Introduction. Structural optimization in combination with other measures to improve the organization of primary health care in conditions of shortage and imbalance of personnel allows for higher performance of a medical organization. To develop proposals for improving the organization of primary health care, it is necessary to take into account the opinions of all participants in the processes of medical organizations - healthcare organizers, doctors, nurses and patients. The purpose of the study is to study the opinions of experts, local therapists, local nurses and patients on the organization of primary health care for the adult population. Materials and methods. A medical and sociological study was conducted - an anonymous survey of specialists in the field of healthcare organization (experts) from 53 constituent entities of the Russian Federation; district physicians, district nurses and patients of 2 constituent entities of the Russian Federation selected for the implementation of a pilot project to introduce a team form of labor organization at a medical therapeutic site. 74 experts, 152 local physicians, 105 local nurses and 531 patients took part in the anonymous survey. Results. One of the reasons for the decline in the availability and quality of medical care is the shortage of personnel. According to experts, the main reasons for the turnover of personnel involved in the provision of primary health care are a large workload (volume of work) (82.4%); outflow (departure) of young specialists working as local therapists after the appropriate specialty and accreditation, including in connection with obtaining another medical specialty (72.9%), and low prestige of the profession (54.1%). To increase the accessibility of primary health care 47.3% of experts believe that additional measures are needed in addition to increasing the number of medical personnel. Both doctors and nurses noted higher wages (22.4% and 31.4%, respectively) and better working conditions (14.5% and 12.4%) as the main reasons why they would change jobs. % respectively) in a new place. In the current situation with the organization of primary health care, 61.1% of local physicians and 54.2% of local nurses consider the distribution of time in the structure of the work shift to be insufficient for performing various types of work (therapeutic and diagnostic, preventive, organizational and methodological). Also, as labor organization problems, medical workers note a high workload during a shift, an increased number of the population actually served, a large amount of work with medical documentation, including due to the unsatisfactory performance of the medical information system or duplication of paper and electronic forms of documents. According to the survey, 71.7% of doctors, 60.9% of nurses and 97.2% of experts believe that the organization of the local service needs to be changed, but there are no proposals for specific organizational models. Discussions. Medical organizations spend a lot of time and resources on training young specialists, but they cannot form a permanent team. The shortage and imbalance of personnel, coupled with unsatisfactory material and technical equipment, negatively affect the quality of medical care. The problem of developing human resources, optimizing its number and composition, requires taking effective measures and implementing a set of measures, one of which is improving work at the medical therapeutic site in order to increase the efficiency of medical personnel. Conclusion. To increase the accessibility and quality of primary health care, it is necessary to implement a set of measures aimed at improving organizational approaches, material and technical equipment of medical organizations, and providing qualified personnel. Increasing economic efficiency based on structural optimization in combination with other measures to improve the organization of primary health care allows for higher performance of a medical organization. One of the areas for improving the healthcare system is the introduction of new organizational solutions to work in therapeutic areas.