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PRESIDENT’S
MESSAGE

Physician Leadership

in a Pandemic

By Gerald Q. Greenfield Jr., MD, 2020 BCMS President

The current pan- portunity to lead can political leaders be empowered to make pru-
demic points out, dent and appropriate decisions.
once again, the Political leaders, however, also have a role to fulfill. The job of
need for physician political leadership includes providing security for the population,
leadership, especially with health care issues. Fear of the unknown, financial support in case of disaster and maintenance of order in
guarded only by the knowledge and skill of physicians, is what can the society. In order to accomplish this, the political leadership
restore balance in a chaotic world. As is evident in reports and must provide a safe living area, source of income and the promise
commentaries, the population trusts the word of physicians and of economic stability. When appropriate medical recommendations
medical leaders to a far greater degree than it does the word of are offered as solutions to ongoing public health issues, political
elected or appointed political leaders. leadership must assure that they are instituted. The political lead-
As COVID-19 rampages across this country and indeed across ership is responsible to the population to provide timely and accu-
the world, medical professionals are at the vanguard. Nurses, physi- rate information based on objective evidence; only then can
cian assistants, therapists, medical assistants, and physicians are the accurate forecasting for the health and economic well-being of the
frontline combatants against the “invisible enemy”. Instead of bul- people be reached.
lets, rocket-propelled grenades and bombs, the fighting forces uti- The final level of responsibility lies with each individual member
lize soap, alcohol, pharmaceuticals and mechanical ventilators. of the society. When appropriate public health information is pro-
Rather than meet the enemy head-on in a frontal assault, the front- vided by medical professionals, is transmitted accurately by political
line forces use social distancing and asymmetric warfare techniques. leaders, and finally is applicable to the ongoing problem, have all
The techniques are guerilla tactics reminiscent of those used by met their obligations. Should members of the population then
the American colonists and Francis Marion (The Swamp Fox). choose to ignore those recommendations, they then accept respon-
Wars of attrition are won by the side which can persist; with pa- sibility for the outcome of their decisions. If those people then
tience and taking the long view. When the tactics in use are suc- become ill, is it fair to then expect front line workers to now risk
cessful, persistence offers the best chance of victory. It is only their lives in order to rescue them? Is it fair to ask those front-line
when change will provide a greater or more rapid chance to reach workers to now be required to correct the poor decisions? If so,
the goal, with less loss of life, that a tactical shift is reasonable. at what cost?
When bystanders in the population (the locals) seek to highjack Given the opportunity, the physician community will lead and
the tactical role, danger and the risk of loss of life rise precipitously. meet the challenges facing medicine in our community in this pan-
It rises not only for them, but also for the front-line defenders. In demic. The solutions to health and good outcome require the pop-
the current pandemic the locals are the population. They are at the ulation to support evidence-based medicine and listen to physicians
greatest risk of becoming wounded (infected). This will then obli- who have dedicated their lives to keeping them well.
gate the medical professionals to rescue or save them. But in order
to do so, the front-line, true medical professionals will put at risk Gerald Greenfield, MD, is an Orthopedic Surgeon in Bexar County and
their own health and lives. It is only when medical professionals is the 2020 President of the Bexar County Medical Society.
(the generals in this war) are given the authority or seize the op-

8 San Antonio Medicine • June 2020