The distribution of health professionals, particularly physicians and dentists, has been especially critical for rural America. An effective lasting solution will depend not only on economic incentives but on the development of a health care delivery system that links providers to hospitals, decreases professional isolation, and utilizes physician extender personnel in isolated areas. Before building a health system, the community must consider four basic issues: (1) need--are there enough people to require the services of one or more physicians? (2) feasibility--is the community able to financially support health care personnel and facilities? (3) existing health care sources--where does the population currently obtain health care? and (4) linkages--are major health resources accessible and available in the larger region for required backup services? The health system should address the population's needs for all three levels of care--primary, secondary, and tertiary. Emergency medical service should be an essential component at all levels. Consideration should also be given to linkages with medical schools and health departments, transportation, and community and financial support. Seven models of the rural primary care center depicting various levels of organizational arrangements are described. (NQ)