Leadership Lessons from the Mission Field

By Dr. Dan Doolittle

As we head into June and the heat really starts settling in for the long haul, I’ve been doing a little reflecting on how I ended up here, sitting in this chair, leading this company, after a career that mostly involved running between exam rooms in an ER. The honest answer is that most of what I’ve learned about leadership didn’t come from a classroom or a seminar. It came from the mission field.

Over the years, my work in emergency medicine has taken me to places I never expected to go. Refugee camps. Disaster zones. Cities torn apart by war. And while plenty of my leadership “foundation” was built right here at home in the ED, some of the most defining lessons came from those missions. They didn’t just stretch me as a physician. They reshaped how I think about leading people.

The mission field has a way of stripping things down to what actually matters. When the systems are overwhelmed, the resources are scarce, and the people in front of you are hurting, the theory just falls away. What rises up instead is presence, clarity, and genuine care for the people next to you.

Probably the hardest trip that always comes to mind was a medical mission to Sudan during the ongoing civil war. A city built for about 250,000 people had suddenly swollen to over a million because of an influx of refugees fleeing the rebel army. There was one OB hospital serving the entire region, and it was completely overwhelmed. It became clear pretty fast that the women and children, especially the laboring mothers, were the ones most in need.

So we set up a field hospital right outside the main OB facility and got to work. The volume was staggering. On any given day, the main hospital was managing 50 to 100 deliveries. In our tent, we’d assist with another 20 to 25. Over the course of that mission, I personally supervised the delivery of so many babies, something I never imagined I’d do as an ER doc.

But that’s the thing about the mission field. Leadership often starts by just saying yes to the need right in front of you.

In moments like those, leadership has almost nothing to do with title or authority. It’s about being present and willing to step into uncomfortable situations. On a lot of those trips, especially in a disaster response, there is simply no backup. No second team waiting in the wings. When you’re there, you’re there to work. For weeks at a time, we worked 12-18 hour days, seven days a week, because the need just never stopped coming.

Those long days taught me something important. Leadership doesn’t require elaborate plans or long speeches. It’s found in the steady, unglamorous stuff. Listening to concerns. Helping a team navigate a tough triage decision. Adjusting the workflow. Reminding folks they’re not in it alone. Presence matters more than perfection.

If there’s one lesson the mission field hammers home over and over again, it’s that caring comes first. Genuine care for people isn’t just a leadership “trait.” It’s the foundation. People know when you actually care, and when they feel seen and valued, they’re willing to walk through some incredibly hard things together.

Early on in my mission work, I had to confront some of my own assumptions. On one of my first disaster responses, I’ll admit I was quietly judging some of the volunteers around me, particularly the older folks, the retired ones. I wondered if they could really keep up with the physical and emotional demands. Six weeks later, I realized just how wrong I had been. Those same people turned out to be some of the most resilient, patient, and encouraging teammates I have ever worked alongside.

That experience really changed how I see people in a team setting. I learned to slow down, extend a little grace, and assume good intent. And that mindset followed me right back into emergency medicine and into Integritas. Nurses, administrators, colleagues, patients… most people are genuinely trying to do a good job. Leadership starts when we choose to assume the best of others around us.

Over time, I’ve come to frame what I’ve learned around the “Four Cs” of leadership: caring, communication, clarity, and consistency.

Caring has to come first. That’s the foundation everything else sits on.

Communication has to be intentional, and honestly, often repetitive. You almost always have to “overcommunicate.” People want to be heard, and they want to understand what’s going on.

Clarity matters more than we sometimes realize. People will follow when expectations and goals are clear. Frustration grows fast when they’re not.

And consistency is what ties it all together. Change isn’t wrong. But inconsistency without explanation will breed confusion every time, especially in high-stress environments.

On medical missions, clarity is just essential. When team members understand why they’re there and what they’re trying to accomplish, they’re all in. Same thing back home in our hospitals and in our organization. Clear expectations create alignment. Confusion stalls everything out.

One other lesson I’ve carried throughout my career is that leaders shouldn’t be afraid to get involved. Early on, I was warned that being too present would cause people to rely on me too much. I’ve never found that to be true. In my experience, leadership doesn’t require control. It requires availability. Taking a few minutes to listen, look at a situation, or address a concern early on almost always prevents a much larger problem down the road.

Mission work also teaches humility in some pretty powerful ways. When you’re tired and stressed and stretched thin, it’s awfully easy to misjudge people. Over the years, I’ve learned to pause before assuming the worst, give the benefit of the doubt, and listen more carefully. Those habits have shaped not only how I lead but how I practice medicine.

The point is, medical missions don’t just impact the communities we serve. They change us. They refine our leadership, widen our perspective, and remind us what actually matters. Leadership doesn’t have to be complicated. It takes care, clarity, communication, consistency, and the courage to show up, especially when the work is hard. The mission field makes those truths impossible to ignore, and my hope is that we keep carrying them forward into our teams, our hospitals, and the next generation of medical leaders coming up behind us.