
Loading summary
A
This is Scott Becker with the Becker's Healthcare podcast. I'm thrilled today to be joined by both a founder, but also someone who's a leader in sort of the world of search and executive leadership and just a terrific individual in person, Miriam Spears Carr. Miriam, could you take a moment to tell us about yourself and your background and just to introduce yourself?
B
Yeah. Thank you, Scott, and thanks for the opportunity to be with you and talk to your audience. Yeah, I'm Marion Spears Carr. I've been in the executive search and leadership development space in healthcare for 34 years. If you don't recognize the accent. I'm a native of North Carolina and I live in the mountains of Georgia. Been in the staffing world and executive search side. Work with healthcare organizations, both hospitals and physician practice, but also private equity startups, med tech and a couple instances, and have been obsessed with leadership development and started a couple companies. So that's, that's my work.
A
And what inspired you to found your company? What drove you to find it? And why was it ideal for you to move at that point to found the company and come from idea to execution and building the company?
B
Yeah, I love that question because it was the company. Inflow Executives is a new launch that I launched two years ago. It's been in the back of my mind for quite some time. And the idea was what if we could take all of this experience in the executive search side, plus all of the work and development work and the leadership development side, and create a company that had that look and feel of a boutique retained search firm, but also was embedded in organizations at the table with them, trusted advisor and also helping them develop their teams. And so it was this idea of what could we, how can we marry these two different interests of mine that have been revenue sources for me for a very long time and multiple entities and then create a company that leverage those to make healthcare, particularly healthcare companies that are in growth mode, medium sized, small size or even large companies where there was a segment of the work that they were doing where they needed that level of connection. So that's the whole idea of Inflow Executives is creating that environment where we could do that type of work well.
A
Fantastic. And you've done a wonderful job of it. Take a second on your own leadership style and how that's evolved over the years. I've known you for a decade, a terrific person, one of the nicest, most gracious, sincere people. If they, they have this book called the Go Giver, you might as well have written that book. Talk a bit about Your leadership style and how that's evolved over the years.
B
I had a very, I was very fortunate, very young to have some mentors who saw leadership as a skill set that I had. And I'm not saying you're. They're born leaders and grown leaders. I don't know if I was a born leader, but there were mentors of mine that really drove my interest in being leadership in a leadership capacity. And the thing that I learned from them that has really help me is their whole idea is if you can bring value people you want to lead, the people you want to, to follow you, the people you want to work with, be it a customer, be the client, be it your network, etc, if you can find ways to support and grow them, they're going to follow you. They're gonna more likely listen to what you have to say or at least be open to what you had to say. So that was kind of the foundation of that and where and how that's evolved it now it's, it's how can I help other people grow, organizations grow, but also embed gratitude through that process. And when, when I really locked in on gratitude as a key leadership acumen, not just a feeling, that's when things really started to shine and work well for me. So help people grow, help people succeed, as long as it aligns with kind of what you're trying to do and what you're trying to grow. But then embed gratitude is a key part of that connection. You do that so well, Scott. You think you, you, you're very much locked in on a gratitude as a leadership skill set, if you know it or not.
A
But talk about that for a second because what happens is, I think for many people it's almost a glass half full, a glass half empty thing. At some point you have to naturally come around to the concept of being really grateful for those people that are involved with you in any way, shape or form. Particularly I'm involved with so many people that are helpful, that are, that are positive and they have a positive impact on my life. Every once in a while you run into people that you think of as takers versus givers. And of course it's hard to be as thankful and grateful for them, but by and large people are fantastic and a pleasure and you sort of view it as everybody's trying. And so at some point it becomes natural, but it also becomes very intentional that you're grateful to people because it's a way of life, isn't is.
B
And I think one of the things that We've learned through this. This journey around understanding gratitude as a. As a. As a leadership skill set is moving gratitude. Saying thank you, showing graciousness to others, moving it from habit or manners to ritual to it where it has a reason to do that. So to your point, as we think about gratitude from an intentional perspective is looking for those opportunities where we can elevate the other person, that we can help them see something that they don't see in themselves or see a process that they've developed that they don't even realize is so more valuable than even. Than they see it. I think when you move gratitude from being, you know, a nice way to treat people to being intentional, to look for opportunities to elevate others like Chippendan Heath talked about in their book, the book that they had written around. Around that topic. But then move that from being such a core value that it's embedded in everything you do. That's where I want to go with it and where I feel like we. We begin that journey toward. To be honest with you.
A
Yeah, no, I think you do a wonderful job of that. I think I remember first meeting you and you always being so gracious by. By nature. I just find it to be so natural for you. How do people. With that intentionality, that naturalness of being grateful, you're naturally one of the most grateful. One of the things I love about you. Right. I've known you for years now, and it's always. You're always trying to help, you're always positive, you're always encouraging. And quite frankly, you never ask for anything. You never ask like, oh, can you do this for me? There's a. There's a quid pro quo with it. How do you develop that naturalness that, that, that intentionality, that positiveness, you know, in. In that right nature, because you do it so beautifully. Well, and the thing that I'm always reminded of is that you're never asking me for a favor. You're never asking for something. You're just grateful by nature and how you deal with people. And is. Is that learned? Is that born. And if you're not born with that type of attitude and positivity, can you develop it intentionally?
B
Great. Two questions there. First, for me, I grew up in a family that. Where gratitude and our faith was so such a core value. And I grew up in the mill village of Concord, North Carolina, and the textile industry. Mom and dad both work in the cotton mill. And I kind of grew up around people who were just grateful for being alive, grateful for what they had saying thanks and being grateful. And so for me, that's, that was kind of, that, that was like I saw a foundation. But I do think it could be learned. And here's, here's the way I talk about it. If we want to grab onto gratitude as a way to, to help others, the first stop on that journey is to think about what you're grateful for. I mean, everybody in our industry, or any industry for that matter, Scott, they have something to be grateful for. Someone help them get where they are. Someone opened the door for them or someone said something that encouraged them or someone, you know, you want to mean. Like, there's so much there and if we start thinking about it from that perspective, we start thinking about gratitude from, from what we're grateful for. There's this natural peace within your brain that starts moving you toward wanting to share that. So to your point, the other point that you want to, that not asking, not making an ask. Here, here's how I look at it. If I bring value to a relationship and I help someone connect or find the right opportunity or whatever it is, that's great. And it's not just putting stuff out in the, in universe. It's going to come back to you. But over time, you create really this feeling of, wow, he did something for me, he helped me. Or it just come. You don't have to ask, right, Scott? You just don't. Like, you don't have to ask. Will come back to you. And if it only comes back to you in the, in the, from the concept of wow, you help that person, then you need to be good with that. And that's just, that's just how I look at it. Like if I can help someone. And here's the other thing, Scott, last part of that. When you help someone, if you do it intentionally, you also learn something. And that's for me, I'm a brain injury survivor who had a brain injury when I was 18 and I had to learn how to learn again. So I'm always trying to learn, you know, I'm always trying to learn something. Every time I help somebody, there's some learning experience around it. So that's a long answer to your short question. But that's where gratitude really moves from being this, oh, he's such a nice guy to oh, that's valuable. Oh, that's important.
A
But, but I love the point that gratitude in doing the right thing can't be a quid pro quo. It can't be, I'm doing this, I'm thankful. I'M helping this person with that person because it's going to help me. That's sort of the wrong way. The right way is I'm helpful in a lot of different ways. It all ends up working. It's almost like the karma concept. And yes, you have to be intentional about making a living, intentional about feeding your family. But. But there's a lot of gratitude that doesn't have to have a plus minus, just the right way to act, the right way to behave. And you do a wonderful job. Talk about your business today, about inflow and what are you most excited about with the business today and who you're working with? And clients Are the clients mostly health systems? Are the individuals looking for a position? Is it coaching? Where's the core of what you do today and what are you most excited about?
B
Yeah, so core our core business revenue and our primary revenue is with, in, in being embedded in growing healthcare companies. We still do some one off searches. We do a number of CEO searches for community and rural hospitals. That's kind of a focus of ours. It's not necessarily domain of the big players, you know, so we can, we can target that. But what makes inflow executives different is we partner with companies that are in a high growth mode be it a physician practice that's scaling across a region or home health company or anything in that regard. Again, common thread is they're patient centered and we actually embed as a white label executive search firm internally. To give an example, we're working with a very fast growing urology practice in the Carolinas. We've been their white labeled partner in house since December. We've already placed a chief technology officer, two senior financial accounting key people within their team and we just had a CFO start last, last week. So we have four people already in this organization and we have multiple physician practice opportunities for them. We basically influence executives. Is a key talent advisor internal to the organization over a 6 month, 9 month, 1 year contract type thing. So what we've done is we've taken the quality of retained search and mold, put it into a mold where you can completely embed it in a company that has multiple needs over a period of time. That's exciting because it's a, is, it's, it's, it's, it's the new concept, it's the idea that we had. What's got me crazy excited though is my authentic gratitude communication framework leadership training. We partnered with a couple major health systems to do the research. One in Texas, very large nonprofit where we're using this gratitude structure. And we're researching how we can teach leaders to reframe how they communicate, to change behaviors within their teams, both to support a culture of safety, clinical excellence, risk mitigation. There's so much to that. And it started as a concept and now we're kind of in that proof. Now we're proving it with research. So those are the two things that's really what we do. Inflow executives is the from a search perspective, is this company that will come into your medium or, or even a large company that has a segment that they need very focused on and partner with you internally on the search side. And then from leadership development side, is, is building teams that are focused on gratitude, focused on communication, focused on developing a culture of accomplishment. And that's, that's the, that's the two things we do.
A
Thank you. And take a second. Don. What advice would you give to emerging leaders who are trying to be great in leadership? Whether it's the CEO of a health system, the, the division head of a gastroenterology practice, a physician. What advice do you give people that, that are emerging leaders?
B
Correct. I love that question too. And Scott, you. I've alluded to this and some information I've sent you over the time over, over, over our relationship. I'm a student of flow theory of being in flow. Mihaly Csiksmith Miha's theory around Flow theory around when we have a command and control over our skills and we're up to the challenge, we can be fully locked in, we lose all track of time. We feel this autotelic experience where we're, we're feeling self worth being developed, et cetera. He also talked about the fact that when we own a set of skills that are not being used appropriately to the role that we can either be in a state of anxiety and conflict or we can be in a state of boredom and apathy. Why is that important to emerging leaders? They need to pay attention to when they feel in a state of anxiety or conflict. And they need to pay attention to when they feel bored or somewhat apathetic about the work they're doing because that's going to give them clues about the skills that they really own the most that they want to work with. So as an emerging leader, the more you can focus on the skills that support your self worth, the skills that develop you as a leader, you can lean in heavy on those for a higher success rate within the role that you're playing and identify roles that matter and will matter to you long term. So think about it from the flow perspective. Merging leaders need to pay attention. It's not to say we're not going to have this time, we're going to be bored or be apathetic, but over a long period of time, if the role we're in or the company we're in, or the group that we're in puts us in that state for a very long time, performance is going to drop and we're going to fail in the same light that's going to happen in the state where we're over challenged. So for emerging leaders, start paying attention to those things and then start building on that foundation of the things you really do. Well, if somebody would have told me that, I don't know, when I was in my 20s or 30s, I might have like glossed over it. But the older I've gotten and the more I've talked to leaders around that, the more I realize it's so true. To give you one last example on that, Scott, when people are fired in our industry, in healthcare, there's a lot of different, myriad reasons. But I, I would suspect if you pulled that group of people that got exited for performance, they would tell you they were either in a state of anxiety at a high level for a lot of their, their work or they were in a role that didn't leverage the skills they really like to use. And they were in the state of apathy or boredom. I don't have any that's anecdotal, that's just over years when I talk to people who lose their job. But I think as an emerging leader, understanding what puts you in flow, what locks you in and what your core values are in alignment with that, that's the thing to grow from as a leader. Just my opinion.
A
No, and I, and I absolutely love that. I've always said about leaders, if they're not engaged, for example, if you have a great talented person at your organization and they don't have a clear role, some leadership role, at some point they'll get disjointed and at some point they'll probably walk, you know, out the door because they weren't engaged fully, because they didn't have an opportunity to strive and to do what they're supposed to be doing. And I think that's right on. And obviously if you see that in yourself, you're bored, you're not engaged, you're not fully after it. Or the flip side, which I find myself doing sometimes is being over scheduled, overburdened. Either way can lead to Sort of the wrong kind of engagement, either under involved, under passionate or over scheduled, either one. And, and I think managing that in oneself is a great talent and a great challenge. I absolutely love that. Well, thank you for that.
B
You're welcome. You're welcome. I think if we, if we could teach that more, if we could teach people to really lock in on their, on their skills that they own. And there's so many ways you could do that. But just take your job description and get a highlighter out and highlight three things on your job description that you really, really like to do and then highlight everything you hate or dislike. If the job description is, is like hundreds of lines of you just, I hate this, I don't like this, I don't like to do that, et cetera, then you probably have to find a different job. And if you're a leader and you've got someone who owns a whole bunch of skills that you're not leveraging, you're doing them a disfavor that's not fair to them. And you know, back to Inflow, for example, that's one of the things we do is we, we see ourselves as problem solvers when we're embedded in an organization. They may say they need X, but what they really need is Y. Let's go find somebody and write the job description around that person as opposed to trying to find somebody to fit a job description. That's not really the problem you're trying to solve. And that's a whole other discussion we could have on another day.
A
No, just absolutely fascinating. Mary. Where could people learn more about you and your company?
B
Best place is to connect with me on LinkedIn. I spend a lot of my time there. Inflow executives, websites actually in, we're rebuilding it. We actually took it down because we, we didn't feel like we were telling our story. But. Find me Marion Spears car Only K A R or Marion Spears K A R R that I know on, on LinkedIn that's the best place to look and you can learn a little bit about the company. Company small, we're a startup now but we, we believe we have a model that's going to be scalable and, and we will be building our team over the next three years. And so yeah, just connect with me on LinkedIn. That's the best way. And send me a connect request and we'll, we'll definitely connect.
A
Marian, great pleasure to visit with you as always. Thank you for joining us on the Becker's Healthcare podcast. You're the best of the best. Thank you for joining us.
B
Thank you so much, Scott. Thanks for having me on the show and I really appreciate you very much. I look forward to seeing you at a conference soon.
A
Thank you.
Becker’s Healthcare Podcast
Episode: Marion Spears Karr on Gratitude Driven Leadership and Rethinking Executive Search
Date: March 25, 2026
This episode features an insightful conversation between host Scott Becker and Marion Spears Karr, a veteran in healthcare executive search and leadership development. Marion shares his journey, the origins and vision behind his company Inflow Executives, and delves deep into the philosophy and practical application of gratitude-driven leadership. The discussion also covers paradigm shifts in executive search and advice for emerging leaders in healthcare.
[00:27-02:44]
"What if we could take all of this experience in the executive search side, plus all of the work... in leadership development, and create a company that had that look and feel of a boutique retained search firm, but also was embedded in organizations at the table with them, trusted advisor and also helping them develop their teams." [01:24]
[02:44-05:44]
"...when I really locked in on gratitude as a key leadership acumen, not just a feeling, that's when things really started to shine and work well for me." [03:10]
[05:44-07:05]
"...move gratitude from habit or manners to ritual... where it has a reason to do that... looking for those opportunities where we can elevate the other person." [05:44]
[07:05-10:55]
"...start thinking about gratitude from what you're grateful for. There's this natural piece within your brain that starts moving you toward wanting to share that." [08:07]
"...you don't have to ask. Will come back to you. And if it only comes back to you in the... concept of wow, you help that person, then you need to be good with that." [08:07]
[11:46-14:52]
"We actually embed as a white label executive search firm internally... we've already placed a chief technology officer, two senior financial accounting key people... and a CFO." [11:46]
"We're researching how we can teach leaders to reframe how they communicate, to change behaviors within their teams..." [11:46]
[15:13-18:18]
"They need to pay attention to when they feel in a state of anxiety or conflict. And they need to pay attention to when they feel bored or somewhat apathetic..." [15:13]
[19:12-20:25]
[20:30-21:11]
"That's the best way... send me a connect request and we'll, we'll definitely connect." [20:30]
On merging executive search and leadership development:
"...create a company that leverage[s] those to make healthcare... where they needed that level of connection. So that's the whole idea of Inflow Executives..." [01:24]
On gratitude as a foundation for leadership:
"If you can bring value [to] people you want to lead... if you can find ways to support and grow them, they're going to follow you..." [03:10]
On the intentional practice of gratitude:
"...move gratitude from being... a nice way to treat people to being intentional, to look for opportunities to elevate others..." [05:44]
On non-transactional giving:
"It can't be, I'm doing this, I'm thankful. I'm helping this person... because it's going to help me. That's sort of the wrong way. The right way is I'm helpful in a lot of different ways. It all ends up working..." [10:55], Scott Becker
On leadership growth and “flow”:
"The more you can focus on the skills that support your self-worth, the skills that develop you as a leader, you can lean in heavy on those for a higher success rate..." [15:13]
Marion Spears Karr’s episode offers a deeply human and practical perspective on leadership in healthcare—anchored by gratitude, authenticity, and a commitment to developing others. Listeners will leave with not just actionable advice, but an invitation to rethink how they lead, hire, and support their teams. Connect with Marion on LinkedIn for more insights or to explore Inflow Executives’ innovative approach.