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JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. University of Wisconsin Press andThe Board of Regents of the University of Wisconsin System are collaborating with JSTOR to digitize, preserve and extend access to The Journal of Human Resources. ABSTRACT This paper presents an activity analysis model of primary medical care which, through the use of integer constraints, captures both the technology of ambulatory care and the institutional restriction that labor inputs must be employed in discrete units. The result is that staffing patterns and optimal choice of techniques depend on the scale of practice. Empirical experiments demonstrate this relationship and, furthermore, reveal that introduction of physician extenders into the medical care system increases the scale at which economies o f staffing are obtained and raises the diseconomies of suboptimal practice.

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