Doctors as system leaders: medical professionalism and 'making a stand'

Regional collaborative networks are an important focus of healthcare policy around the world. Doctors are increasingly taking up roles as 'system leaders' in these networks. These roles are seen as important for facilitating collaboration between stakeholders to coordinate services and foster innovation. Drawing from a study of 12 senior medical leaders who have taken on the new role of 'Chief Medical Officer' in the Integrated Care Systems in England, we explore how they understand and enact these new system leadership roles. We develop a novel theoretical perspective on medical professionalism as a mode of governance. We contribute original insights on new forms of solidarity and collective action that have important governing mechanisms and effects, such as engaging intrinsic motivation, countering coercive management hierarchies to advance the interests of patients; and 'making a stand' on moral issues. Our analysis rebalances the focus on knowledge in the sociology of the professions. The profession remains an important sociological category because professional ethics continue to furnish meaning and guide action. A professional concern for quality, intrinsic motivation, and professional integrity can promote population health and health equity and uphold the quality and safety of patient care. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.]