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Howard M. Jackson
Associate Director for Health Appalachian Regional Commission Washington, DC

JAMA. 1975;234(12):1221.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The article by Kane et al (232:1023, 1975) is a welcome and long-needed analysis of what many in the rural health field dismissed as a well-intentioned, even noble failure.

Instead, the results of 13 years' effort by the Sears Roebuck Foundation's Community Medical Assistance Program seems, in the light of present knowledge, to show a rather startling degree of success.

The experience of the Appalachian Regional Commission, and that of the few others in the rural health field, is that a success rate of more than 50% for clinics is remarkable considering the small annual budget, the state of the art of primary care center development at the time, and the reimbursement philosophies of most third-party payors.

From the article, it seems that the Foundation came up early with the key ingredients: the necessity for strong community support, even to insisting that people back up their commitment . . . [Full Text PDF of this Article]

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