This issue of the Journal provides a sense of the wide range of innovations occurring in ambulatory care today.

In the 1980s, when I was medical director in charge of employee health services of a large company, I and many others wrote about and implemented employee wellness programs. While some of us spoke about worksite-based coordinated primary care, this was just a dream. Doug Roblin reports on a well-designed workplace health promotion program. Brian Klepper discusses the work he is doing to link employee wellness with primary care.

The next several articles continue the critical conversations and experimentation currently underway on primary care. John Kralewski examines the critical topic of the impact medical group characteristics on preventable services such as emergency room visits. Guy Clifton provides a commentary. Roderick Hooker with a commentary by Kavita Patel continues the ongoing debate about the role of physician assistants and nurse practitioners in primary care.

We continue to be very interested in the distinct themes of community health workers and patient engagement. Torres and colleagues continue the Journal's interest in community health workers.

Michael Millenson and colleagues provide us with case studies pertaining to patient engagement. Vasanth Kainkaryam provides us with additional information on shared medical appointments. Lepore and colleagues including John Wasson, an associate editor for the Journal provides us with another in a regular series of snapshots on patient engagement. Calderwood's article highlights the importance of mental health state as part of patient engagement in primary health care.

Finally, Mark Holt continues to keep us up to date with the latest developments in the Republic of Texas.

-Norbert I. Goldfield, MD

Editor