Building our future: a plea for leadership.

In recent years the spastic nature of the health care marketplace has continued to increase, which has greatly escalated the demands of leadership in academic medical centers. The expectations of leaders, including surgery chairs, have increased considerably, whereas their capacity for independent action has undeniably diminished. In such a predicament, it is useful to revisit fundamentals, using them as a guide to build a sound future. Five leadership principles are critical to building a better future: (1) recognizing that the work of leadership involves an inward journey of self-discovery and self-development; (2) establishing clarity around a set of core values that guide the organization as it pursues its goals; (3) communicating a clear sense of purpose and vision that inspires widespread commitment to a shared sense of destiny; (4) building a culture of excellence and accountability throughout the entire organization; and (5) creating a culture that emphasizes the development of leaders and leadership as an organizational capacity. Leadership and learning are inextricably linked. We must change the perception that learning in academic surgery is about correcting a deficit rather than a natural part of human growth and development. Our ability to learn, grow, and contribute to an organization is what provides each of us with meaning and identity. This feeling of being part of something special that is larger than ourselves is a powerful force and an important dividend of great leadership.