This issue of the journal continues with our efforts to be multinational in scope with a focus on primary health care in Europe. Primary care health care constitutes the linchpin of any form of ambulatory care, and Professor Majeed provides us with a good picture of a rapidly changed European landscape on this issue.

We continue to add to our understanding of various managerial aspects of primary health with separate articles by Basu and Willits.

We are continuing to explore innovative aspects of ambulatory care management. For the past year, we have highlighted ambulatory care challenges through the lens of Dr Ron Goodspeed. In this issue, we begin a new series of articles with an article by Berger on group medical visits. I hope to use this article as a springboard for commentaries on this and similar ambulatory management practices. If "medical homes" are ever to financially (ie, breakeven) and organizationally (ie, provide greater primary care access for patients/greater remuneration to primary care clinicians) succeed in this country, we will need to stretch ourselves on how to best organize ambulatory care. Hopefully, Berger's article will be part of the stimulation for this conversation.

We conclude our issue with a report from the Republic of Texas.

-Norbert I. Goldfield, MD

Editor