[영문]This paper provides an analysis of the structure of the health care delivery system, emphasizing physician group practices. The authors argue for comprehensive integrated delivery systems (IDSs). The jumping-off point for their analysis is the recently published Redefining Health Care: Creating Value-Based Competition on Results, by Michael Porter and Elizabeth Teisberg. The authors focus on the book’s core idea that competitors should be freestanding integrated practice units (or qqqquot;islands in archipelagosqqqquot;) versus IDSs (or qqqquot;medical homesqqqquot;). In any case, the authors contend that this issue should be resolved by competition to attract and serve informed, cost-conscious, responsible consumers on a level playing field.