In a call that goes beyond respiratory physicians to the broader medical community, doctors have been asked to step up to six challenges facing healthcare.

In the opening ceremony keynotes address, Dr Darrell Kirch told the American Thoracic Society (ATS) 2018 International Conference that leadership was a critical issue.

Dr Kirch, president and CEO of the Association of American Medical Colleges, said doctors had to exert their leadership more in both small and large ways.

Referencing executive advisor Liz Wiseman’s book Multipliers, he said those leaders did not have to be geniuses, but should be able to bring out the geniuses in those around them.

“We need to fill the void in health care with clinicians with the true ability to be multipliers. People are depending on us – current patients and future generations.”

Dr Kirch said one of the other challenges was disruption in the form of acquisitions, mergers, consolidations and break ups of health institutions.

“Clinicians have ceded responsibility to others; we have lost the clinical sensibility in organisational leadership. Yes we need business rigour but it needs to be balanced with clinical sensibility.”

He said the ‘post-truth’ era, where opinion and emotion overrode evidence, was an existential threat to science and medicine.

Again, clinicians and researchers had to step up to counteract this trend.

He said the next generation of doctors were also demanding something more from their medical education than ‘the sage on the stage’ and rigid curricula.

“Students are impatient for AI-decision support software, apps and virtual reality to help develop their basic and advanced competencies as physicians.”

Widening health inequalities, largely related to income inequality both in the US and globally, also had to be addressed, Dr Kirch told delegates.

He added that burnout and mental health issues for clinicians was yet another major challenge for the profession.

Even away from the pointy end of suicide and suicidal ideation, ‘burnout takes the joy out of medical practice’.

He said change was possible. A pivotal report on medical errors and how to build a safer health system, To err is human, had driven change from 1999 onwards. Now it was time for a similar initiative ‘To care is human’.

“Quality and safety has improved now because we put in on the front burner. We need the spotlight now to be on breaking down the stigma of burnout.”