October 7, 2026 Salus Forum

The October 7, 2026 Salus Forum was the  twenty-fifth in the series. This forum was attended by Mitch Applegate, Bill Bergquist, Jenny Chen, Jeremy Fish, Bill Gillanders, Howard Haft, Walt Mills, Perry Pugno, Mark Vukalcic, and Jack Westfall.  Dr. Warren Newton was invited to attend. The Trigger topic for this forum was provided by Dr. Newton. He offered his own perspectives on leadership in the health care community.

Warren

My name is Warren Newton. I currently serve as the president of ABFM and I’m also a recovering residency director back a lg time ago. I’ve done a lot of large-scale practice improvement across the state of North Carolina, which is relevant to this talk. I’d like to talk about three different things. I’m really intrigued with the question of what kind of leadership we are trying to train and develop in healthcare. The question is really important for the future of family medicine.

I thought it might be useful to start by reflecting on how to teach leadership. What are the right ways that at least in my experience have either worked or not worked. I realize that there’s a number of people attend this Salus forum who have a lot of wisdom about leadership development; however, I think if we talk about how do we teach about leadership. This might help us get to where we’re trying to arrive.

As many of you know, a lot of my clinical experience has been starting the first hospital service at the University of North Carolina. This was back in the late nineties. I’ve always believed that in residency training, one of the things that I really thought was useful about inpatient care was the opportunity to train managers and leaders. Running a team, setting expectations. Interacting with them in a very busy environment was a great culture for developing leadership.

And one of the things we did was to try to bring that out in various ways. It was like a formal curriculum about leadership as people moved from internship to a supervisory role. One thing I never completely figured out is how to do that in the context of an outpatient team. You of course start with attribution, but how do you get at the hiring and firing decisions—those kinds of practical issues. I’ve done a lot of work in what we used to call quality improvement. I am aware that somewhere in the early 2010s, the label increasingly began to be performance improvement rather than quality improvement.

I’m really worried where some of that teaching is now. Where is it in good hands, with someone trying to improve care for more than one cycle. This forces you to get at some of the system sense that is so important. When one thing doesn’t work, (when you see that measure goes down as they typically, but then what are the issues? It forces you to think about broad areas. Of course, there’s didactics. And there’s a lot of different ways of doing that. Oftentimes some flavor of Myers-Briggs is used and other things. I think that can be useful, but sort of where I am right now, concerns what kind of leadership we’re trying to train. And I’m intrigued with learning more. Jeremy in your sheet, it was more about what adaptive leadership looks like.

I would say if I’m looking at my own journey, I do a lot of reading and thinking about leadership but a lot of it is experience and reflection. It’s not, you go to servant leadership is sexy. So you hear people talking about service leadership and you say, well, I think there’s part I like and I move on. But for me personally, (and this isn’t necessarily a curriculum) you get involved in something and then you reflect on it and you try to grow over your career.