Every physician is a leader, most just don't know it yet

Leon Moores, M.D., has led teams in places where the stakes don't get much higher — as an infantry officer and combat-zone physician in the U.S. Army, as chief of neurosurgery at Walter Reed and, later, as CEO of one of northern Virginia's largest medical groups. These days he's a pediatric neurological surgeon at Inova Health System and the author of "All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes." He has spent nearly four decades moving between clinical and executive roles, and that range has given him a specific view of where physician leaders consistently fall short.

Medical Economics sat down with Moores to talk about what medical teams actually need from their leaders during uncertain times, why projecting false confidence tends to backfire and why he believes the single most powerful thing a physician leader can do this week costs nothing and takes about two minutes.

All physicians already know how to lead

Early in the conversation, Moores makes a point that reframes leadership for physicians who don't think of themselves as leaders. Ask a hundred doctors to name a physician leader, he said, and almost every answer will be a title — medical director, chief of service, chair, chief medical officer. But leadership, by its most basic definition, is influencing behavior to achieve a desired outcome. By that measure, every physician is leading every day: persuading patients to change behavior, directing teams in the OR or ICU, coordinating care across specialties.

"The fact that we are not more explicit about that with medical students, residents and young faculty means we are missing opportunities to teach and coach that skill," Moores said. The clinical method — gather information, formulate a plan, evaluate, adjust — is already a leadership loop. Most physicians just haven't been asked to think of it that way.

What do teams actually need when things are uncertain?

Moores draws a clear line between the kind of steadiness that builds trust and the kind of false confidence that erodes it. The instinct to project certainty in uncertain times is understandable, he said, but it backfires. Teams don't need a leader who pretends everything is fine when it obviously isn't. They need what he calls "a credible stabilizing force" — someone who acknowledges what's happening, is honest about what isn't yet known and models the kind of calm that makes it possible for others to function.

He pointed to a real-world failure mode he witnessed during an electronic health record rollout. Senior leadership kept talking about how well the system was working — but they weren't the ones using it, and the people who were could see exactly how wide the gap was between the message and the reality. "That kind of 'pay no attention to the man behind the curtain' leadership does not help," he said.

The parallel to clinical medicine is direct. Physicians already know how to be honest with patients when the data is incomplete. "This is what we know right now. As we learn more, things may change."

That same framing, he argues, is exactly what teams need from their leaders — and it's already in physicians' toolkit.

Why psychological safety matters more than any communication framework

Moores spent considerable time on psychological safety — not as an abstract concept but as a practical operating condition. In high-stakes environments, people are less likely to speak up unless they feel genuinely safe doing so. And the cost of silence can be significant.

He offered a concrete example: a recent night in the operating room where the combined experience of everyone in the room added up to 123 years. "If every one of those people does not feel comfortable asking a question," he said, "then you are missing out on something that could help your patient."

The behaviors that build that safety are small and repeatable: turning toward someone when they speak, making eye contact, following up when you say you will, and visibly celebrating when someone raises a concern — even if they turn out to be wrong. The behaviors that destroy it are equally small: brushing someone off, saying "catch me later" while walking down the hall, snapping under pressure. "Comments like 'stay in your lane' are not useful," Moores said. "They do the exact opposite of what you need."

The one thing physician leaders can do this week

"I do not think any of us listen enough or as intently as we could, and that is a switch you can flip pretty quickly just by being mindful of it," he said. His prescription is specific: when someone speaks to you, look up from the computer, put the phone away, turn your body toward them and sit down if you can. Research suggests that sitting, even briefly, makes people feel the interaction lasted longer than it did.

Done consistently and visibly, he said, it compounds. "Over time, people will say, 'He really listened to me,' and that goes a long way." In a profession where the pressure to move to the next task is relentless, that kind of deliberate attention is rarer than it should be — and more powerful than most physician leaders realize.