In health care, as in life, change is the only constant. Today, the tides of change are pushing the health care system toward ever greater shared accountability among physicians, hospitals, and payers. Whether that change will ultimately benefit patients — or simply become an exercise in rearranging the deck chairs on the Titanic — will depend, in large part, on the skill of those who are leading the movement. As physician leaders of three of the nation׳s largest integrated health care delivery systems — Kaiser Permanente, Virginia Mason Medical Center, and the Mayo Clinic Health System, respectively — we believe physicians must be central to this effort, in solid partnership with skilled administrators.

Among all providers, physicians have a disproportionate impact on the health care system and therefore have a disproportionate responsibility and opportunity to lead change. Patients experience their own health and the health care system in many ways: physically, socially, psychologically, and financially. As the first and primary point of contact with the health care system for most people, physicians must therefore act as caregivers, teachers, trusted information sources, and fiduciaries for their patients. They cannot and should not opt in and out of accountability toward their patients in any of these roles. In post-reform health care delivery systems, physicians are ideally positioned, and in fact compelled, to take responsibility for helping shape the health care system — not just their own practice — to better serve patients׳ physical, social, psychological, and financial needs. Many physicians in small, private practice are already experienced as civic and small-business leaders in their communities. However, the skills needed to run a small business and manage its resources are very different from those needed to lead delivery system change. This expanded paradigm of physician leadership cannot be accomplished working in isolation from the integrated systems of care, nor with indifference to the resources necessary to achieve good outcomes for entire populations.

We have a uniquely bright view of physicians׳ ability and willingness to take on this expanded leadership role. We also believe physicians can be led as trusted and respected members of a team that is greater than the sum of its parts. We call on physicians as a profession to view leadership — and the development of leaders — as key aspects of their role as advocate for their patients. In doing so, we draw on our 68 years of collective experience leading physicians into stable, respectful relationships with other delivery system stakeholders to support some of the most successful, patient-centered care systems in the nation.

Click here to read more about  “Why now, and why physicians?,” “What is a physician leader?,” and “Policy levers” in the full article by Drs. Jack Cochran, Gary S. Kaplan, and Robert E. Nesse in Healthcare: The Journal of Delivery Science and Innovation.