A Physician’s greatest threat is not business in itself.
It’s isolation.
How a Quiet Belief Stifles Growth, Fuels Burnout, and …

Article Written By Editor-in-Chief, Concierge Medicine Today | Winter 2025

This is always a hot vs. cold topic to address in healthcare. Few are FOR it, many are against it (although when you ask why the complaint cards come out). 

So, it’s not without a certain amount of skepticism, humility and trepidation we revisit this topic once again.

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In the early decades of modern American medicine, healthcare teams often included community leaders, administrators, and business-minded partners. Physicians didn’t do everything alone.

That said, the cultural tide shifted and here’s a little recap:

1. Scientific dominance reigned (1940s–1960s)
   Breakthroughs led to a belief that if it wasn’t medical… it wasn’t valuable.

2. Managed care’s rise (1970s–1990s)
   Administrators and insurers seized decision-making power. Clinicians felt powerless.

3. Regulation overload (2000s–present)
   Physicians became data clerks instead of decision-makers. Bitterness, cynicism, resentment and burnout increased among Physicians in most practicing circles, big and small.

The resulting worldview:

“Business hurts care. We must keep it far away from the bedside.”

Today, that belief has calcified over time (see what I did there!) into something akin to doctrine in a majority of clinician circles, societies, medical associations and the all the rest.

But is all the resistance and cynicism now the automatic default?

Some Physicians would say “Yes!”

Some Physicians would say “No.”

Today, there’s no doubt that from both side of the fence things have been said, mistakes were made and healthcare is plagued by poor leadership (albeit MBA-led or MD-led) — depending on who you wanna believe. Some would say business and healthcare put:

• Profit-first decisions and ignored people

• Administrators in places and spaces who don’t understand clinical reality

• “Efficiency projects” that added bureaucracy, not breathing room

• Consultants into places they should never have been in the first place — and whom disappeared immediately after the invoice is paid

So skepticism around business and consultants working in healthcare is completely understandable.
Necessary, even.

But skepticism has an evil twin: cynicism.
And cynicism pretends to protect you while actually shrinking your world.

When our minds close, so do our options.

What This Unhealthy Mindset Destroys

📉 Innovation stalls
Teams stop borrowing ideas that work in other industries.
(Goodall, 2015)

🔥 Burnout rises
When clinicians must “MacGyver” every business issue alone, exhaustion surges.
(Shanafelt et al., JAMA 2019)

❌ Patient care suffers
Quality improves when operational and clinical minds collaborate.
(AHRQ 2020; NEJM Catalyst 2022)

One hospitality leader famously said:

“Excellence cannot exist without efficiency.”

If it’s true that medicine loves excellence, is it also true that we are too quick to dismiss (and often reject) exercising the operational muscles needed to support it?

But here’s the rub and the unfortunate internal script we so often here in practicing circles and medical banquet halls:

“If you’re not a clinician like me, you can’t help me.”

That does sound good. It even seems brave.
It feels principled.

But here’s the other side of the coin: it shrinks your vision and puts a lid on your growth and impact as a Physician.

Hear me out. Your perspective doesn’t just uncover your path —
it determines it.

Meaning, if the only voices allowed at the strategy table are clinical ones, some of those practical, albeit maybe breakthrough ideas never get a seat.

Here’s a case in point. You’ve had great practice administrators work for you once. Why’d they leave? Did you “how” them right out the door? Or was it something else?

A healthier, more human approach might be to recognize rather than resist the idea that some of the strongest medical practices you admire today operate like championship teams:

• Clinical leaders guide the mission and lead patients to better outcomes

• Business leaders are invited (and sometime encouraged) to support and strengthen your mission to serve your local community in a contain you built!

• Experienced leaders protect the dignity of every patient

• Financial partners ensure it’s sustainable through any storm

Whatever you take from this today, all I’m trying to say is nobody loses authority if you are truly a Physician with a mature mindset about this topic. Some of the best Physicians I’ve had the pleasure of meeting know more about business because they studied it, they learned it and they surrounded themselves with people in business who could help them see their blind spots.

One concierge medicine physician we admire and respect around here when we asked “What benefits have you or others on your team experienced professionally (or personally) when you executed ‘The Practice of Delegation’ effectively. What happened. Please briefly describe … “ had this to write in response:

“The practice of delegation was core to the founding of the company. I learned quickly where I excelled and where I did not. I was not determined to be a master of all things, but rather delegated tasks to other leaders, who could do them better.”

Here’s a few ideas to consider. These are simple. Powerful. Immediately actionable.

✅ 1. Choose Curiosity Over Cynicism
Instead of reacting with “no,” ask:
“What can we learn from this?”
Curiosity fuels progress.

✅ 2. Invite Partners Who Share Your Mission
Look for experts whose success depends on your success.
Great collaborators are for your people — not just for the budget line.

✅ 3. Aim at a Shared Definition of “Better”
Business initiatives should enable:
• more listening
• more presence
• more human connection
Every operational decision should ask:
Does this help us care more deeply for patients?

Here’s the bottom line:

A Physician’s greatest threat is not business.
It’s isolation.

Healing is a team sport.
Every field has wisdom that can restore humanity to healthcare.
Wise partnerships don’t always dilute the mission — sometimes they multiply it.

Patients deserve a healthcare environment where caregivers are free to care…
because they are supported, not suffocated, by the people, processes and systems around them.

Let’s be a group in healthcare setting the standard for others to look up to.

Select Citations & Sources

• Shanafelt, T. et al. “Burnout and the Business Case for Physician Well-Being.” JAMA, 2019

• Goodall, A. “A Theory of Expert Leadership? Evidence from Healthcare.” Social Science & Medicine, 2015

• AHRQ. “The Role of Business Partnerships in Healthcare Quality,” 2020

• NEJM Catalyst. “Team-Based Leadership and Patient Outcomes,” 2022

• AMA. “The Business of Medicine: A Historical Analysis.” 2020

• Mayo Clinic Proceedings. “Leadership Structure & Organizational Success,” 2021