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This paper argues that successful transformation of the healthcare system requires inclusion of women at the top. Women are missing in top leadership roles in healthcare at a time when the US healthcare system faces daunting challenges. There is a documented need for diverse leadership teams with transformational leadership skills to successfully lead organizations, yet women who comprise three fourths of the healthcare workforce are sparsely represented in board rooms and in the senior executive suite. Through a review the literature the authors explain why this leadership gap persists and recommend strategies to increase gender diversity in leadership ranks of the healthcare industry. Studies from other business sectors are also examined for application in healthcare. A lack of focus on female career development and succession planning, often based on persistent stereotypes about women leaders is a major deterrent to advancing women in top leadership positions. A compelling case is made for immediate remediation of this issue and implementing strategies to fill the leadership gap with talented women leaders. There is a demand to increase the number of women in top leadership positions in healthcare to assist in overcoming the current crises facing the industry.

There was no identified leadership model for American Indian women leaders. Through an exhaustive review of leadership styles it was identified that the Centered Leadership approach lends itself to the culture of American Indian Women. The components of the Centered Leadership approach include: utilizing personal strengths, managing energy, positive framing, relationship building, and collaborating with others to take advantage of opportunities. Based on the review of the literature and native women's leadership styles, the concepts of the Centered Leadership Model were utilized to develop "Native Women Leadership: Indigenous Pathway". Prior to European contact, native women held positions of leadership, shared in decision making and owned property. Today Native women leaders and managers are reclaiming their decision making authority to improve the lives of their nations. The Native Women Indigenous Pathway has not come without barriers and discrimination. The Centered Leadership approach assists in the examination of the American Indian woman's pathway to decision making. Native women find themselves living in two worlds and must navigate expectations and responsibilities by switching between mainstream American and tribal values. How a native woman decides to negotiate these two worldviews is part of what creates her individual identity and her leadership style. A Native American Leadership Indigenous Pathway model is proposed.

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The purpose of this article is to explore the role of recreational therapy within a medical home model. Medical home is a movement to manage the care of individuals with complex and chronic health needs through their primary care physician and the physician’s team. The concepts of medical home are discussed. These concepts are the same as those on which recreational therapists have been trained. This article demonstrates the various ways in which recreational therapists can meet the challenges posed by serving individuals with chronic disease.The medical home model provides a rare opportunity for recreational therapists to combine clinical skills with community skills to meet the needs of those individuals in the community with chronic and complex needs. This article demonstrates that recreational therapists are already engaged and invested in this model. What is lacking is the promotion of skills and services of the recreational therapists to market and communicate this to primary care providers.