Tom Bodenheimer has a compelling article in this week's BMJ :
Summary Points:
Primary care in the United States is facing difficult times: doctors are overworked and dissatisfied with it, and medical students are not very interested in it
Primary care is unable to deliver everything expected of it and offers neither timely access to acute care nor state of the art chronic care
A redesign of the primary care sector that addresses these problems is gaining acceptance in the United States
The redesign envisages the development of clinical teams, open access scheduling, implementation of a new model of management of chronic care, training patients to manage chronic conditions themselves, and group medical visits