I am en-route home from the Academy of Management meeting. My experience is that this is the best scholarly meeting around whose focus is on management research in general and health management research in particular. All of the sessions were worthwhile on one level or another but one late today captured my attention. The three papers were around the idea of competencies that health managers would need in order to become effective leaders. However, one in particular got my attention. That paper asked what competencies health care leaders would need in order to be effective in a complex adaptive system. I find this interesting since we prepare students within the context of learning specific skills like finance, HR, IS/IT, and the many other content areas. However, nowhere do we prepare students to think about managing complexity much less systems approaches to organizational change. My question really is what competencies are we going to propose and ultimately assess if we think that health care leaders need to think about their organizations as complex systems.