Leading Through Action: The True Role of Leadership in Health Care

When we speak of leadership, we often think of strategy, vision and the ability to make key decisions. But in health care—especially in contexts like Latin America—leading also means taking on every role needed to get a program up and running, knowing every corner of the institution and being present where real change happens. My experience as founder and CEO of the Fundación Cardiovascular de Colombia (FCV) and the Hospital Internacional de Colombia (HIC) has shown me that true leadership is exercised not only through decisions, but through action. It is this hands-on approach that has allowed us to transform an idea into one of the most recognized medical institutions in Latin America.

From Humble Beginnings to a Vision for Change

In the 1980s, after completing my medical studies, I was assigned to the San Juan de Dios Hospital in San Gil—a small town in Santander, Colombia—for my mandatory social service year. The conditions were precarious: a basic clinic with limited supplies and scarce resources. Yet in that setting, with barely the essentials, I began to imagine the possibility of a modern hospital that could provide world-class care to those who needed it most—especially children with cardiovascular diseases. That is where the conviction was born: It was possible to change the course of medicine in my region.

Shortly afterward, that vision began to take unexpected shape. In 1981, I had the chance to support a pivotal initiative: the “Heart to Heart” program, led by Dr. Franklin Quirós. That same year, I traveled to New York with the medical records of two children in urgent need of heart surgery. Thanks to the commitment of the North Shore Hospital medical team and the solidarity of the Colombian community abroad, we began a chain of hope that, in the years to come, benefited hundreds of children.

The medical missions we carried out in San Gil—supported by international professionals and the local community—not only saved lives but also proved that it was possible to build a collaborative network to offer specialized care to those who had never had access to it. These were intensive weeklong missions, several times a year, during which doctors, nurses and volunteers performed dozens of surgeries, exams and consultations. Locals opened their homes as improvised shelters for hundreds of children and their families.

Thanks to the impact of those early missions, we gained invaluable clinical and operational experience in a short time. In 1985, during the National Cardiology Congress in California, I spoke with Dr. Quirós about the urgent need for a permanent facility specializing in cardiovascular diseases. That conversation led to the idea of creating the Fundación Cardiovascular de Colombia (FCV).

A year later, in 1986, we co-founded the FCV with a firm commitment to a shared vision: building a fairer, more modern and more humane health care system. At a time when the health sector in Colombia was in deep crisis, many saw our proposal as a risky bet. But we believed—with discipline, commitment and faith—it could be done.

In the early years, the work was fully hands-on. From organizing shifts to coordinating donations, I took on multiple roles to ensure everything moved forward. When we obtained decommissioned medical equipment from Hershey Medical Center—machines considered obsolete and intended for farms or rural clinics—we saw them as an invaluable opportunity. With that equipment, we performed our first 150 open-heart surgeries, all free of charge for patients without resources. None of the children operated on during that initial stage died. These procedures were carried out in a private clinic rented by the FCV, as we still had no facility of our own. By then, I had completed my specialization in cardiovascular surgery, which allowed me to take on a key clinical and technical role in getting this surgical care model off the ground.

In 1990, we established an agreement with a clinic in Bucaramanga that allowed us to formally begin cardiovascular surgery services. The first operation corrected an atrial septal defect in a girl identified through the “Heart to Heart” program. She sadly died from a postoperative infection. Eight days later, we operated on another patient with full success. Our ability to recover quickly and move forward was essential.

The next 50 patients were treated with excellent outcomes. Thanks to a medical team working pro bono and the support of international partners, we consolidated a service that became a national benchmark. I personally took on the fundraising, team coordination, hiring, construction supervision and patient support. That laid the foundation for a hands-on leadership model where nothing was asked of others that one wouldn’t do themselves.

Institutional Growth and Leadership Rooted in Experience

Since 1992, when I took on the institutional leadership of the FCV, we have worked closely with the Assembly, the Board of Directors and our collaborators to build an institution that not only prioritizes patient care but also contributes to regional development and the strengthening of Colombia’s health care system. Through donations, institutional partnerships and rigorous management, we built our own facility and developed a portfolio of services that met international standards.

With that accumulated experience, in 1997 we took a major step forward: the inauguration of the FCV Heart Institute, now the HIC Cardiovascular Institute.

This was a true milestone for the region. It was the first hospital in northeastern Colombia dedicated to cardiovascular diseases, housed in a 14-story building equipped with cutting-edge technology and designed to integrate diagnosis, treatment, research and medical education.

Building this facility meant overcoming financial obstacles, redesigning the original project and making strategic decisions. The first surgery at the new site was performed on October 2, 1997. From that point on, the hospital not only transformed health care in the region, but also marked the beginning of a new era of institutional autonomy, sustainable growth and broader social impact.

Our work in research and biomedical technology development—including creating our own software—enabled us to expand services like telemedicine to remote areas of the country, making us pioneers in this field in Colombia. Through careful management, we built a financially sound institution with the ability to reinvest and grow based on a portfolio of high-quality services.

A key marker of our commitment to excellence came in 2005, when we became the first hospital in Colombia to receive National Accreditation from ICONTEC, the country’s official standards organization. Four years later, we were also the first Colombian institution accredited by the Joint Commission International (JCI), a global benchmark in hospital quality.

To support this growth, we created an international patient office and strengthened our capabilities through academic alliances with universities and hospitals in the U.S. and Brazil. These collaborations helped us establish permanent training programs for our clinical and administrative staff, ensuring adherence to international standards and continuous improvement.

When we decided to build the Hospital Internacional de Colombia (HIC) in 2016, we didn’t just draw up blueprints and hire experts. We visited medical centers across continents, walked through operating rooms, spoke with patients and observed hospital workflows. We wanted to understand what worked, what could be improved and how to adapt those lessons to our context.

Many of today’s flagship programs began as pilot initiatives I was directly involved in—from developing our electronic health record system (SAHI) to launching our artificial intelligence strategy. Leading didn’t mean just approving budgets—it meant sitting with engineers, reading technical proposals, debating operational issues and proposing solutions. In other words, building with our hands what we envisioned with our minds.

We were also the first in Colombia to offer an exclusive medical transport service for critically ill patients. These actions reflect how innovation and a commitment to quality have remained constants on our path.

This approach to leadership has a profound impact. When a doctor sees their director scrub in for surgery, when an engineer knows their idea was heard directly by leadership, when an administrator feels valued because their role is understood by the CEO—these moments create a sense of belonging that no manual can replicate.

Today, the HIC is recognized across Latin America for its surgical capacity, clinical outcomes and dedication to innovation. But none of that would have been possible without a leadership model rooted in coherence: demanding, yes—but also doing; inspiring, but also accompanying.

Leading through action doesn’t mean doing everything yourself. It means being close enough to the process to understand it, support it and improve it. It means making informed decisions based not only on metrics, but on firsthand experience. Above all, it means remembering that before being a CEO, you are part of a human team with a shared mission: to save lives and improve people’s health.

That is the kind of leadership health care needs—the kind that is built day by day, on the ground, alongside the people who make an institution work. Because only those who truly understand their team’s effort can make decisions that are fair, effective and humane. And in health care, more than in any other sector, to lead is to serve.