This paper reports on a workshop held at the 19th National Family Practitioners Conference in August 2016. The aim of the workshop was to describe possible future scenarios for the discipline of family medicine in South Africa and identify possible options for action. The workshop led a group of 40 family physicians from academic, public and private sector settings through a scenario planning process developed by Clem Sunter and Chantell Ilbury. After an overview of the current situation the participants reached a consensus on the rules of the game, key uncertainties, future scenarios and options for action. The main message was that the South African Academy of Family Physicians as a professional body needs to take a stronger role in advocating for the contribution of family medicine to government, health managers and the public.