For the times they are a-changin'

Today, as we deal with managed care, vertical integration, mergers, new technologies, diagnosis related groups, stockless or just-in-time distribution, capitated contracts, consignment, health maintenance organizations, preferred provider organizations, total quality management/continuous quality improvement, reengineering, federal regulations, care mapping, patient focused care, and so forth, it is obvious that the only thing that is constant is change. "For the times they are a changin."