Fourteen physicians were invited to reflect and give a presentation on the lessons they have learned while leading change in healthcare … and how they learned them. The lectures were held at the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, U.S., from the fall of 2008 thru the spring of 2009 as part of a "Leadership Lessons" series. The invitees were working leaders in healthcare. We invited some who saw themselves as educators, some who thought of themselves as researchers and some who saw their work in the "operations" of healthcare. They all were individuals with local, and in many cases regional and national, recognition for their efforts to lead change in healthcare. When we invited these leaders to present, we shared with them our intention to make their reflections available to a larger audience via this book. To facilitate the preparation of the book, we transcribed the talks and shared the transcripts with the authors. We asked them to prepare a written version of the substance of their spoken message. We did not heavily edit their submissions. We want their words to reflect their way of communicating.