The ACP seeks to offer a nuanced position on team leadership issuing from the requirements of medical professionalism—that is, the necessary commitments of health professionals to patient welfare and the meeting of patient needs. According to the ACP, assignment of responsibilities within a team must be such as to assure that patients receive the care they need at any given time. From this promising beginning the question of team leadership is then fudged in what follows. Patients, we are told, deserve “access to a personal physician who ... has leadership responsibilities for a team of health professionals.” But, on the other hand, “effective and dynamic teams have a ‘nuanced’ approach to defining team leadership” and such teams “recognize that leadership of a team in any particular task should be determined by the needs of the team and not by traditional hierarchy” (1, 6). The latter statements echo an Institute of Medicine discussion paper that explicitly disavows taking a position on who should lead clinical care teams (6). Readers are left wondering whether physicians must lead clinical care teams or whether nurses and other health professionals may lead.