Character, some say, is defined by what we do when nobody is watching.

I thought about this recently while watching first the automakers and next banking executives sit before members of Congress to, in effect, defend the way they managed—or mismanaged, depending on your viewpoint—their company’s finances.

Coupled with the latest admissions by baseball’s Alex Rodriquez regarding steroid use, these images of grown ups being hauled, at least figuratively, to the proverbial woodshed, made me wonder how it was all playing in the minds of those who run the healthcare industry—ironically, for good or ill, the next potential target for a major overhaul if some in Washington have their way.

What many of the wizards of Wall St., professional baseball players, and others who count their compensation in millions, even billions, failed to consider over the past few decades was the potential pitfalls of excess. They behaved as if the good times would never stop rolling and a day of reckoning would never come. And when their bubbles did finally burst, the damage went well beyond financial—for themselves and far too many who depended on them—to include loss of reputation and public trust.

What is important to those of us in health care is the impact of these events on our industry. More exactly, what impact they have on the attitudes of those in a position to affect our industry in a big way. The question is, if a hospital administrator, health insurance executive, or other major decision maker who reaps great financial benefits from his or her position were held up to public scrutiny, would the result be positive?

Such days of reckoning could be closer than many think. Even before the current economic meltdown, many were clamoring for big changes in the American healthcare system. In cities and regions around the country, healthcare has become a dominant—sometimes the dominant—industry, providing employment for large segments of the population. Perhaps most critical, health care now means big money in the form of research, community investment, and, most critically, salaries and compensation for those in charge, for-profit and not-for-profit alike. There’s a growing scrutiny of both pay and perks.

For sure, we are seeing some signs of some who are “getting it” – hospital executives around the country opting to trim budgets, forego unnecessary expenses, turn down salary increases, even offer pay cuts—to improve the situation of their organizations, employees, and clients. These, of course, are all good signs, even if they are sporadic at best at the moment.

Of course, the biggest challenge will come when the current economic maelstrom passes, leaving in its wake a changed landscape for all industries, not just in America, but worldwide. Simply put: Will we in health care have learned our lesson? Will we promote greater transparency, intelligent business practice, and—most importantly—a renewed commitment to all of our patients? Or will those left standing view the future with smugness or arrogance, blinded by the belief that to survive today’s troubles somehow makes one invincible.

“Those who fail to learn from history are doomed to repeat it.” In every challenge lies opportunity. We in health care are being handed a golden opportunity to rethink our industry even as we navigate through these precarious times. Let’s hope that the lessons we learn enable us to emerge on the other side of this storm stronger, more effective and, most importantly, more noble than ever. In doing so, perhaps we can serve as a positive example for all other individuals and industries to follow.

It’s a big challenge, one that some might call impossible. But in a world that cries out for leadership, someone should heed the call. Why not us? Why not you?

Harvey Kart