Leading in the field of health care, the largest service industry in the world, has unique challenges due to changing environmental and organizational dynamics. The very nature of health care is being redefined with a greater focus on increasing the quality of health care delivery, restructuring the delivery of health care itself, and containing the cost of health care. Physician leaders are particularly essential to quality care and service in modern medicine. Physicians are trained to be proficient in the technical and clinical aspects of their role, yet a concentration on developing fundamental leadership skills is relatively absent. Changing structures and relationships require physicians to redefine their roles as leaders. A 21st century definition of physician leadership is needed for the complex world of health care today, incorporating interpersonal skills and emotional intelligence. This study proposes to identify competencies demonstrated by successful physician leaders, thus contributing to our understanding of the indicators for success in physician leadership.