The next big free fall seems to be the patient centered medical home model. Every conference I attend and every person I speak with seems to be head over hills into this model. I think like most other booms this will make some well positioned individuals very rich while not really fixing anything. I really beleive the real problem is the administrative cost we as docs have to incur in putting our product out to the our patrons. It is not only insurance executives but hospital ceos, dme ceos, head hunter ceos and all the middle men who are taking a lions share of compensation that should be going to the care of the patient thus our reimbursment. A lot of individuals positioned just perfecttly to be medical directors of the large PCMHs will likely become very wealthy while many of us who are actually providing excellent evidence based care will continue to suffer.
