‘Leading when everyone is watching—and when no one knows what to do’

Julie Ann Freischlag

The title of the Southern Association for Vascular Surgery (SAVS) Jesse E. Thompson, MD, Distinguished Guest Lecture was heralded as “Leading when everyone is watching,”—but COVID-19 lent the message Julie Ann Freischlag, MD, was attempting to transmit a certain sharpness.

“In parentheses, [leading when everyone is watching] means, actually: When no one knows what to do,” the CEO of Wake Forest Baptist Health system in Winston-Salem, North Carolina, told the recent SAVS annual meeting (Jan. 27–30) in a virtual version of the lecture, which for the first time was delivered by a female surgeon. “And I’ll tell you, the pandemic has challenged us all.”

Freischlag was talking about the impact on practice and helping lead her institution through the rollercoaster of events since surgery was ground to a halt last March. Learners were pulled off rotations, she said. Research was stopped. People had to deal with shifting advice around mask-wearing. Surgery then restarted. Testing for the virus improved. Then COVID-19 came rip-roaring back in November, December and January, with many more cases, Freischlag explained. Which is when leaders like her had to figure out how to get people vaccinated.

Yet, the pandemic also provided opportunity. She pointed to the pick-up of telemedicine and the recent success of Vascular Surgery Board exams, having been delivered remotely. “Challenges are gifts, even though sometimes it’s really hard to appreciate the gift we’re given from COVID-19,” Freischlag said. “We need to figure out what kind of opportunities come out of these kinds of calamities and disasters,” she added.

Freischlag pointed to data showing that only 47% of people strongly agreed that their employers communicated a clear plan of action for COVID-19. “I think that’s because it’s been so confusing,” she said.

Freischlag outlined a slew of potential leadership remedies. Team together, she said—in a way that means others will feel compelled to follow. For instance, she highlighted the example of surgeons who shifted their cases to outpatient centers as among those making a difference.

Do right by your patients, families and communities, she continued: by helping those suffering from food insecurity, wearing masks and not congregating in large groups.

“Authenticity is really important. I know with my leadership style, you really need to show who you are,” Freischlag said. “When I was the chair of surgery at Johns Hopkins, I was the only woman chair for 11 years, so my job was to speak out, and say what I felt, so that people could go forward and maybe do things differently in the future. Now, there are a few more women chairs, and a few more diverse chairs.”

On a personal level, Freischlag was the first person randomized to the Moderna vaccine trial, she recently learned. Indeed, Freischlag prizes taking time to ask people how they can be helped through some of the rigors of the pandemic. In a recent instance, one such exchange had a remarkable ending.

“We have also asked people to start asking, ‘Are you going to take the vaccine?’” Freischlag explained to the SAVS gathering. “And to have a conversation about how it’s so important, because there are some people who are scared to take it. I was just at my dentist last week, and my dental hygienist wasn’t going to take the vaccine. So I talked to her a bit about how I was the first patient in the Moderna trial, and how I had my vaccine months ago. At the end of my visit, she said, ‘I think you did more for me than I did for you today.’ She goes, ‘I am going to get my vaccine.’”


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