Technological, social, economic, and political changes have increased the rapidity of changes in the pattern of living in small towns and rural areas. As a result, a large percentage of rural Americans who live at or below the poverty level are not provided adequate medical care. After realizing the shortage of physicians in North Carolina and after focusing its attention on the problems of small communities and communities with acute health manpower shortages, the state suggested that existing resources be more effectively utilized and that advice on how to develop appropriate kinds of health care mechanisms be provided. This booklet, then, provides a background for communities involved in planning for improved health care delivery, which involves organizing at the community level, identifying community health needs and resources, and defining the planning area. Changing concepts in rural health care and alternative types of rural health care delivery are discussed under the heading of Innovations in Rural Health Care. Some basic guidelines in recruiting a physician are provided, such as what conditions influence the physician's choice of a practice setting, how a community can generate physician interest, and what the community can do to keep the new physician. Appendixes and a selected bibliography are included. (HBC)