Empowerment over uncertainty: 5 keys to strengthen physician leadership in turbulent times

When the world shifts, the true measures of leadership — sound judgment, accountability and integrity — are laid bare. That moment is now. Global tensions, political disruptions, rapid advancements in artificial intelligence (AI) and declining trust in institutions have contributed to a new era of heightened uncertainty. Physicians and clinicians frequently navigate these intersecting forces while caring for patients, requiring them to adapt swiftly to change.

As health system leaders and practicing physicians, we hear the echoes of this uncertainty in the anxious questions of our patients and the growing fatigue of our colleagues. These are not isolated incidents; they are signals of a much broader transformation reshaping our entire industry. Over the next decade, $1 trillion in annual spending is expected to shift from fragmented, transactional health care systems to more efficient, digital-first and proactive value-based care models.

This movement will only succeed if it is led by the physicians and clinicians who deliver this care that brings true value to patients and the health system alike. Our goal is to provide the leadership needed to harness this talent, creating a safe and supportive environment where clinician voices drive the industry forward. In doing so, we protect our most essential resources: the credibility we share with our colleagues and the connections we have with our patients. The following are five strategies for empowering clinicians to lead a value-driven transformation of modern health care.

Listen first, lead second

Trust is not granted; it is earned through the practice of servant leadership. This starts with listening — setting aside time to hear doctors’ perspectives and using this feedback to drive meaningful change. Physician input was essential in implementing ambient AI listening technology for clinical note-taking in late 2024, aiming to reduce burnout and improve clinical visits. A real-time quality assurance feedback loop with clinicians helped enhance accuracy, electronic health record integration and medical interpretation and accommodate workflows. The rollout, one of the largest of its kind in modern medicine, successfully made the technology available to more than 25,000 physicians and clinicians in all our service areas. Users report that the tool has helped bring joy back into practicing medicine by saving thousands of hours of administrative time and allowing them to focus on patients.

Turn clarity into credibility

Amid shifting federal policies and rapid technological adoption, one of the most credible things a leader can do is acknowledge what is still unknown. To protect our teams from information overload, we must provide communication that is concise, relevant and timely. By proactively sharing the data and the “why” behind evolving policies, we demystify the decision-making process. This openness transforms a top-down mandate into a shared mission, ensuring that when challenges arise, every clinician feels empowered to be part of the solution. This is critically important given the conflicting guidance on vaccines and other preventive care measures. Physicians still rank among the most trusted sources of information and play a major role in communicating accurate, science-based information to patients to make informed care decisions.

Ensure safety, enhance care

We know that rising costs, long wait times and confusing guidelines can be deeply frustrating for patients and families. While incidents of conflict are on the rise, they can and should be prevented. Our priority is to ensure that clinics and hospitals remain calm, safe havens for everyone. This requires a multilayered approach, including training care teams to de-escalate potentially violent situations, installing protective measures like increased security and metal detectors in some facilities, community and law-enforcement outreach, advocacy with policy leaders and responding promptly to safety concerns. When we feel safe, we can focus on what truly matters: patient health and the shared journey toward healing.

Invest in resilience, support career growth

We build trust by treating wellness as a core business priority. This starts with the philosophy that physicians and clinicians focus on care rather than driving income for the health care system. Removing obstacles such as administrative work and prior authorization, and making investments in services to support their well-being, especially those in high-burnout specialties, are critically important. From meeting their mental health needs to establishing wellness champions, clinicians benefit from the opportunity to disconnect and recharge through structured programs that allow them to engage with their colleagues. Research shows retention and job satisfaction rates follow. But resilience isn’t built on recovery alone. It also requires continuous leadership development, ensuring that physicians and clinicians at every level of the organization are guided and mentored by those who have walked the same path as those who came before them. A strong clinical workforce is fundamental to the practice of value-based care, with physician leadership as a key driver for system transformation.

Tackle tough challenges with physician talent

When physicians and clinicians feel safe, supported and empowered, they are driven to innovate. By championing them to lead clinical research or process improvements — such as the Northern California colorectal cancer screening program that cut death rates in half — they redefine medical excellence. Physician-led design further transformed the patient experience through the Southern California Permanente Medical Group’s (SCPMG) “point-of-care” hemoglobin A1c program, which provides immediate results and counseling in a single visit, and The Southeast Permanente Medical Group’s remote monitoring for high-risk pregnancies.

Physicians are also tackling access and improving the patient experience through AI-driven patient portals and inbox management. We see this in The Permanente Medical Group’s Desktop Medicine initiative, which processes millions of patient messages — labeling 77.6% by topic and resolving nearly one-third without physician intervention. Similarly, SCPMG’s Smart Messaging Tool streamlines communication by filtering millions of messages to identify high-acuity cases requiring rapid review. Beyond the metrics, these interventions simplify care pathways for patients and clinicians alike.

We know that the decisions we make today will define the future of medicine. As we navigate the shift toward value-based care, success depends on our ability to build a health system that harnesses physician expertise and deploys technology to return the focus to caring for patients. This is why we are investing in tools and providing support that allow clinicians to lead. Through this commitment, we do more than manage a transformation; we build the trust necessary to sustain it.

Maria Ansari, M.D., FACC, is CEO and executive director of The Permanente Medical Group; president and CEO of Mid-Atlantic Permanente Medical Group; CEO of Northwest Permanente; and co-CEO of The Permanente Federation.

Ramin Davidoff, M.D., is executive medical director and board chair of the Southern California Permanente Medical Group; board chair and CEO of The Southeast Permanente Medical Group; board chair and CEO of The Hawaii Permanente Medical Group; and co-CEO of The Permanente Federation.