As a graduate of Temple University’s medical school and psychiatric residency program, and as a current faculty member, I had the good fortune of studying under highly respected physicians who served not only as chairpersons, but also as presidents, CEOs, and chief medical officers. Anthony (Tony) F. Panzetta, MD, was one of them. Panzetta passed away in 2021 at age 87. As with all great mentors, he had multifaceted talents and extraordinary leadership qualities.

First and foremost, Tony was very open to sharing his experiences with trainees. Medical students, residents, and early-career physicians benefited from his sage advice. He was very easy to work with and took a true interest in trainees and faculty members. You felt as though he always “had your back.” Tony had a great sense of humor, as well. He kept a sign on his desk that read, “If you don’t have it in writing, I didn’t say it!”

In addition to being an astute clinician and administrator, Tony was an entrepreneur, innovator, and visionary. As early as 1967, he was proposing models other than psychoanalysis for understanding and treating psychiatric patients. He was interested in social determinants of health long before the term was coined, and he was one of the first to question the costs and benefits of psychotherapy and search for empirical studies to shed light on the issue. His eventual disillusionment with the community mental health movement was captured in a short but classic article titled “Whatever Happened to Community Mental Health?”

When Tony stepped down as chair of Temple’s psychiatry department in 1986, the department threw him a farewell party. Tony remained mum about his next move. We soon discovered he was involved in a start-up company. Tony founded a managed care organization, which he named TAO. We believed “TAO” was a reference to his interest in transaction analysis – hence, the name TAO for transaction organization. Also, given Tony’s interest in Chinese philosophy, we couldn’t be certain that TAO might be an unintentional double entendre.

In any event, TAO, Inc. was acquired by Independence Blue Cross (IBC) of Philadelphia. As health care costs were spiraling out of control at the time, just as they are today, the promise of TAO – to eliminate unnecessary and unproven psychiatric treatment – was highly appealing to health insurers. Managed care was unwelcomed by physicians everywhere, but Tony was more concerned about practicing evidence-based medicine than winning a popularity contest.

I literally followed Tony to his new office space in the IBC building and became an associate medical director, initially part-time and then full-time. By working closely with Tony, I learned how business practices could impact care delivery, both positively and negatively. He and I often discussed the need for physician leaders to protect the interests of patients in a cost-cutting environment because we both recognized how easy it was for physicians working in the industry to become trapped between medical and management decisions, wrongly erring on the side of management.

As my interest in the business aspects of medical practice deepened, I decided to take the plunge and apply to business school. My benefits as a TAO employee included tuition assistance. I approached Tony and asked him for a “free ride” for two years at Temple’s executive MBA (EMBA) program, which in today’s dollars is over $100,000. Normally I would only be entitled to standard tuition benefits, which fell far short of the cost of an EMBA program.

Tony replied, “Have you ever heard the term ‘indentured servant'”? We both had a good laugh. As much as I enjoyed Tony’s company, I did not want to be indentured to him or anyone else. I utilized the customary tuition benefit and financed the rest of the EMBA program. In retrospect, given the frequent turnover of industry-employed medical directors, indentureship might not have been a bad idea!

When I was the medical director of a psychiatric hospital undergoing downsizing, my high salary put me at risk of losing my job. Tony told me I never should have let my salary become a “liability.” He recommended that, in future jobs, I should be content with a mid-range salary that aligns with my peers and job level. I managed to save my job, but in case I was to lose it in the future, Tony uttered an Italian proverb: “Sempre aria fresca dopo la tempesta” (there is always fresh air after the storm), which I have always remembered as the winds of change engulfed me over the years.

Tony worked the latter part of his career as an executive coach training organizational leaders. He believed that leaders must learn to contend with an environment that is spinning in unpredictable ways. His views on leadership were as follows:

• Organizational leaders need to acquire skills that allow them to be productive with limited resources.
• Leaders require people skills, i.e., emotional intelligence.
• Leaders need to be motivators and create organizational vision.
• Using interpersonal skills and influence, leaders must empower their subordinates.
• Leaders must coordinate activities and facilitate teamwork.
• Leaders must be able to manage conflict.
• Leaders need resilience to chart a personal course over which they have some control.

Above all, Tony believed that without emotionally intelligent leaders, organizations will be unable to reach their full potential or adequately meet their business challenges. He also gave the following advice, universally, to all his clients:

• Be clear about who you are and what you want to become.
• Be clear about what your skills are and about the options those skills allow you to consider.
• Be clear about a realistic plan to get you where you want to go, using your real skills.
• Act on that plan, and don’t become discouraged.
• Keep in mind that accurate self-knowledge is a necessary first step.

It’s a philosophy well worth remembering.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. His forthcoming book is titled Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.