Helping Doctors Succeed - NYTimes.com Re "Clinic Races to Adapt to Health Care Overhaul" ("Remaking Medicine" series, front page, June 23): The uncertainty posed by health reform highlights the importance of primary care practices. Reform cannot succeed without them, and they cannot succeed without better, cheaper technology. Small practices and clinics are already the front line of care, providing close, continuous patient support that prevents costly hospital visits down the road. They are also facing unrelenting debt and a shortage of doctors. Technology can help them survive and thrive. The Louisville, Ky., clinic saved time and reduced no-shows with its electronic system. Medication reminders, "time for your checkup" alerts and mass patient e-mail tools would assist with prevention and reform outreach. We need to make these innovations available without further financially burdening small practices. Effective reform requires major changes in patient behavior. Despite the attention paid to hospitals, they aren't equipped to influence attitudes, foster prevention or handle millions of newly insured patients. Primary care doctors are. Without solutions from policy makers and innovators, however, they could disappear, and health care reform along with them. RYAN HOWARD San Francisco, June 26, 2013 The writer is the founder and chief executive of Practice Fusion, a health care technology company.