Improving opportunities for primary care are evident in the evolving health care marketplace. Yet a secure and meaningfully scaled role in the future for family medicine and primary care is not assured. Family medicine can help lead the primary care movement now-from both clinical and policy perspectives-by energetically embracing newly emerging care options rather than becoming complacent or defensive. Avoiding complacency means: (1) improving assessment and intervention for social and health system complexity (our complex patients), (2) regarding primary care as a way of operating, not as a geographical place-even with the name medical home in place, (3) coordinating with dedicated mobile teams for our most complex and costly patients, and (4) improving leadership competence at a level required for transformation, not just maintenance.