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Background: Comprehensive outpatient medical care is being increasingly threatened due to the decreasing willingness of physicians to establish their practices in rural areas. Partly, municipalities feel impelled to support doctors setting up their practices with their own resources. The aim of this study was to get the community perspective on the ambulatory care situation and to examine the role and influence of the local authorities., Methods: The mayors (n=411) and district administrators (n=38) in Lower Saxony received a self-developed written questionnaire in September 2015 (comprehensive survey)., Results: The response rate was 72%. Availability of general practitioners was considered as inadequate by 30% of those surveyed and 71% described specialist care as being insufficient. Two-thirds of respondents saw local problems with filling vacant doctors' offices. 42% of mayors and 65% of district administrators said they had already supported outpatient doctors. The most frequent measures carried out so far included financial support, consulting services and the development of cooperation and networks. The majority considered the model of medical care centers being operated under municipal sponsorship to be unsuitable in principle., Conclusions: Local governments prevalently see problems with filling vacant doctors' offices as well as a need for local support. A significant proportion of municipalities has already implemented various support measures. Community participation in the outpatient care with medical care centers under municipal sponsorship is assessed rather critically., Competing Interests: Die Studie wurde finanziell unterstützt durch Fördermittel der AOK Niedersachsen und der Kassenärztlichen Vereinigung Niedersachsen., (© Georg Thieme Verlag KG Stuttgart · New York.)