I think I have developed an obsession with company vision and value. As I consider two books I read recently, Starting with Why (Simon Sinek) and Delivering Happiness (Tony Hsieh), I keep thinking of what this means for medical practices. Of course a medical practice values patient care and quality outcomes, but Sniek challenges us to think of this as “what” and “how” and doesn’t really address “why”. It seems that these authors stress the clarity in decision making that comes from knowing why an organization exists. This is where the understanding of “why” transcends the service being delivered and the value of the people who work for the organization. At Zappo (Hsieh) the value is “Wow with a little Weird”. Customer service is taking it beyond the expected and still reflects the individuality of person providing the service. Since it is a value imbedded in the individual the leadership of the company “serve” their staff and managers the same way, Wow with a little Weird. How do we get to clarity in values? What role does the business leader have in helping the physician owners reach this clarity? Is it even possible when a medical practice has many owners?