9: Conclusion

Clinical leaders are essential for recovering from the COVID-19 pandemic. Paradoxically, the pandemic may have provided a unique opportunity to implement and attain the hybridisation of doctors into leaders. Hospitals have always played a vital role in well-being. They provide care to the ill and indispensable services that, when successful, restore and enhance quality of life. For this reason, it is fundamental to show political courage to change the system for the better.

Granting wide-reaching discretion and decisional power to physicians can subvert conventional bureaucracy, which rests on the theory of control by regulations and codes of conduct to oversee doctors' behaviours, otherwise patients would not be protected against potentially poor treatment choices and low-quality services. Contrary to Weber and his theory, the answer to these risks – which exist even in advanced countries such as Italy for instance, a leader in healthcare outcomes – is to devise a check-and-balance scheme that allows physicians to decide without restraint and evaluate their performance not by observation of a mere procedure but rather using indicators of quality of services provided and financial resources invested. The performance results should be linked to a reward/punishment system to incentivise healthcare professionals to achieve the outcomes expected. Only in this way may doctors assume both medical and managerial duties and become clinical leaders.