This article—the first in a series on primary care—outlines
the daunting challenges facing primary care today. Most people in the United
States desire a primary care "home" to provide for and coordinate their health
care needs. Yet primary care is endangered by physician stress, inadequate
performance in managing chronic illness, and inability to provide prompt access
and reliable continuity of care. Fundamental redesign is needed to improve
access to and quality of care while easing physicians' workload without causing
major increases in health care costs.