ABSTRACT
Medical errors in primary care are personal, systemic, and relational. Primary care is about sequels and daily acts of creative imagination. Insurance companies provide; primary care practice teams, the "clinicians", offer healing relationships that support and facilitate patients' healthy return into the emerging stories of their lives. Surefootedness is the secret of the wilderness walker, the tracker, the backcountry skier, and effective primary care leaders. Leadership is engaging with self and others to make sense and find a way through life's mazes. Leadership is creating space and intention for better and crucial conversations. Physicians too often believe that leadership means giving directions and being the boss. Leadership is "standing by words" with intentional integrity. Adaptive reserve features include regular whole practice meetings with times for reflection, facilitative leadership, a repository of helpful stories about the practice, the ability to improvise, and a learning culture.
