This week the market is reacting to the news that Unilabs’ CEO Jos Lamers is transitioning away from a full-time role. The managed succession, where senior management will still report to Lamers for long-term strategy purposes, means it will retain a familiar face in a figurehead position. Why is this important? Can one person ever mean so much?

Managed succession is often seen as a sign that things are going well – no need to rush a departure or frantically find a replacement. But it is as much about not spooking the market into thinking that something is amiss as it is retention of knowledge. Lamers is credited across the industry with boosting Unilabs’ EBITDA margin from around 15% to 20.6%, largely through a string of strategic acquisitions. Unilabs is making a very clear statement: he’s not being booted out, he’s done a good job! Read our story here.

Not all CXOs have faired so well or been so lucky – though the reasons varied and often unclear. High-flying CEO Attila Vegh found himself in the wrong place at the wrong time leading for just six months at Capio before it was bought by rival Ramsay General de Sante, which had its own plans. Aarne Aktan lasted three years at Pihlajalinna before being replaced in a move that led to a share price drop, as the chairman of the board of directors said group performance had played its part in a joint decision. Jill Watts left BMI after three years driven by family circumstances in summer 2017. In November 2017, owner Netcare announced a 60% fall in BMI’s EBITDA.

Some moves take us by surprise. If reforming a company is hard, then imagine trying to reform a whole healthcare system. This week Martin Brunninger, who worked in for-profit healthcare services for over 19 years, talks to HBI about how he’s now in charge of reforming Austria’s entire health and social care system. That will involve coordinating the mergers of statutory insurance funds and well as introduce a whole host of measures.

The best leaders are visionaries who can get things done. And the bigger the job, the bigger the rewards – and the greater the risk. Elizabeth Holmes, founder of disgraced point-of-care (POC) blood-testing startup Theranos is a visionary, but now facing federal fraud charges and a class action lawsuit. It remains to be seen whether Holmes will end up vilified or vindicated.

Visionaries often cut a distinctive figure. Holmes, with her husky voice and roll-necks reminiscent of the late Steve Jobs, absolutely fits that mould that in extreme cases can inspire a cult of personality.

The healthcare sector will always need visionaries, as long as they’re the right ones. And even for the right ones, the top seat can end up being a short stay for reasons outside of their control. So those who succeed in a longer tenure – and leave a company in better condition than they found it – should be celebrated.