This presentation explores the origin of mitochondria as a metaphor for adaptive leadership and multidisciplinary collaboration in modern healthcare, with specific relevance to obstetric and gynaecologic care environments. Drawing on the evolutionary model of endosymbiosis — a biological union that led to the rise of complex life — the paper illustrates how hospitals must now function: not as hierarchical machines but as dynamic ecosystems powered by coordinated diversity. Obstetric care settings, from antenatal clinics to birthing suites and neonatal units, rely on high-functioning, interprofessional teams. This model reinterprets burnout, conflict, and systemic stress not as breakdowns but as evolutionary signals — calling for systems-level adaptation. Just as mitochondria generate energy (and oxidative stress), so too do high-performing care teams generate both innovation and tension. Leadership, then, becomes the art of integration: aligning clinicians, systems, and values to channel organizational energy into resilience rather than overload. Through metaphor, lived clinical examples, and organizational design theory, this paper offers a fresh framework for women’s health leaders seeking to navigate complexity, support collaboration, and build systems capable of healing both patients and themselves. It invites us to reimagine care not as command-and-control, but as symbiosis — where power arises through partnership, and complexity is not feared but embraced.

Brian McCully has been appointed Adjunct Associate Professor with Monash Rural Health Mildura. Currently working as the Clinical Lead of Obstetrics and Gynaecology at Mildura Base Public Hospital, he has been supervising Monash medical students during their clinical placements on the wards. He moved to Mildura from far north Queensland in 2021 and is a passionate advocate for rural medicine, having provided care for women in some of Australia’s most remote communities throughout his career.