The percentage of hospitals that are physician led has been steadily declining and now stands at or near an all-time low. What price do the health care system and the people it serves pay for this decline in physician leadership? What might health care look like if medical educators devoted more time and attention to developing future physicians as organizational leaders? What changes would medical schools need to make to prepare medical students to play such a role? What advantages might accrue for patients, communities, and physicians themselves if more hospitals were physician led? Because hospitals are a vital resource in caring for the sick, promoting health, and addressing the challenges facing the U.S. health care system, it is now more important than ever before to explore how medical education can complement its traditional focus on the molecular, cellular, and organismal levels of health and disease with insight into the organizational dimensions of patient care. The authors believe the time is ripe to rethink medical education's role in preparing tomorrow's physicians as leaders.