This paper contributes to the evolving body of literature diagnosing the ‘business-like’ transformation of American medicine by historicising and recuperating the concepts of medical leadership and the corporation. In an analysis of the evolving uses of ‘leadership’ in medical literature, we argue that the term’s appeal derives from its ability to productively articulate the inevitable conflicts that arise between competing values in corporations, and so should be understood as a response to the neoliberal corporation’s false resolutions of conflict according to the single value of profit (or consumer welfare for the business-like non-profit). Drawing on mid-century theories of the corporation to reframe dominant social histories of medical corporatisation, we go on to argue that large medical institutions are productive sites for deliberation over the medical profession’s social contract. Our primary case study for this longer historical and broader theoretical argument is the MD Anderson Cancer Center, the world’s foremost treatment hospital for patients with cancer. We hold that the historical trajectory that led to MD Anderson’s exceptional but exemplary place in the evolution of American corporate medicine is reflective of historical trends in the practice.