Physician Associates (PAs) in military and operational medicine are frequently placed in environments where clinical expertise must be matched with adaptive leadership. Traditional leadership models often fail to meet the demands of modern healthcare delivery, particularly in preparing for Large-Scale Combat Operations (LSCO), humanitarian missions, and crisis response. Drawing on over 36 years of military medical leadership and diverse operational experiences—from trauma bays to forward surgical units and multinational exercises—this article introduces The 7 Commandments of Clinical Leadership. Inspired by Stephen Covey’s 7 Habits of Highly Effective People yet tailored to the unpredictable tempo of clinical and operational medicine, the commandments—Forge Initiative, Frame the Future, Command the Clock, Cultivate the Coalition, Listen to Lead, Fuse the Force, and Reforge the Blade—provide actionable guidance for resilience, collaboration, and transformational purpose. Implementation demonstrates measurable improvements in patient outcomes, training efficiency, morale, and readiness, offering a mission-tested framework to equip current and future PA leaders for success in both peacetime and combat.

Modern medicine demands more than technical proficiency; it demands moral courage, team-building under pressure, and the ability to lead with empathy even when lives are at stake. As Physician Associates (PAs), we are often placed in roles that require us to bridge clinical excellence with operational demands, whether in trauma bays, forward surgical units, or policy discussions at the highest levels.

Over the past three decades, I’ve served in diverse roles across the spectrum of Army medicine, culminating in my current position as a senior leader at the national level of military healthcare. From surviving a venomous snakebite in the Amazon jungle to advocating for the modernization of the Physician Assistant profession, my journey has tested and refined my clinical judgment. More importantly, these experiences have forged a leadership philosophy grounded in humility, initiative, and a commitment to transformational purpose.

Informed by that lived experience, I propose a new, mission-tested model: The 7 Commandments of Clinical Leadership. These principles – Forge Initiative, Frame the Future, Command the Clock, Cultivate the Coalition, Listen to Lead, Fuse the Force, and Reforge the Blade – offer an adaptable approach to leadership in complex operational environments. Drawing inspiration from Stephen Covey’s 7 Habits of Highly Effective People but adapted to the high-tempo, unpredictable world of clinical and operational leadership, these commandments emphasize practical action, human connection, and team cohesion. Each commandment includes real-world examples and actionable implementation tips. They are my blueprint for leaders who must balance saving lives with sustaining the mission.

“Leadership without empathy is like medicine without healing.” – COL James J. Jones, PhD, PA-C, Venom and Valor