The so-called “medical home” is touted as the future of primary care. But consider how difficult it is to implement one, as it is currently written.

Primary care physicians are overworked and don’t forget, only a small minority have adopted electronic medical records. Who is going to pay for the time and effort to transform a practice to a medical home, in exchange for benefits that may not materialize?

Richard Reece calls it a bottom-up problem:

You can proclaim from the top-down rooftops of payers, businesses, government, and from medical societies, and health plans ““ what you want to happen and what you think should happen. But the central players ““ primary care physicians ““ in making medical homes happen, may be unable or unwilling to make it happen, and the whole idea may never get off the ground. Furthermore, many primary care physicians may regard medical homes as bureaucratic or electronic prisons, as another nail in their autonomy coffin, and they may choose other options, such as concierge care, cash only practices,locum tenens, refusal to accept Medicare or health plan patients, careers outside of direct patient care, or retirement.