An interesting article was published recently in HealthcareIT Today. It offers the hypothesis that in the future it will be the care manager and not the physician who is central to the patient relationship. This is an interesting notion and one we must take seriously as we look to better engage and better care for patients who have historically not done well in traditional medicine. This would include the medically complex and socially disenfranchised who for different reasons do not engage well with the healthcare system as it is. I do not see this as a suggestion that physicians must surrender their role in leading patient care, but instead it is a challenge for us to re-imagine how we relate to patients in the community around us. Iora Health has been doing something like this for a number of years with good results.