The communication by Harrell appearing in this issue (p 1103) describes the approach of one medical school to training for the delivery of health care in small towns and rural areas. The educational and training program is conceived as a realistic one to meet the needs of the community for care of chronic illnesses, minor acute problems, triage of emergencies, the handling of less severe diseases or the "worried well," and the health education of the community. These problems require a facility for ambulatory patients and not hospital beds. In order to give the public continuity of care, the unit should be staffed by mature physicians committed to the community rather than a succession of house officers and medical students.
If the hypothesis of the school is correct, the money formerly placed through the Hill-Burton program into the construction of small hospitals should be channeled into the ambulatory type of