When we were a group of four primary care providers it was easy to share information, communicate and work collaboratively. Having grown to ten, we struggled. As our lives became more hectic, our time scarcer, and the number and complexity of issues grew, it became impossible to manage practice governance, pursue QI projects, develop work flows, and deal with directives from our parent organization. Keeping everyone in the loop was simply not possible. Even if we could get all ten providers in one place for an hour/week, the task was too large to squeeze into an hour a week.