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The U.S. Army has been fighting the wars in Afghanistan and Iraq for over 10 years and in the process produced a new military doctrine called mission command. Mission command doctrine was conceived from a wartime environment to allow followers in the field to act according to the dictates of the situation on the ground, giving them maximum discretion. The concept of mission command fits nicely into followership research and theory. For a military widely dispersed both by geography and mission, this concept represents an effective way to empower followers and encourage them to take initiative and accept prudent risk. Mission command doctrine expects officers and exemplary followers to be courageous. It requires them to act on their own, be wise in assuming risk, be actively engaged in executing the commander’s intent, and find multiple ways and options to accomplish the mission. Since mission command is a philosophy born of our recent wars in Afghanistan and Iraq, the question remains of how this philosophy will fare in an inter-war period of forced reductions, downsizing, and substantial budget reductions.

Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans.

This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes.

Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships.

Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles.

The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study’s findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care.