We’ve confused visibility with leadership in medicine.
When we were developing the new medical school in Greenville, Andrew Sorensen — former president of the University of South Carolina — told me there are two ways to lead. As a band leader or as a shepherd. I’ll be honest — I spent years thinking the band leader was the model to aspire to.
The band leader is out front. Charismatic. Certain. Everyone plays the same song, at the same tempo, under the same direction. There’s a place for that. But understand what you’re signing up for when you follow one — you’re joining their band. Their song. Their stage.
For physicians who are worn down and just want to practice medicine without the weight of running a business, fighting payers, or navigating consolidation alone — I understand the appeal. Another band, a different song. Sometimes that’s what you need.
But if you still feel the original calling — if you went into medicine with a specific sense of purpose, a commitment to your patients, a practice you built on your own terms — then following a band leader will eventually feel like losing yourself.
What you’re looking for is a shepherd.
The shepherd knows every member of the flock — not as a group, but as individuals. Their pace. Their strengths. The ones who move confidently and the ones who need a little more time. The shepherd doesn’t ask the flock to conform to a single speed on their journey. The shepherd learns the terrain so others don’t have to fear it.
This kind of leadership is quieter. It requires more patience, more presence, and a genuine respect for the fact that the physician next to you came into medicine with their own calling — not yours. It means celebrating when someone in your flock finds their footing, even if it looks nothing like the path you would have chosen.
That’s harder than standing in front of a room and setting the tempo. But it’s also more fulfilling — for the leader and for everyone being led.
Because when a shepherd does their job well, the flock doesn’t just stay together. Each member of it thrives.
I’ve spent my career in medicine — as a vascular surgeon, chair of the American Board of Surgery, president of a health system, building a medical school, and now leading organizations focused on physician autonomy — and the most important thing I’ve learned about leadership is this:
The best leaders in healthcare aren’t the ones commanding the stage. They’re the ones making sure you still have one.
Find the shepherds. They’re the ones who will respect your practice, honor your calling, and protect your right to lead it your way. Thanks, President Sorensen. Sometimes a Tiger can even learn from a Gamecock.
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