Despite leadership roles being critical, we persist with outmoded models of organisations and pay inadequate attention to developing individual leaders and new models of leadership within the medical profession. New forms of leadership are required. Among many important roles, leaders are called on: to enhance the meaningful identity of a profession; to create effective linkages with other healthcare professionals and stakeholders, as well as with healthcare system managers; to interpret complexity so that their institutions and followers can operate successfully in uncertain times; and to consistently model ethical behaviour.