In the age of value-based care, organizations are leaning on clinicians to lean in to leadership. This opens new vistas for physicians and nurses, but health systems and insurers must do their homework. A physician who heads his or her own practice may have valuable leadership skills, but leading, say, a staff of 12 is different from overseeing a $2 billion budget and ensuring a board and a C-suite are in sync with your vision.

One such physician who has made the jump is Leana Wen, MD, the Baltimore City Health Commissioner, who leads a staff of 1,000 employees. Since being named to the role in December 2014, Wen has shown a predilection for taking decisive action, perhaps unsurprising as someone trained as an emergency room physician.

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 The health commissioner of Baltimore City made a statement Thursday in a Facebook post about the suit filed against the Trump administration for “intentionally and unlawfully sabotaging the Affordable Care Act.

“I am gravely concerned for the wellbeing of my patients, my city and millions of individuals who are finding themselves unable to afford health care,” Dr. Leana Wen, city health commissioner, said.

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In this edition of Midday’s “Healthwatch” with Tom Hall, Dr.

Cities used to stay out of courtroom battles over health, leaving that role predominantly to state governments. In the 1990s, states sued the tobacco industry and won more than $200 billion for the damages it had done to public health. States have filed lawsuits against and in defense of the Affordable Care Act (ACA).

But in recent years, more and more cities have been going to court.

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