Not a rah-rah battle cry, “Be bold,” but rather encouragement to help give a provider the agency to move forward and drive change. The kind of bold that, at times, is necessary to survive our current, fast-paced, evolving health care system. The kind of bold attitude that can create solutions despite the risk of uncertain outcomes in an uncertain future. This bold effort is all to preserve what you have already built and to create a future with sweat equity that builds what is next—not one that was built around or, worse, on top of you.
The “do something that scares you each day” kind of bold is different. This type is more like a football game on the line, fourth-and-two; you must go for it because everyone knows the cost of punting. It is almost as if your profession and career are on the line. This is happening now, whether you show up for it or not.
I was in a meeting recently about how to fix health care. It was easy for our group to pick a problem; in fact, the list was long within minutes. But almost out of nowhere, someone said it. Not a slide, not a strategy deck—just 2 words casually dropped into the middle of the conversation: be bold.
Why? Simple. Almost too simple. Health care, especially ophthalmology, is at a genuine inflection point right now. Supply is outpacing demand in ways our training never prepared us for. Technology is creating efficiencies we hoped for decades ago, yet it also brings a level of uncertainty never faced before. And the doctor-patient relationship, the thing that actually brought most of us into this field, is shifting under our feet. Some of that shift is intentional. Some of it is happening while we were unintentionally not paying attention.
I want to walk through what boldness actually looks like in 3 places at once: in the exam room with your patients, inside the practice or system where you work, and across the profession as a whole.
The Exam Room: Doctor and Patient
Let's start by looking back at what electronic health records did to our profession. It benefited everyone except the provider standing in the exam room. Now every corner of the health care system is deploying artificial intelligence (AI), and somehow the analysis and the burden keep landing back on the doctor. It fills the schedule, so you're fully booked with no gaps left to catch up. Everyone else in the office is fully booked too, as staff and exam rooms are stretched thinner across the day. It helps middle management with audits and compliance, which mostly means more documentation and more time providers need to learn how to do it right. Scribes powered by AI are not the solution. But wait—who is bringing AI into the exam room to support the doctor-patient interaction, and who is actually helping you with your patients?
It should be you. Why? Because only the providers actually working the floor understand what it takes to preserve a relationship built on trust. Only then can AI be leveraged to earn that same trust. The final call on every clinical decision still belongs to you. After all, you are the one signing the chart. You're the only person in the room with a medical license. It certainly is not the AI. Well, not yet. Artificial intelligence is growing exponentially. We providers need to attempt to ride the wave rather than let it crash down on us.
As you question your ability to shape the evolution of health care, ask yourself: Are the entrepreneurs, the computer scientists, and the businesses building this technology smarter than you? Better trained? Better positioned? Do they care as passionately about trust in our system as you do? Not a chance. Your street cred was earned in exam rooms and operating rooms, and it outweighs anything a large learning model or a computer science grad can claim. They just moved first.
Boldness here isn't resistance. It's insistence on being in the room where these tools get designed, not just the room where they get handed to us. If physicians don't help build it, we will simply be the ones it is used on.
The Practice: Employee, Owner, Stakeholder
Inside our own walls, the pressure looks different but harmonizes with the same tune. Hospitals watching revenue cycle management. Practices tracking billing, throughput, days off. Analytics on everything, applied to everyone.
Data synthesis has accelerated to the point where we can measure almost anything in real time, which is genuinely useful. But we need to watch closely how and when the data reach the provider, and especially what that looks like once it follows us into the exam room. It could get to the point where I step out for a bathroom break, grab a coffee, and come back to a text message asking why my productivity dropped 50% in the last 20 minutes. I wasn't hiding. I was being human. A dashboard never knows the difference between a coffee break and a crisis.
This isn't hypothetical. I watched it happen in real time at one of our sites: A manager started sending weekly productivity reports to providers—numbers with no context attached, just data and an implicit question of what is wrong. Everyone felt watched. Doctors got stressed. A few started talking about leaving. The reports were right but, on the streets, wrong. They were corrosive.
So, we stopped it fast and did something different. We had managers sit down with providers and ask a simpler question first: What are your goals for productivity and for the clinic? Then, how can we actually support you in reaching them? Only after that did we ask which analytics would help, and how often anyone actually wanted to see them. We layered in benchmarks so people had real context for where they stood, not just a raw number with no comparison. It worked. Same data, same technology. The only thing that changed was who got to define why it existed.
Do not allow your job description to define you. Somebody, somewhere, is going to decide what metric matters. It might as well be a physician in the room saying which ones actually reflect care, and which ones just reflect how easy something is to count.
Why Bold Efforts Fail (And How to Make Yours Stick)
My daughter recently moved into her college apartment, and I built her only dresser. Three hours. Two Band-Aids. One Allen wrench that vanished somewhere around hour 2 and was never seen again. In an honest, transparent moment, it is not, structurally speaking, a great piece of furniture. But every time I walk into her room, I stare at that dresser as if it belongs in a museum. I might even feel a little tear well up. I built that.
There's a name for what's happening to me, and it applies directly to health care's AI moment. Boston Consulting Groups's Julia Dhar, drawing on research called the IKEA effect, describes "people who have had a hand in creating something" as ending up disproportionately attached to it.1 I am guilty. I am so proud of my own lopsided handiwork, more than I would ever be of a flawless version someone else assembled for me.
That's the whole argument for providers advocating for, or being given, a real seat at the table on AI in the clinical pathway. Not a survey afterward. Not a rollout memo. Actual input on the how, the when, and a straight answer to the why, before the tool ever touches a patient encounter. Physicians who help build the thing end up not resenting it, quietly sabotaging it, or waiting it out until it fails. Providers will defend it, the same way I am required to defend my…I mean, my daughter’s dresser until the day it falls apart, which is likely sooner rather than later. Ownership is tied to success.
The System: What We Actually Are
Zoom out, and you should begin to question whether a health care system exists. Many believe it is not inherently healthy. Not always caring. And "system" implies something coherent, something designed. In fact, most days feel like a pile of incentives, vendors, payers, and platforms that each provider is just trying to navigate.
But what happens in your exam room does not have to stay in your exam room. Every clinical decision, every place you push back, every place you lean in, multiplied across tens of thousands of physicians doing something similar every single day, is the actual mechanism by which that so-called system evolves to a better build. Not by policy alone. Not by hospital administrators alone. By us, one decision at a time.
There is a real opening happening now. Artificial intelligence is forcing a redefinition of our profession, whether any of us opt in or not. That's the real opening. This is bigger than surviving the next 5 years. It's recognizing that a shift this size, at this scale, only comes along once or twice in a career. Only providers, if empowered, have the leverage to shape how it lands. We can let it happen to us. Or we can claim it and use it to redefine our future. For us, for our patients, and for our health care system.
Health care will inevitably keep changing, with us or without us. That part was never actually in question. The real question is whether the version that gets built has physicians at the table, or just physicians on the receiving end.
You know the play. You know the cost of punting when the game is on the line, and it is fourth and two. The only option is to BE BOLD.
References
- The leadership skills that make transformation stick. HBR IdeaCast. Harvard Business Review. May 12, 2026. Accessed August 23, 2026. https://hbr.org/podcast/2026/05/the-leadership-skills-that-make-transformation-stick
