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Physician leadership is key to creating a safer, more reliable health care system.

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This position paper by ACPE's President and CEO outlines the value of physician leadership and explains why leadership and business activities must start and end with the patient's clinical needs foremost in mind.

Unemployment, home foreclosures, and a rising percentage of uninsured families are just a few of the casualties of the recent downturn in the economy. With these developments, there are growing questions about the ability of our health care system to handle the social and medical fallout of these stresses on individuals and businesses. With our current system of health care finance and delivery, even if the financial sector is stabilized, health care coverage, cost, and access issues are likely to plague American business for years to come. Therefore, it is reasonable to believe that major opportunities for change will emerge from the current chaos of our economy and health care industry.

Combined with the economic factors affecting health care, we are facing a shortage of primary care physicians. This shortage will become even more apparent if universal coverage becomes reality. We believe primary care physicians need to be prepared to lead groups of mid-level health care professionals, who will become the more convenient and less costly alternative to most physician-patient encounters of today.

We are hearing from physicians and health systems across the country that economic pressures are pushing physicians and hospitals into integration discussions--again. Not wanting to repeat some of the failed experiences of integration in the 90s, both sides are trying to find fresh approaches to working together that are more satisfying and productive.

This article will describe what physicians can do to be a force helping to create positive change within health care. We will show how a new and more effective business model for health care delivery should leverage a clinical model that is focused on a patient or consumer. Building on the concerns, priorities, and decisions made by patients and their physicians, we believe that health systems can no longer view clinical activities separately from management and administration. Leadership and business activities must start and end with the patients' clinical needs foremost in mind.

It is a model that should resonate with all other clinicians as well as our managerial colleagues on the health care team. It will require us to be open and curious to new...

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