We do not have enough primary care physicians [PCPs] and the shortage is especially acute in rural and urban poor areas. In the USA there are about 30% PCPs and 70% specialists. In other countries of the developed world, the ratio is the opposite. And PCPs now need to attend to many more patients with complex, chronic diseaes that last for life and require a team-based approach to care. Rather than be an interventionalist, the PCP must become an orchestrator.