Much is made of the need for strong leaders in healthcare. Yet increasing regulation and a fiscally restrictive environment leaves little room to manoeuvre for even the most effective healthcare leaders.

For consumers searching for visionary leadership, hospitals (inanimate, often impoverished and frequently imperfect) by their sheer physical presence are emerging as the most visible symbol of reliable care, quality training, specialty services and referral.

While bricks and mortar cannot provide leadership its construction can house the healthcare delivery process.

Sloan Kettering, The Mayo Clinic, Guys and St Thomas’ are top institutions whose names most of us can recite. But few of us are familiar with the identities of the doctors within these institutions.

When the NHS provided doctor league tables to assist patients in choosing where they receive hospital treatment, patients chose by hospital (usually one nearby) rather than by doctor. The aims of the NHS Patient Choices Policy (efficiency, responsiveness and ultimately improved quality) appeared to have little impact on patients who, wary of providers, were after the best available care.

A future without effective health leadership may not be as bad as it sounds.

With the internet providing enough information on treatments to satisfy even the most voracious health consumer, optimal treatment with minimal side effects is the desired outcome. As patients are offered more information on which to make choices the power of individual providers diminishes.

But a future without effective health leadership may not be as bad as it sounds. Hospitals will continue to function as long as the management is efficient. Chameleon-like hospitals will become department stores for health products and services. Consumers will purchase online, convert into patients in hospitals and emerge again as consumers. Health care providers will be no more than highly educated sales assistants on a shop floor.

In as much as the time has come for consumers to lead their own health, the time is rapidly approaching for us clinicians to adjust to our future roles and begin preparing our students.