October 7, 2026 Salus Forum

Warren

I would emphasize the importance of being aware when you’re on the edge. I sort of agree with both you and Jack, but the other thing that I want to have in contemporary leadership is the sense that things can be different, and that it must change. That’s where vision comes from. Once you try to figure out how to get things done, that’s where systems sense is engaged. The notion that you could actually do something different is what I think is important about confidence. However, we’re no longer the people throwing bombs, we’ve become mainstream, Jack. I keep a list of cases that just anger me. We must instead say: that’s why I’m here. This is why I want to change the system. I found it useful to have cases that fuel my fires along those lines. But part of what I think is the kind of transformative leadership we’re talking about is having a sense that things can and should be different. And I think that is another part of the leadership trait here. And again, to Jenny’s point, is that intrinsic or is it learned? Probably a combination of both.

Bill B

I want to go back to one of the points that Warren was making early on about how do we train leadership? How to work with prospective leaders. I was involved for many years in leadership development. One of the leadership development tools was invented by you folks in medicine. It is the Balint Method, (which has been used for clinical training. I used it extensively concerning leadership issues. Where you bring people together, one person presents their leadership issue. Other members of the group take on one of the perspectives, roles or concerns of the presenter. These group members then deliberate with one another as if they were the perspectives, roles and concerns operating inside the presenter’s head and heart. The presenter observers what is going on in front of th em, rather than inside them. Rich insights emerge for the presenter as well as other members of the group. This method is an extraordinarily useful piece in leadership development.

The second thing concerns what Warren was talking about. Several times Warren talked about systems thinking. Warren, I think you mentioned MIT. I had the wonderful pleasure of working with the folks at MIT. Particularly, Danelle (Dana) Meadows. I used to promote a lot of systems thinking with many leadership groups, including the leadership of a large worldwide church.  I would sit down with a group of ministers who would use a church-related simulation I prepared. I would actually bring in a model of a church or a system of churches when working with a group of church leaders. We would work with what happens when you introduce change in the church or system of churches. What’s the likely backfire? What’s the delay function? So we play with systems that operate like real systems. I would suggest that we’re not doing enough with simulations, I think. And the tools are becoming increasingly powerful. I hate to say it, some with the use of AI, but we can play with systems and people begin to appreciate how systems really work by playing with them rather than just talking about them.

Walt

Leadership is an integral part of playing the role of family doctor. It always has been. It’s becoming even more important if family physicians are to exist, let alone contribute to a healthy future. If we think where medicine’s going to be in 10 years, 50 years, 100 years, leadership needs to be something that we just embrace along with followership. Warren mentioned transformative leadership. We need maintenance leadership. We need management. We need so many dimensions of this. And some of them are very appropriate for a medical student, for a resident, for a fellow, for a recent graduate. It’s a very big, big area. But I think having us officially ensure that there’s an organized, agreed to, supported way for it to be a part of playing a role, in this case, it’s the role of family doctors.

I mean, with Bill Berquist et al, it’s much larger. It’s the world we’re talking about. But I’m just saying family doctors because having Warren here enables us to focus on this role. Beyond that, what kind of leadership? And that’s where the excitement has been since February when we first started to address the issue of master adaptive leadership. That’s a nuance. It doesn’t exist anywhere as an actual title.