Primary care, the foundation of an effective, equitable health system, is under strain. Clinician shortages are worsening as providers leave traditional settings for concierge and virtual-first models, while rural and safety-net clinics struggle to keep their doors open. The result: millions of patients are losing access to the preventive, relationship-based care that keeps communities healthy and costs down. Where do we go from here to sustain primary care for the foreseeable future? Clinical, policy and innovation leaders are rolling up their sleeves to rework reimbursement models, utilize technology that can expand the reach of a single physician and develop team-based, interdisciplinary approaches to care. Primary care that remains both viable for clinicians and accessible for every community is worth the effort.