From trial by fire to modern CLO
In a candid conversation on the Legal Leaders Podcast, Michelle Clatfelter and LawVu CLO and EVP Advocacy David Lancelot discussed trial-by-fire leadership, building a legal function from scratch, and why today’s Chief Legal Officer must be a strategist, problem-solver, and partner to the business, especially in the high-stakes world of healthcare.
On Clatfelter’s second day as Chief Legal Officer of Springfield Clinic, her carefully sketched 90-day onboarding plan was rendered irrelevant. She spent the entire day in mediation, confronting a payor dispute that would later escalate into a prolonged out-of-network battle. That same evening, news broke around that payor’s lack of network adequacy and use of so-called “ghost networks,” pulling the organization into public scrutiny almost immediately.
It was not the measured introduction to a new role she had envisioned, but it was precisely the kind of moment that reveals what modern legal leadership looks like.
Clatfelter’s journey – from private practice to healthcare executive, from team-of-one to trusted strategic leader – mirrors the broader evolution of the Chief Legal Officer role itself. In highly regulated, high-stakes industries like healthcare, the CLO has moved far beyond the traditional remit of contracts and compliance. Today’s legal leaders are enterprise problem-solvers, crisis navigators, cultural stewards, and strategic partners. Clatfelter’s career offers a vivid case study of how that transformation happens in practice.
The changing face of in-house legal leadership
Early in Clatfelter’s career, in-house lawyers were still relatively rare, particularly in healthcare markets outside major metropolitan hubs. Legal support was often external, episodic, and reactive. Over time, that model has proven insufficient for organizations operating under intense regulatory scrutiny, reimbursement pressure, and consolidation.
“What we do is so multidimensional,” Clatfelter explains. “It goes so far beyond risk mitigation and management. A lot of what we do is professional problem solving: connecting dots, exercising judgment, and applying a business lens to complex situations.”
That mindset captures the shift. Modern CLOs are no longer valued simply for spotting risk; they are expected to anticipate it, contextualize it, and help organizations move forward thoughtfully. As Clatfelter puts it, “If the answer you’re hearing from me or our team is ‘no,’ we’re not doing our job. Part of our job is to find the way to yes – sometimes in very creative ways.”
A path rooted in healthcare – and curiosity
Clatfelter’s affinity for healthcare leadership is personal. She grew up in a family of clinicians: a head and neck surgeon father and a nurse anaesthetist mother, running a small independent practice that would be difficult to sustain in today’s environment. While she knew early on that clinical practice was not her calling, healthcare as an industry – and as a mission – never left her orbit.
Drawn to debate, policy, and social sciences, she pursued law school at an institution known for its health law program. That academic focus, combined with a formative stint working for the Illinois Senate, gave her early exposure to how policy, regulation, and real-world impact intersect. “Seeing how the sausage is made,” she says, proved invaluable later in her career.
Her first professional chapter unfolded in private practice at a law firm with a dedicated healthcare group. There, she honed her technical skills, learned to manage demanding matters, and built relationships that would later become career-defining. But even then, the absence of a clear roadmap for becoming an in-house leader was evident. The role itself was still being invented.
Learning in-house leadership through example
Clatfelter’s transition to her first in-house role came when a regional health system decided, for the first time, to build an internal legal function. She joined as corporate counsel and steadily advanced, eventually serving as Vice President of Legal Services for Illinois operations across nine hospitals.
What shaped her most during that period was not formal training, but observation. Her mentors, themselves former private practitioners, modelled how to operate as part of an executive team: giving counsel latitude, encouraging ownership, and emphasizing alignment. “I learned by example,” she reflects. “Seeing good leadership, and sometimes not-so-good leadership, was incredibly instructive.”
In-house work demanded a new way of thinking. Instead of discrete projects for multiple clients, she was embedded with one organization, one mission, one set of stakeholders. She learned how governance, matrixed leadership structures, and board dynamics influence decision-making. And how legal advice must adapt accordingly.
Building something that didn’t exist
When Clatfelter joined Springfield Clinic as its first-ever in-house lawyer, she stepped into a blank slate. There was no legal department, no defined processes, no established expectations. Springfield Clinic itself is a complex organization: an independent physician group of roughly 350 physician owners, over 650 providers, and nearly 90 locations across central and southern Illinois. Its commitment to physician independence, amid accelerating industry consolidation, adds another layer of strategic and cultural complexity.
“I had to build something that didn’t exist, and give it meaning and influence,” she says.
Her early days were defined by crisis rather than planning. The payor dispute she encountered immediately forced her into high-stakes negotiations, board engagement, and public-facing issues. Yet that trial by fire accelerated trust. “Sometimes jumping into the trenches, or being thrown into them, gets you there faster,” she notes.
From there, she built the function deliberately: assembling a team grounded in trust and prior working relationships, designing processes where none existed, and integrating legal counsel into the fabric of executive decision-making. The legal department became not a gatekeeper but a partner, helping clinicians, administrators, and leaders navigate complexity without losing momentum.
Healthcare complexity as a leadership catalyst
Healthcare is often described as one of the most regulated industries in the world, but regulation is only part of the challenge. Springfield Clinic operates within a broader ecosystem that includes hospitals, Level I trauma centers, ambulatory surgery centers, rural outreach programs, and collaborations with other hospitals and health systems. Decisions ripple across clinical, financial, operational, and community dimensions.
Clatfelter’s fluency in clinical culture, shaped by her upbringing, helps her bridge gaps between legal analysis and physician realities. Independence, in particular, is a defining value at Springfield Clinic. Preserving it requires not just legal sophistication, but strategic foresight and sensitivity to physician governance.
In this environment, the CLO’s role is inherently integrative: aligning legal guidance with organizational values, patient care imperatives, and long-term sustainability.
Relationship capital and the power of community
One of the most distinctive aspects of Clatfelter’s leadership philosophy is her emphasis on relationships, inside and outside the organization. Over nearly two decades practicing in central Illinois, mentors became peers, peers became collaborators, and former colleagues became trusted counterparts across competing systems.
These relationships, she says, have been essential in moments that could otherwise have escalated. “We’ve become a channel for problem solving in the background,” she explains. High trust allows for candid conversations, de-escalation, and solutions that serve patient populations rather than institutional egos.
This sense of professional community reflects a broader trend in the in-house world. Modern CLOs increasingly recognize that credibility, influence, and effectiveness depend as much on external networks as internal authority.
Lawyers as strategists and culture carriers
Clatfelter is clear-eyed about the emotional and cultural dimensions of legal leadership. In moments of workforce reductions, reorganizations, or major change, legal leaders are often involved in both the decision-making and the communication. How those moments are handled can shape trust and morale for years.
“Our role is not just to protect the organization legally,” she says. “It’s to help lead with empathy and clarity, and to support the broader team through difficult moments.”
That perspective underscores how far the CLO role has evolved. Today’s legal leaders are expected to bring judgment, emotional intelligence, and strategic insight – qualities that cannot be captured in a checklist or playbook.
What the future of the CLO role looks like
Clatfelter’s journey reflects a broader shift underway across industries – and especially in healthcare. In-house legal roles are gaining traction as organizations increasingly recognize the value of having legal leaders embedded at the center of strategy, operations, and culture. The role may not come with a roadmap, but its impact has never been greater.
As more organizations invest in legal leadership earlier and more intentionally, the CLO is emerging not as a back-office function but as a critical driver of sound decision-making, resilience, and long-term success.
Explore more insights from modern CLOs on the Legal Leaders Podcast and connect with forward-thinking peers through the Legal Leaders Community.
