A healthy primary care system is essential to our nation’s health system, but primary care practice is at a crossroads. Burnout is rampant, fewer physicians are choosing the specialty, and many existing primary care doctors are leaving it. Physicians Chris Sinsky and Tom Sinsky and their colleagues visited more than 20 primary care practices that have adopted innovations to enhance the job satisfaction of physicians, other clinicians and staff while also improving the quality of care and the patient experience. They share the lessons they learned in these visits and discuss some of the most appealing innovations, such as pre-visit planning and labs, using non-physicians as “scribes” to record physician-patient interactions, and expanding the role of nurses and medical assistants.Drs. Christine and Thomas Sinsky are general internists at Medical Associates Clinic and Health Plans, in Dubuque IA. They are frequent invited lecturers on practice innovation, redesign, and the Patient Centered Medical Home (PCMH) and have given workshops for the American College of Physicians, the Institute for Healthcare Improvement, the New York City Department of Public Health, as well as private and academic medical centers. Dr. Christine Sinsky serves on an expert advisory panel for the CMS Innovation Center’s Comprehensive Primary Care Initiative, and is a co-author of the Institute of Medicine’s 2011 report, Health IT and Patient Safety. She is a Director of the American Board of Internal Medicine. She has also provided testimony to the Office of the National Coordinator for HIT on EHRs with respect to both care coordination and usability. Both Drs. Sinsky are investigators for an ABIM Foundation study of high functioning primary care practices. Both Drs. Sinsky received their B.S. and M.D. degrees from the University of Wisconsin, Madison, Wisconsin, and completed their postgraduate residency at Gundersen Medical Foundation/La Crosse Lutheran Hospital, in LaCrosse, Wisconsin.