is not inexpensive, and yet the cost of a failed project is actually more than. And so once you get through all the, you know, ROI and return on value of making the Prosci investment, you realize, hey, you know what? We haven't had 70% of our projects fail anymore.

Because of the other projects happening in tandem. So all your points are spot on entirely. So why pivot from consulting into a Silicon Valley healthcare startup?

Sarah Richardson: Well, I started in hospitality, so yeah. the only win, Erik, is that they've merged at this point in our careers because hospitality patient experience.

Erik Howell: so when I graduated, Google came to my college to recruit, and at that time they had about 500 employees. And so I wondered what that would've been like. to working for a software startup was in some ways kind of scratching that 20-year-old [00:08:00] itch. also after 20 years in consulting, I was ready for a change. consulting had given me really great exposure to health systems and projects and different health tech. It started to feel like I was running some of the same plays, so I was asking myself like, what's next? I was pretty sure I wanted to stay in healthcare and technology, but I wanted a new lens on that, and the two paths I saw for me were working for a provider, which I do now, or joining a software company. So I joined NTUs, a Silicon Valley startup that's focused on machine learning and gen AI solutions for hospitals and health systems. And it's a really fantastic software company solving some of the hardest problems like reducing length of say and improving surgical access. And because they're solving some of the hardest problems, the solutions take more than just tech.

So the health system would become a long-term partner and in many ways it was a natural extension of what I did and learned in consulting.

Sarah Richardson: What did you learn from the experience of working in a software startup? Because we still hear about startups and new innovation all the time, and quite honestly, all these point solutions are hitting CIOs at a pace faster than ever. So how are you not only taking that experience, but also balancing that in your new role?

Erik Howell: I'm so glad that I got the experience to see what it's like to be inside of a software company. It was fascinating. and. A great experience and a lot of my consulting skills and experience transferred. So if anyone else is interested in a similar pivot, know that it can be done. one thing that was really interesting was the internal dynamics of the organization.

So the sales team is pushing for new features that they can sell to new clients. the implementation team is making sure that promise. From sales can and are delivered. The client success team wants, improvements for the base client, base for existing customers, and then engineering. There's always some tech debt and engineering always wants time in the roadmap to reduce that tech debt and product is in the middle.

Of navigating these priorities and all these tough calls and it's this really fascinating push and pull in the organization that I didn't have, I didn't see in consulting, being in the provider space, I see a little bit of it, but it really was quite a unique environment to be in. I am.

I'm curious if you've seen that in some of your leadership roles in orgs you've been in with competing priorities in the organization itself.

So you get out of a build trap, as they call it. Is really key.

So efficiency mattered in a way that was different than I had experienced before. because like the goal over time with SaaS is for your delivery function to shrink as a percentage of your revenue. And that was one of the goals that I had. I loved the team that I built there and the experience that I had. and a little ironically, part of the reason my role was eliminated there, in addition to summary restructuring, was because I had built such a strong team that didn't need me as much as they did when I began there.

Sarah Richardson: But you didn't take that downsizing as a failure on your part. You actually pivoted and made that a midlife career break so you could travel, reflect and recharge.

Erik Howell: Well, I'd be lying if I didn't admit that it didn't feel like failure at the time. before we go into some of that, I would like to talk about how leaders frame Some of depart their departures. So, so when my role was eliminated, this is just an interesting topic that I'm interested in other leaders' perspectives on. I would love to talk more about it with folks, but I have a choice of how to frame it. and you know, many leaders take the option to say they resigned, which makes the exit seem voluntary, when maybe in reality it wasn't.

And it, I think individuals departing do this so. They aren't viewed as a failure. And I think companies decide to do this so the remaining employees don't worry about instability. So it allows both sides in a way, kind of the department leader and the company to save face. I'm interested if you've ever struggled with that or noticed other legal leaders struggle with that, Sarah, about how to talk about career transitions like that.

So years later, I almost wear that badge of honor, but it took me a long time to get to a place where I could say, yes, I got fired.

Erik Howell: Yeah, and there was definitely. A week where I really struggled with it. but it wasn't a resignation, so it didn't feel authentic to frame it that way. So I ultimately told my team, my colleagues, my friends, and my family, that my role was eliminated and I'll always be immensely grateful to the company for the runway they gave me at the end as well.

Allowed me in part to do the sabbatical and the way they allowed me to depart with a lot of integrity. I'm really grateful for. But it was really tough. in some ways I felt like a failure. I had tied my identity to career success to climbing the ladder and being proud of the companies I worked for.

I was gassed. so being burned out like that along with some lovely timing in my personal life, gave me, an opening for the concept of this sabbatical. my husband and I were already living nomadically, we were moving month to month in Airbnbs across the US due to being able to work remotely.

And, we had a little bit of savings and so we thought, why not pull a few months of retirement forward, keep traveling, but take it internationally and turn this into an intentional sabbatical period of 6, 9, 12 months. Unsure exactly how long it would be. that's what led to the decision.

So what were the biggest lessons learned, Erik, that shifted your perspective?

I could do a whole podcast on those if people wanna talk about like some of the travel adventures we did. but those months together really gave us stories and experiences that will carry forever. Another one that I wasn't sure about. I felt that I wanted to stay in this space of healthcare technology, but I wasn't sure and taking a step.

But I, I also know now that like when I do retire, I'm not gonna be the type that just wants to sit on a beach. it's just not me. So working up until Medicare eligibility doesn't sound as bad as it used to. And because of that, it really impacted what my next career. Choice would be I didn't need to maximize income at all costs.

That I could actually find a role that felt like it aligned, with purpose and things that mattered more than just income.

Erik Howell: window. We will see. I'm 45 at the moment, so I feel like I still have a little bit of runway to figure all of that out, but, I hope it stays at 65.

Sarah Richardson: Yeah, same. Because that means I'm only 14 years away, so I'm a few steps ahead of you for sure. But now you've reentered the workforce in a mission focus role aligned with your values. How did you know it was the right fit?

Erik Howell: so during my sabbatical, I used a framework called the Flower Exercise, and it's from a book called, what Color is Your Parachute? the book is. Fine. I like, I didn't read it from start to finish. I'm not sure that I'd recommend that, but that particular flower exercise is fantastic for figuring out. the type of role, the type of organization that aligns with what you want to do next. I also asked myself if my career ended today, what would be missing from my biography?

Specifically, I wanted to be in one that focused on serving the LGBTQ plus community, so that really became my focus there are about 10 community health center FQHCs in the US that, that fit that description. I stalked every one of them. I researched their boards and leaders. I learned about their challenges and strategies, and I imagine where I could add value. I LinkedIn stalked. I friend of friend stalked, I knocked on the doors of CEOs and COOs to introduce myself. Be like, Hey, I'm Erik. You got 15 minutes. Just get on your calendar and say hello. So I was really very laser focused on this one healthcare segment for three months. and. I don't know.

Sarah Richardson: I believe, Erik, to your point, it depends on the level of awareness and intentionality because you had the finances to be able to be selective, and sometimes people get to that point where they just need to pay their bills.

And so I would recommend to people have six months savings in the bank because you never know what may happen and when you aren't worried about literally keeping the lights on at home, you can be a bit more strategic about what you choose to do next.

So it was like, yep, folks here are fun, creative, they're safe to show up in a way that makes them shine. Like I found the right spot.

Erik Howell: Every six

Sarah Richardson: months.

Erik Howell: Oh.

Sarah Richardson: I'm gonna like find a reason to attend. I'm like, I'm just Here to have a good time just here to watch.

I'm like, can they do love Cats by the Cure? I would be like, oh my gosh, I'll put in a special request. We'll make it background. Okay. I'm like, I want that song, to be what's performed. I absolutely love that. So what advice would you give to leaders who may feel stuck and are afraid of stepping away?

Erik Howell: I'd say listen to that discomfort and fear. It's, it's pointing to growth. This is my first podcast interview and I've been nervous as heck to do this, but that discomfort to me means there's an opportunity for growth. And in the case of stepping away, as we said earlier, it doesn't mean falling behind.

Sarah Richardson: It absolutely is, and I'm so grateful that you shared that perspective with the audience because I don't believe anybody listening would ascertain this is your first podcast, and so kudos to you for really taking to heart the opportunity to not only share your journey, but you know, it also helps when you have a friendship that's already established, and I'm just grateful to you as well because you've expanded things that I wasn't aware of.

I didn't know there were 10 FQHCs that were specific to the L-G-B-T-Q community and I live in Northern California. And we have several opportunities here in this part of the country. So I'm grateful that there's always a safe place for people to go to get their healthcare and that people are seen and hurt and valued.

Erik Howell: Yes. I mean, I still work my ooie off. Yeah. I care very deeply about the role that I play in the organization. and I can respect a little bit more work life balance than I had, in previous roles.

Sarah Richardson: And it's time for speed round. Erik, are you ready? Okay, I'm ready. All right. One leadership trait you believe is most underrated,

Erik Howell: quiet, steadiness. it's not flashy. It doesn't grab attention, but it builds trust. And, in times of change, which my organization is experiencing a lot of right now, people look for consistency.

Sarah Richardson: They do. And you and I have chatted about more than charisma. So you can be as charming as you need to be at the end of the day.

You still have to be able to deliver. All right. Book, podcast, or resource that inspired you during your sabbatical,

Mm-hmm. There's one more. there's a novel that I read, that really reminded me to pause, to be outside, to connect with nature, and to expand. Let's get, when I get stuck in my head. there's a gorgeous novel called, prodigal Summer by, Barbara King Solver. And I read that one while Myka and, um, it, uh, [00:27:00] really brought me back to a center.

Sarah Richardson: Yeah, she's amazing. Have you run deep in copperhead? Not yet. I'll just send it to you because I have it on my shelf. I'd love to share books. I mail them out all the time and I have a few of her others on my shelf I need to read. She's absolutely phenomenal. And you really do become the characters. Like you have so much empathy for them and for what they're represented.

So I'm glad you chose her as well. And you, If you could go back though and give your younger self one piece of career advice, what would it be?

Erik Howell: Uh, to not over identify with my job because change is inevitable and, and related to that, don't lose sleep over wanting to get a gold star or fearing failure, because my ego is not my end ego.

Sarah Richardson: Very powerful, Erik, thank you for sharing your story with us today. Your journey is such a powerful reminder that stepping away doesn't mean falling behind. It can mean stepping forward with clarity and with courage. For our listeners, I encourage you to check out Erik's article, midlife Recharge on LinkedIn.

Erik Howell: Thank you, Sarah. I loved it.

Sarah Richardson: that's flourish soundbites, find your community at this week, health.com/subscribe. Every healthcare leader needs a community to learn from and lean on. Share the wisdom.

That's all for now.