As a former pediatrician in rural Vermont and a career-long believer in the centrality of primary care, I have been frustrated and dismayed to witness the lack of definitive evidence demonstrating what is considered to be conventional wisdom—that a high-performing health system must have primary care at its core. For a decade, I have been in the position of counseling patience, insisting that the upfront investment in the quality of, data for, and access to primary care will eventually pay off.