In particular, numerous faculty perceived a lack of attention to the social mission of providing care for all people and to the community, a lack of prioritization of excellence in clinical care, a devaluing of educational roles, questionable ethical behavior among leadership or management, and the necessity for self-promoting behavior to achieve success.” Austin has pointed out the many advantages of term limits and proposed a maximum of two renewable 4-year terms for AMC division heads, department heads, deans, and presidents. 8 Beeler et al. accentuated the positive impact that term limits have on diversity, equity, and inclusion. 7 It is interesting to note that at Mayo Clinic, routinely ranked the number one health system in the United States, chairs rotate every 8 years, and with minimal changes to compensation based on leadership roles and no recruiting packages. 8 Clearly Mayo is on to something. Insist that leaders govern fairly and transparently, seeking consensus when possible; Promote a holistic management approach, connecting every individual in the enterprise, inviting input, and minimizing one-on-one exchanges; Formalize leadership training in self-awareness, hubris management, effective communication skills, and trust building 10; Perform annual reviews of senior leaders, utilizing a 360 process to ensure input from all groups, and importantly, providing appropriate institutional feedback following each review; Develop working strategic plans, with tangible goals and timelines, shared institutionally and re-evaluated regularly; Provide leaders authority commensurate with their responsibility; Develop clear policies and procedures, and ensuring that they are applied equitably; Provide for centralized, transparent financial accounting throughout the enterprise; Incentivize leaders to maintain their clinical roles and avoid disconnecting from clinical medicine 8; And provide mechanisms for those termed-out individuals to exit leadership positions gracefully as well as predictably 8.