Looking at medical care administration, 14 assistant principals noted that the hospital administrator managed the business of health care, while the chief of staff provided leadership to the doctors and nurses. The assistant principals then posited: Can the organization model found in many hospitals offer any insight into ways that school leadership might be re-conceptualized? In an attempt to match the hospital responsibility with the school equivalent, the assistant principals labeled the school administrator the Manager of Programs (MP). The assistant principals titled the chief of staff in schools as the Instructional Leader (IL). The guiding question for the action research then became: In what ways might the responsibilities of the school principal be re-cast so as to have a Manager of Programs and an Instructional Leader? It became clear that there was a need for an individual who managed the business of schools and for an individual who mentored instruction. In their most recent feedback, the 14 participants in this work report that only one school site had been able to sustain the program where the principal was the MP and IL was the teacher-leader. Based on the group's responses, the reluctance to instituting the ideas of a MP and an IL did not seem to be a reflection on the quality or applicability of the notion. Rather, the reluctance to support the notion of a MP and IL came from a lack of central administrative support and the deep resistance to change within the school culture. Clearly, the perceived "reasonable approach" needs additional study and could benefit from a more rigorous research design that more fully addresses the question of whether there is an absence of instructional support among administrative leaders in schools outside the 14 in this action study. Questions that future studies might consider are also presented. (Contains 1 table.)