In Reply We thank Loud and Shipman for their insightful response to our Viewpoint, “Consumerism, Innovation, and the Future of Pediatric Primary Care.”1 In our piece, we argued that our system of pediatric primary care must innovate to avoid decline, a possible future suggested by 2 complementary theories from the business literature, creative destruction, and the innovator’s dilemma.2,3 As a starting point, we suggested that supporting team-based care, improving access and efficiency for consumers, and implementing telehealth as a part of the medical home would provide 3 ways to begin to reshape practice.