Why the medical home sounds good but won't work

A sister Family Physician says in her blog, “Musings of a Dinosaur,”

It is the source of endless angst among family doctors in solo and small group practice, because the structure of the PCMH excludes us by definition. The PCMH is advertised to work best in large group practices like Kaiser and the Mayo Clinic. All I can say is “DUH!”You know what the PCMH really is? Nothing more than this:

IT’S A WAY TO MAKE LARGE GROUP PRACTICES WORK MORE LIKE A SOLO DOC!!!

I am already performing every meaningful function of the PCMH. So is virtually every physician in solo and small group practice. There is absolutely nothing to be gained — and a significant amount of money to be lost; this thing is expensive! — by adopting any of this PCMH shit. Somehow that doesn’t seem to stop our Academy from tossing us to the wolves by simply ignoring us.