Open access · No proprietary content · The barrier to entry is doing the work  ·  Target: public availability 2038
PrimaryCare.Solutions
Integrative Primary Care · Open Framework

"We never change things by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete."

— R. Buckminster Fuller

A framework for primary care built from the ground up — the clinical model, the cooperative delivery structure, and the principles that make both work. Available to any community that wants to build something better.

A globally accessible, community-powered, and economically sustainable primary care system that treats quality of life as the foundation of medicine.

The tree is universal. The cultivation belongs to those who plant it.

This site presents a framework. It does not claim to know what that framework looks like where you are.

The principles here were developed through more than twenty years of research and integrative practice in one place, by people who know that place. We share them because we believe they point toward something real and replicable. What replication looks like in your community, your culture, your resource environment — that is work only you can do.

The Clinical Framework

Fifteen primers. Start anywhere. Read in sequence or follow the thread that matters to you.

Group 1 — Foundation

Why this framework exists

The execution gap, the Alma-Ata promise, historical clinical lineages as evidence, and the two algorithms that govern clinical reasoning. Five primers that establish the diagnosis before presenting the model.

Primers 01–05 →
Group 2 — The Model

Three pillars: strategy, integration, trust

Isolated care, inclusive care, and true integrative care. The arc from presenting condition to full recovery. Trust as a clinical variable, not a soft outcome.

Primers 05–10 →
Group 3 — Clinical Tools

The instruments every practitioner carries

The stress/diet/sleep triad. The patient capacity pyramid. Constitution as the variable that makes care genuinely personal. Health agency as the highest-order outcome.

Primers 11–14 →
Group 4 — The Practitioner

The clinical confidence problem

Why technically skilled providers still fail patients by optimizing for the presenting instance rather than the full arc of recovery.

Primer 15 →

The Cooperative Model

The delivery structure that makes the clinical framework sustainable.

Business Model

Why a cooperative

The structural argument for community ownership. What the insurance model gets wrong and why removing it from primary care changes everything.

Explore →
Delivery

How it works

Membership, the integrated care team, what most people need in a given year, and the four-tier payment structure that keeps care accessible.

Explore →
Scale

The federated backbone

How local cooperatives connect through shared infrastructure without losing what makes them local. The principle that makes the model scalable.

Explore →
Participation

How to get involved

Three doors: as a member, as a practitioner, as a community builder. The model is open. The invitation is genuine.

Explore →

A Worked Example

What we know, because we built it.

Minnesota, USA · Everspring Health

One application of the model

More than twenty years of research and integrative practice in Minnesota. The hub model in practice, the patient population it serves, and what the arc of care looks like when it is held consistently over time. Presented as one application — not the application.

Read →

Global Resonances

Places where existing conditions align with parts of this framework. Presented with what we recognize — and honest about what we do not know.

The following are not implementation guides. We do not claim to know what this model looks like in Rwanda, Brazil, or Thailand. We recognize conditions that rhyme with the framework. Local practitioners, communities, and policymakers are the only ones who can know what it actually means where they are.

If you see your community in this work, we want to hear from you.

Sub-Saharan Africa

Rwanda — cooperative health workers

Community health worker cooperatives with performance-based incentives and community-based insurance covering more than 90% of the population. The cooperative structure exists. The integrative clinical arc does not yet.

Coming →
South America

Brazil — the Family Health Strategy

41,000 transdisciplinary teams covering 120 million people. The community-embedded team structure maps closely to the integrative model. The arc of care framework is the missing layer.

Coming →
Southeast Asia

Thailand — near-universal access at low cost

Comprehensive coverage for nearly the entire population at less than one US dollar per visit, anchored in community-based primary care. Proof that access can be achieved. The integrative clinical depth is the next question.

Coming →
East Africa

Uganda — cooperative healthcare exported

A cooperative healthcare model that did not exist in 1997 now serves tens of thousands through 70+ providers. Community ownership and cooperative governance proven in a low-resource setting.

Coming →

Reference

Quick-reference pages, primary source documents, and the evidence base behind the framework.