At a time when patients are craving more personalized care and search engines are providing "diagnoses" that are all too often incorrect, this sort of collaboration among physicians is essential to maintaining a first class health care system.

Private practices will not disappear, but increasingly they will become a niche to provide good old fashioned service to the generation in the habit of "going to see my doctor," while the more mobile young have already discovered the instant gratification of clinics and particularly the ERs.

The insufferable pace of primary care combined with the erosion of the doctor-patient relationship deters young physicians from entering the field. In my graduating class of 30 or so internal medicine trainees, only two of us chose to go into primary care.

But it is also a terrible deal for taxpayers. The American taxpayer needs to understand how this Medicaid patient ended up in Randy's office.