The Centers for Medicare and Medicaid Services (CMS) released proposed changes for payments for 2019. The medical media and the various professional societies are busy identifying the losers and winners. For a move that will affect all physicians and impacts approximately 1.5% of our GDP [1], we deserve to know more about these changes than a self-serving summary of winners and losers. The Current System Practitioners [2] are currently paid for five levels of office visits based on how broad a patient history…