The purpose of the article is to enhance the understanding how changing the culture of health care organizations may improve patient safety. A conceptual model is developed using results from sampling primary care physicians using the “Minimizing Error, Maximizing Outcome” study and analyzed via structural equation modeling. The study found culture plays a lesser role than hypothesized, but a cultural emphasis on quality played a key role in both quality outcomes. Moreover, it was found that stressed, burned out, and dissatisfied physicians do report a greater likelihood of making errors and more frequent instance of sub-optimal patient care.