In order to set primary care physicians up for success, it is imperative those in charge understand our challenges. Rural physicians are alone, save for our spouses running our medical practices while we see patients. For physicians to be successful, additional revenue would be necessary to meet the expensive health IT burdens placed on us by this new payment model. Creating “virtual” groups to consolidate reporting will still require provision of a “virtual” assistant because it is more administrative burden than we can handle. Our profit margin is too narrow to accommodate additional employees.