I am a former subscriber to the magazine and read its follow-up (Authentic Medicine) religiously. I even send out some of my favorites on LinkedIn and Twitter. I ain’t going anywhere.
Peter Winston
Impressed that a lot of teachers are reading this material. Your site is the Writing on the Wall. Keep it coming!
David Devonis
Finally, one of us has stepped forward to confirm that indeed, the emperor has no clothes. So many docs are so busy being “providers” that they cannot see what is being lost day by day. You are accelerating the “wake-up” point and may just be the catalyst to doctors seeing through the veil that keeps them moving into this madness. May you be guided to continue this important work, inspire other doctors to find the courage to listen to their higher wiser self, and to take action to restore the dignity and sacredness of the doctor/healer-patient relationship.
Susan Ortiz MD
I did laugh and cry over this issue. Every single, last topic was great, and spot-on.
How can we help get the message out other than telling our colleagues and forwarding your emails?
Dave Rogers MD, MBA
Just a quickie to let you know that what you do is very appreciated amongst the masses of us frustrated physicians, especially those of us who have seen the practice of medicine gradually morph from an honorable, respected profession to one a being tarnished by an overwhelming, protocol-spewing bureaucracy that is threatening to choke us all. You provide a great outlet to us.
John Difini MD
Keep up the good work. We need more physicians like you to take a ( politically incorrect) stand and prevent the wholesale destruction of our profession.
Marc Binard
Impressed that a lot of teachers are reading this material. Your site is the Writing on the Wall. Keep it coming!
I’ve been following you for years (as a biomedical researcher), and your
candor always strikes home. I wanted to quickly send you an email saying that your new format makes a
world of difference. Very excellent work. Thanks for all you do.
Daniel Baker
Hi, Doug!
Good luck with your crusade - not as funny as PJ, but unfortunately
necessary.
Susan Stangl MD
Hey - I really like the concept and the site design. Great job!
Linda Becker
Dr. Doug,
I've been receiving your information for many years ... most enjoyable.
Ken Leebow
I enjoy your site. I appreciate your heartfelt concern for patients and your irritation at the “solutions” suggested/mandated by outsiders (e.g. politicians). I don’t always agree with you (I’m adamantly for universal/single payer healthcare), but I appreciate your struggle. Keep up the good work.
Pat Nagle
Hi Dr. Farrago,
You provide a valuable service to both the public and to members of your profession. Keep up the great work and put me on your mailing list. Blessings, best wishes, and Godspeed.
Bob Strickland
Great job, Doug! Blessings on your efforts, Doctor!
Beverly Nuckols MD
Keep up the good work. You brighten every Wednesday.
Jane Helwig
As a nurse for 20 years, I too am sick of the sick care that we healthcare
professionals are suppose to dish out. My idea is to change the disease care system
that we have to a truly "healthcare" system. Abolish all agencies that stand in the
way of that. Let your imagination roam on that last one.
Bobbi
I've followed your writing via email for years now, I suppose. It's time to say thank you for all the heart and soul you have put in to entertaining and educating so many of us. Thank you.
Jeanne Willson
Don't you ever dare to stop being The Voice of Reason!
Cheers,
Stacy Kess
The new site looks great so far. I actually like the black and white look too - reminiscent of "old" medicine! I've always enjoyed the PJ, sent to me a few years ago by a friend. Keep it up, please.
Susie Cannon
I am a doctor in Australia. Your expertise is in the American system, and it helps me cope with the crap in the Australian system.
Philip Clarke
I don’t have a specific comment about ACO, but I disagree that holding a physician accountable for the cost of the care they provide is unethical. I actually think that the opposite, which is making physicians entirely unaccountable for the costs of their decisions, is a large part of the huge increase in the cost of healthcare over time. By entirely insulating physicians (and largely patients) from their choices, we have created every incentive to maximize the cost of healthcare. After all, if we experience no cost for a choice yet gain any sliver of benefit, one would always choose that path. This was discussed in depth in the book “Free: The Future of a Radical Price”, which discusses typical market behavior when a person is presented with a item that costs nothing to them, yet provides a benefit. That market behavior is for that resource to be wasted.
In my own experience operating in an outpatient surgery center where I personally benefit from saving money in the center, I make choices that dramatically decrease costs. I also find that I am able to provide extremely high quality surgery, despite these choices. I need only to look to my colleagues in Europe who are master surgeons yet practice in a socialized system that does not afford them unlimited access to expensive disposable equipment. Their quality is unmatched, yet they spend a fraction of what we do on operative consumables.
I’m not sure about ACOs per se, but I’m all for both physicians and patients having some skin in the game as to the cost of healthcare.
I do not agree. A stable of healthy insured is a gold mine. The risk of additional treatments being more expensive than others, if they are both effective, is minuscule. The profit is in the restoration and maintenance of health.
ACOs are conflict of interest and unethical. You don’t make money by saving money for the system, by scrimping on patient care. I agree we should use tests wisely and help our patients save money, but don’t avoid care to get your bonus.
The unethical part – getting paid to withhold care – is staggering, but no one talks about it.
RISK is an essential cost of every enterprise. Risk is either extrinsic, like farming is, betting that the weather will stay within a certain aggregate range that will allow your crops to grow; or intrinsic, the risk that you have made bad plans.
When someone or something changes the rules arbitrarily, it’s like the gods constantly sending you bad weather. You can’t plan for it. Similarly, the risk of your planning not fitting what’s coming is high, if nobody knows what’s coming.
The CMS tinkerers, and the corporate planners and business hotshots have sunk their teeth into the cashflow of American healthcare, and they’re eager to get more.
They’re introducing unpredictable risk, which equates to unpredictable costs. They are guaranteeing the demise of small-practice medicine, and the rise of industrial corporate Taylorism in medicine. They see the future of medicine, and it is not different from Amazon, which have brought consumerism to the factory floor. The price of risk of stuff like ACOS can be underwritten by large groups; the small folks get overwhelmed. The injustice of bankrupting the individual practices by increased risk is waved a way as a “cost of doing business,” “capitalism in action” (which it isn’t,) and “the wave of the future.”
ACOS costs practitioners’ money, ho-hum. We, the masters of CMS, make the changes and the peons take the risk. We’ve talked it over with our cronies in United Health and Wal-Mart, and they will buy into it. The little guy is the loser. So sad.