Somewhere along the way, physicians were replaced by lawyers and business administrators when it comes to running healthcare. Margins grew thinner, healthcare conglomerates emerged, and competition between practices increased.

This has drawn lots of criticism, and in recent years physicians have gradually been reinstated in leadership roles. It has taken a global pandemic, however, to propel this issue front and center. COVID-19 has shown us that healthcare isn’t just another business, and right now we need physicians in leadership roles more than ever.

‘Every physician must understand that we all have leadership roles, and we must lead to the best of our abilities,” write the authors of this article on physician leadership during COVID-19, published in the Journal of Bone & Joint Surgery. “Our patients and communities, our country, and the world are counting on the physician community to step up and act thoughtfully in doing what is best for current and future patients.”

Physicians have been stepping up, from Dr. Anthony Fauci on a national level to many others at regional and local levels.

“People have come forward and really created amazing leadership teams addressing the clinical issues, not just with algorithms for patient care but in best practices for using PPE,” Dr. Jaime Hatcher-Martin, a Georgia neurologist, told us. “By need, it’s allowed people to really speak to what’s important to the patient. It’s given a lot of physicians the chance to show their leadership skills. Personally, in some cases, I think they really just haven’t previously been given the opportunity.”

Dr. Heidi Schwarz, a neurologist at the University of Rochester Medical Center in New York, added: “All of a sudden the physicians are driving the ship again. And there is so much more collaboration now.”

This has included collaborative work on a vaccine between her institution and “the competitors across town.”

There is a divide between healthcare institutions in most cities, she says, stoked by the ever-more-competitive pursuit of bigger pieces of the healthcare pie. There’s also evidence of the good outcomes of physician leadership, researchers say. A U.S. News and World Report study found that hospital run by physicians scored 25 percent higher on quality rankings than hospitals run by managers.

“Physicians are the ones on the frontlines. They are the ones actually doing the work. They have the knowledge,” says Hatcher-Martin. “COVID-19 has highlighted that we have to be careful. This is not just producing toilet paper — you can’t have these tiny narrow margins.”

Above all, the business of healthcare has to put patients, not shareholders, first.

“The pandemic has made it painfully clear to the bean counters that if that’s all you’re looking at, you’re not going to survive what’s happening next in medicine,” Schwarz says.

Special thanks to the following neurologists for their insights on this issue: