Comprehensive health care can be provided in rural and poor areas despite a decreasing number of physicians in those areas. A single physician increased his productivity by 300% to 400% by combining already available resources: specially trained and supervised nurse-practitioners, problem-oriented charting, and multiphasic screening. With emphasis on the nurse-practitioner as the main "person of contact" for the patient, the physician is able to shift from 50% to 75% of his usual tasks to these specially trained personnel. Patients have come to regard the physician as a "consultant" to the nurse-practitioner.