You’re two years into your first formal leadership role—responsible for an entire emergency department’s clinical operations. It’s 7:13 am. Your inbox dings with a new hospital policy, state guidance is contradicting yesterday’s, and the first COVID patient of the morning is already in resuscitation. Your phone vibrates with staff questions you can’t yet answer. At this crossroads, one fear rises above the rest: What if my decisions aren’t enough—for my team, my patients, or myself?
This isn’t just your anxiety; it’s the collective experience of clinicians-turned-leaders across the country, especially since the pandemic. The leap from clinical work to system-wide responsibility now requires more than clinical acumen; it demands vulnerability, rapid learning, and strategic communication. That’s why I’m sharing Dr. Chris Baugh’s story—a seasoned Emergency Medicine physician at Brigham and Women’s, who became Vice Chair of Clinical Affairs mid-pandemic. His journey offers not just inspiration, but real, applicable tactics for your own pivot from bedside to boardroom.
Picture this: In early 2020, as Vice Chair of Clinical Affairs, Dr. Baugh faced a perfect storm—PPE shortages, evolving science, staff fear, and a daily flood of policy updates. Every clinician leader in the U.S. was improvising. What stood out? The way Dr. Baugh responded: “This was an opportunity for me to stand tall and think about how I was going to support the patients coming through the department and our staff taking care of them.”
He didn’t just issue memos. Instead, Dr. Baugh curated daily department-wide messages, combining clinical data, policy changes, and words of solidarity—all co-signed with nurse and APP leaders. He emphasized clarity and connection, closing every update with “strength in love.” In an era of uncertainty, this unified, authentic communication built trust and combated misinformation.
Try This Today:
Send one message to your team that combines new information with a genuine check-in. Make it personal.
It’s tempting to wait until you “feel ready” before stepping into leadership. Dr. Baugh argues the opposite: “If you want to reach your full potential, that means growing, and that means being willing to fail—it means being willing to put yourself out there and be vulnerable.” He credits previous, sometimes painful career challenges for training him to lead through COVID, echoing the Stoic mantra Amor fati—love your fate.
In practice, that means embracing discomfort as essential to mastery. Leadership, especially in healthcare, is less about controlling what happens and more about how you respond. Dr. Baugh references the book Crucial Conversations as a tool for “seeing yourself from the third person” and maintaining patient-centered calm, even when emotions run high.
Case vignette:
Early in his vice chair role, Dr. Baugh faced a tense negotiation between nurses, physicians, and hospital administration over staffing shortages. Rather than power through with orders, he paused, acknowledged the tension, and opened the floor for staff fears. That vulnerability set the tone for a more honest—and ultimately successful—resolution.
Try This Today:
In your next tense conversation, pause. State your discomfort or uncertainty out loud. See what shifts.
Can your years at the bedside really make you a better administrator? Absolutely, says Dr. Baugh. “Working clinically gives you the perspective of where the gaps are—and how important those gaps are for patient care or clinician wellness.”
He shares that being present across all shifts—weekends, overnights, holidays—opened his eyes to how workflows break down in real time. For example, he learned that “solutions” designed for weekdays often fail at 2 am on a Sunday. That firsthand awareness became the basis for more resilient, system-wide protocols.
Story vignette:
When leading a project to redesign ED admissions, Dr. Baugh shadowed night-shift nurses and discovered the “admission bottleneck” wasn’t a staff issue, but a missing lab courier at midnight. The fix wasn’t more education, but a reallocated resource—something he would have missed without clinical immersion.
Try This Today:
Spend 30 minutes this week shadowing a shift or role outside your usual schedule. Take notes on workflow pain points.
Most clinicians see research as an academic pursuit—nice, but optional. Dr. Baugh flips this: “Research and developing a niche where you can become a deep content expert is a great part of my career… I like the idea of doing a literature search or review whenever I'm looking to solve a problem. The problem I have is probably a problem for other people too.”
He’s not exaggerating. By publishing quality improvement projects as articles, protocols, and “before and after” studies, he’s multiplied his impact far beyond Boston. “Once you get papers out into the universe… all of a sudden you’ll have someone reach out and say ‘Hey, we’re doing this study that’s similar to what you’re doing, we’d love for you to join us as a co-author.’”
Mini-case:
Dr. Baugh’s quality-improvement project on accelerated diagnostic pathways didn’t just improve local ED throughput; publishing it inspired three other health systems to adopt—and then adapt—the protocol. His advice? Start small: write up your process, even if only as an internal white paper.
Try This Today:
Document one recent workflow change—what prompted it, what you tried, what happened. Share it with your team or department.
Here’s the unglamorous truth: Most change initiatives fizzle after the launch party. The real work is sustaining change. Dr. Baugh shares, “I think the idea of sustaining change can sometimes be harder than the initial launch… We launch something, go to the next project, and say ‘job done.’ That’s the wrong way of thinking.”
So how do you build and maintain buy-in?
Connect change to direct patient outcomes.
Show data on “why now,” and the risk of status quo.
Involve frontline staff early—especially skeptics.
Quantify return on investment (ROI).
Clarify what resources are needed, and when results will be measured.
Map project benefits to larger organizational goals.
Vignette:
When introducing buprenorphine for opioid use disorder in the ED, Dr. Baugh didn’t just share research—he invited clinicians to learn the workflow, linked it to patient stories, and ensured bridge clinic follow-up was seamless. Administrators, meanwhile, saw the data: reduced readmissions, lower costs, and improved safety.
Try This Today:
Identify the “why” of your next proposed change for both clinicians and administrators—then craft two different 2-sentence pitches.
Dr. Baugh’s career embodies the “force multiplier” effect—his words, not mine. “I like to think that the literature I put out there is part of someone else’s lit search… and in that way, I can become a bit of a force multiplier in terms of clinical medicine, not just directly care for patients… but for patients all around the world.”
But, as he points out, truly integrating research into leadership requires:
Becoming a content expert—start with a deep dive into your area of interest.
Building a stakeholder group—bring everyone to the table, from nurses to administrators.
Iterating fast—the first draft doesn’t have to be good, just written.
Sustaining with data—measure, re-measure, and adjust over time.
Try This Today:
Next time you solve a workflow problem, run a quick literature search first. Borrow ideas shamelessly—and cite your sources.
What if you’re an administrator or new leader with little research experience? Dr. Baugh is direct:
“There’s many educational opportunities out there, most of them free, that help you acquire some basic skills… I’ve also personally included administrators as co-authors, especially on heavy operational projects. Even as a middle author, you get exposure and learn how the process works.”
Key tactics:
Audit a workshop or webinar on reading research.
Partner with clinicians or researchers—co-author a project, even if you only help with data collection.
Build a network of research-savvy colleagues to bounce ideas off.
Stay open to feedback—let trusted colleagues challenge your interpretations.
Try This Today:
Pick one research skill to develop this month—reading methods, critiquing results, or even co-authoring a QI project.
The through-line in Dr. Baugh’s story is clear: real leadership, especially in medicine, demands vulnerability and the willingness to grow publicly. It’s not about never being uncertain—it’s about owning your uncertainty, communicating it transparently, and rallying others to grow with you. The first step? Embrace discomfort as the price of real leadership, and put yourself in the flow of feedback—through data, conversations, or even just shadowing the night shift.
On your next shift, try this:
Ask one “stupid” question, admit one uncertainty, or invite feedback on a new idea. Growth always starts there.
