THE purpose of this paper is to describe a way in which some of the problems of rural medicine are being approached by the Rip Van Winkle Clinic, now six and a half years old, which is located in New York State on the east bank of the Hudson River in Columbia County.The Rip Van Winkle Clinic was founded in an attempt to provide a means whereby people of a relatively poor rural community could be offered the best available medical care at a cost that at least 90 per cent of the people could afford. It was also . . .