ABSTRACT
This chapter examines the problems involved in organizing ambulatory care by examining individual office practice. Understanding it will facilitate the analysis of the more formal modes of organization that social policy is now emphasizing as a solution to the growing crisis of medical care in the United States. The fundamental barrier to choice that conditions the nature of the organization is, of course, that of medical licensing: individuals are free to choose only among practitioners who are licensed physicians and are not free to choose other kinds of healers. Except perhaps in some urban neighborhoods where solo medical practice still remains somewhat competitive, the abbreviation of services has increasingly characterized the organization of ambulatory medical care in the United States since World War II. The traditional ambulatory care available to the regularly employed, paying patient has been organized around the solo practitioner with his circle of self-selected patients and his links to consultants.
