From Physical Therapist to COO: Beth Ratliff on Systems, Survival, and Strategic Vulnerability

"I thought I understood healthcare—until I had cancer."

Beth Ratliff had spent her entire career in healthcare operations. She'd built multi-site clinical systems, led digital transformations, and risen from physical therapist to C-suite executive. But when she was diagnosed with colon cancer, she discovered something that would fundamentally change how she leads. And it had nothing to do with clinical protocols or operational efficiency.

Today, as Chief Operating Officer of Premise Health, Beth has built a reputation in Nashville's male-dominated healthcare executive world for an approach that shouldn't work, but does. She talks openly about being in recovery for 30 years. She shares her cancer journey in board meetings. And somehow, this vulnerability hasn't weakened her position; it's made her one of the most influential operators in the industry.

There's something Beth figured out early in her career that most leaders miss: the moment when you realize you're not the best clinician in the room is exactly when you're ready to lead. What she learned on a Toyota manufacturing floor as a young physical therapist became the foundation for a leadership philosophy that combines systems thinking with something that can't be taught in business school but can be learned through lived experience.

In this conversation, Beth reveals how she's navigated being consistently underestimated, why she applied for jobs she wasn't qualified for, and what changed in those terrifying moments coordinating her own cancer care that transformed her entire approach to building healthcare organizations. This isn't inspiration about overcoming adversity. It's a masterclass in strategic authenticity from someone who's figured out how to use her platform without making it about herself.

Key Takeaways:

✔ How to turn being underestimated into your competitive advantage in male-dominated executive spaces
✔ The career strategy Beth used to land leadership roles she wasn't "technically qualified" for—and why more women need to do the same
✔ What Beth learned on Toyota's factory floor that transformed how she thinks about healthcare leadership
✔ Beth's framework for sharing deeply personal experiences without making it about yourself—and why this matters for organizational impact
✔ Why patient care technology keeps failing—and the missing ingredient that actually changes outcomes
✔ The unconventional way Beth built her advisory board using both real executives and AI-powered mentors
✔ How Beth gets her entire organization aligned when everyone claims competing priorities are equally important
✔ The critical difference between mentors and sponsors—and how to cultivate both strategically

About the Guest:

Beth Ratliff is Chief Operating Officer at Premise Health, where she oversees clinical operations, technology integration, and business processes for a nationwide healthcare organization serving employer clients. She started her career as a physical therapist on Toyota's manufacturing floor, where she learned the process improvement discipline that would eventually take her to the C-suite. Beth is a Nashville Health Care Council Fellow, a colon cancer survivor, and has been openly in recovery for 30 years—leading Premise Health to become certified as a recovery-friendly workplace where personal challenges become professional superpowers.

Chapters

00:00 - Introduction at Nashville
01:43 - Succeeding as the Only Woman in the Room
04:09 - From Physical Therapist to Power Broker
07:17 - Learning from Cancer: The Patient Experience
10:30 - Recovery Friendly Workplace and Personal Journey
16:10 - The Growing Onsite Clinic Movement
18:32 - Ruthless Prioritization as a Leader
22:08 - Building Your Personal Board of Advisors

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