As the challenges of leading in healthcare become more complex, healthcare institutions have increasingly emphasized the importance of leadership training for physicians. Several institutions have offered in-house training programs. This paper describes the 14-year experience and evolution of physician leadership development training at the Cleveland Clinic. We describe the curriculum, organization, and goals of the Leading in Health Care course, which is offered to high-potential physician leaders. As a metric of the success of this physician leadership effort, we report the number and types of business plans developed in the course that have been either implemented at the Cleveland Clinic or have directly affected plans for program implementation.