Evidence that supports the explicit need to develop leadership skills at all levels of clinical practice is prevalent,1-8 yet intentional development of "self-leadership"within health care, and particularly within physical therapy, remains slow, fragmented, and inconsistent. Delineation and standardization of the definition of leadership, and the approach to developing leadership skills in individuals practicing within health care continues to be debated, producing several key dilemmas. Moreover, there is a lingering misperception that developing leadership capacity is reserved for physical therapists who assume positional or formal roles as "leaders"within communities, health care organizations, practices, or teams. This misperception focuses leadership development on "leading others"rather than "leading self."Similarly, challenges exist between balancing the leadership development needs of the leader as a positional role and the act of "leading"as physical therapists practice and engage within all levels of care and within different communities - as individuals and within teams. This tension further complicates when and how best to prepare physical therapists to meet this essential skill set in clinical practice. The purpose of this perspective is to describe nonpositional self-leadership and its importance to physical therapy practice, to propose common or contemporary leadership-related terminology, and to suggest a framework for leadership development. Through accomplishing these purposes, readers may be encouraged to change and adopt recommendations.