In some form, team-based care is an essential element of family medicine practice; however, the composition, roles, and definitions of team members vary widely. Team-based care has been promoted as a strategy to address rising clinical complexity, workforce shortages, and clinician burnout in family medicine. This article synthesizes a structured dialogue convened by the Family Medicine Leadership Council (FMLC) that examined both the promise and limitations of team-based primary care. Drawing on evidence, national data, and leadership perspectives, the discussion highlights key design considerations, tensions related to continuity and professional identity, and the importance of context-sensitive implementation. The article argues for team models adapted to the specific circumstances of diverse practice settings that preserve continuity, accountability, and the core values of family medicine.