The Meeting That Had No Idea Why It Existed

Meetings without a clear purpose are a waste

Physicians already run superb meetings. A code has a leader, defined roles, one goal, and a decision at the end. So does morning rounds. So does tumor board. Then the same physician walks into a 2 p.m. committee meeting and forgets all of it.

This post tells the story of a clinic executive committee that met for years without anyone asking what it was for. It had no governance structure, no minutes, and made no real decisions — and when it kept running over, the group solved the problem by making the meeting longer.

Meetings earn their place on the calendar only when they do a specific job. Name the purpose before you gather the people.

  • 8 mins

The Medical Arts Building — What Is Lost and What We Still Have

As medicine evolves, is the art of medicine lost?

When I arrived in Ashland, Wisconsin for my first job out of training, a building stopped me. It had the name “Medical Arts” on it, proud for the whole town to see. My teachers had always called medicine an art and a science. They never mentioned the third word that medicine always was as well: business. And it's the business of medicine that has quietly erased those Medical Arts buildings across the north woods. The one in Ashland is apartments now. This post uses my own first practice, sold to a large health system before I arrived, to trace what physicians give up in that trade and the voice they don't have to. The lesson for any leader with more influence than authority: when you carry a strong argument and a sore spot, keep them in separate sentences.

  • 9 mins

A Short Note and a Short Break

I’m not going to publish a post this week, and I may not for a couple of weeks after that. My father passed away this week. I’ve built this blog around a belief that leadership and communication mean nothing if…

  • 1 min

Leading Peers: How to Influence People Who Don’t Report to You

Leadership is about influence, not about authority

When I became chief resident 25 years ago, the title came with a $1,000 a year increase in stipend and authority over the call schedule — yet I still spent the year asking peers for favors. That paradox opens a hard truth about medicine: authority rarely works, even when you have it. Every physician is independently licensed, and replacing an unhappy one costs a fortune. So leaders at every level run on influence, not authority. Drawing on a spring-break scheduling standoff between two psychiatrists I once supervised, we see how to move people who don't have to move — asking before telling, letting facts speak, reframing the stakes, and let them find their way. And when influence fails? Protect the relationship and try a different key.

  • 10 mins

Why New Leaders Shouldn’t Trust Their First Instinct

Rushing to judgment is a big mistake a new leader can make

Early in my first leadership role at a state psychiatric hospital, I learned that a patient was sitting on a locked ward, psychotic and untreated, because her physician had never filed a court petition for involuntary treatment. My first instinct was discipline — the union process, the medical staff committee. A mentor stopped me with four simple questions, and those questions revealed the truth: the doctor wasn't indifferent, he was inexperienced, having never petitioned a court in his long career. A verdict reached in anger became a conversation, a learning moment, and a treated patient. This post uses that story to show new leaders why a verdict reached early may be wrong, and why having a mentor is a necessity when stepping into leadership.

  • 6 mins

What Physician Leaders Must Do Before Deploying ‘AI Therapy’

Emotional support validates and comforts. Psychotherapy comforts AND transforms.

AI chatbots are everywhere. Some people now treat them as therapy. They aren't. This post draws a clear line between emotional support — comfort, listening, reassurance, available from almost anyone — and psychotherapy, which is a clinical treatment delivered by a trained professional who assesses, diagnoses, and is accountable for the result. Using psychiatrist Dr. Steven Reidbord's gym-versus-cardiologist comparison, it explains why tools engineered to be agreeable are excellent at comfort but unfit for care. Confusing the two has already cost lives. Physician leaders have a special responsibility to help their organizations see the difference. This post shows them how.

  • 8 mins