Today's healthcare is faced with enormous challenges with the changes in healthcare policies that require delivering higher quality at a lower cost and at the same time with internal challenges of low tolerance for mistakes, complex nature of the industry, and multidisciplinary teams working together. As a consequence, the need to develop physician leaders to lead through these changes has become critical for the success of the organization. As part of leadership development efforts, an academic medical institution in the U.S. has identified coaching skills to be an important leadership skill to lead through the change. In order to create a coaching culture where leaders use coaching approach to develop staff through the change management, Leader as Coach training was given to group of high level physician and administrative leaders followed by matching the trained leaders as coaches with junior staff who are in the leadership pipeline. Case study was conducted to investigate the processes and challenges of developing physician leaders as coaches and the benefits of leaders engaging in coaching in the organization. Data collection was done through semi-structured interview of twelve physician leaders and documents of program evaluation as well as coachees' evaluation of the coaching engagements. Data analysis consisted of category (or theme) construction, sorting the data according to the categories constructed, and finally by making inferences about the relationships among the categories, developing a model that presents the visual representation of how the concepts or categories are related to one another. As a result, six themes were identified: understanding coaching and its philosophy, coaching as a leadership skill, coming together, coaching process and competencies, coaching challenges, and coaching outcomes. The study provided insights into the learning processes and challenges for physician leaders to be developed as coaches and indicated that increasing the internal coaching capabilities in health care organizations by developing physician leaders as coaches can have great impact in paving the way into many changes and challenges that are facing health care today. Coaching has been shown to be an effective way to operationalize approaches to leadership needed in time of uncertainly and complexity, and to enable continuous learning for the staff by constructing context-specific, tacit knowledge, leveraging the social capital and upholding the organizational values.