Enjoy our most current issue of the most popular medical e-newsletter on the internet.
Blogs and Thoughts for Septemeber 14th to Sept 20th, 2017
Here is what we had this past week:
- Bureaucracy Killed the Family Physician
- The AAFP Continues Their Cluelessness
- The Evil Hospital Administrator
- ZDoggMD and the Joint Commission
- The Only Bright Light Out There by Pat Conrad MD
- Friday Fun: Medically Inspired Wedding Gowns
- Quote of the Week: Joseph Campbell
1. Bureaucracy Killed the Family Physician
Sept 20, 2017
Here is a nice summary in the Medical Economics magazine of why we are having such a shortage of family docs. All of it, by the way, was predicted by me over the past 15 years with proof in this blog. It is summarized as:
- Red tape
- More bureaucracy
- Quality indicators
- More red tape
- Even more bureaucracy
All of this was created and imposed upon doctors by the federal government. And the beauty is that some people think that the one who will fix this all will also be the government. Really? Child, please.
2. The AAFP Continues Their Cluelessness
Sept 19, 2017
At the most recent AAFP yearly meeting, it was decided:
Healthcare is a basic human right and there should be a “publicly funded universal primary care program,” according to resolutions adopted Wednesday by the American Academy of Family Physicians Congress of Delegates here.
The healthcare-as-right resolution stated that the AAFP “recognize that health is a human right for every person, not a privilege.” It was amended to clarify “that the right to health includes universal access to timely acceptable and affordable healthcare of appropriate quality” and was passed with resounding applause.
Good for them. It is so easy to be the good guy. It is so easy to say everything is free. The problem is that the answers are not easy. They don’t say how it will be paid for. They have no plan. Just another wish for the AAFP.
I want better health for everyone. The problem is that I cannot control what people eat, drink, how much they smoke, or how much they exercise. Correct me if I am wrong but everyone has the right to do ALL of this. They just don’t do it. The AAFP, of course, takes the easy road and mentions none of this. They do mention that somehow “universal access to timely, acceptable and affordable healthcare of appropriate quality” should be magically created and paid for. Don’t get me wrong, for a reasonable price, you can actually get this with DPC, which is only attained via a free market. You cannot, however, get it with a government-run, bureaucratically heavy system. It will fail.
And someone please explain to me why having food, water, and shelter is not a right but yet healthcare is?
3. The Evil Hospital Administrator
Sept 18, 2017
I often rip on hospital administrators for many reasons. One, there are too many of them. Two, they think they are more important than they are. Three, they are getting too powerful. Want an example? Here is one from a lawsuit in California:
The suits stems from actions taken Jan. 26, 2016, when the Tulare Regional Medical Center (TRMC) board of directors voted to terminate the hospital’s medical staff organization and effectively remove the hospital’s elected medical staff officers, install a slate of appointed officers, and approve new medical staff bylaws and rules drafted without staff input.
Except for the newly appointed officers, the rest of the staff was then terminated, stripped of their rights as active members and then granted “provisional” status as part of the new medical staff which they had not applied or consented to membership with, according to a post-trial brief filed by the TRMC Medical Staff.
The replacement bylaws also contained a provision, since amended, that physicians could achieve and maintain “active” status by proving their economic value to the hospital, according to the brief—which described that provision as “basically, an illegal kickback scheme.”
All I can say is….wow. Physicians gave this healthcare system away and we continue to pay for it. This power play, by the hospital administrators at Tulare, is unbelievable. And disgusting. And evil.
We need to fight back. All of us.
4. ZDoggMD and the Joint Commission
Sept 17, 2017
A few days back I ripped on the Joint Commission pretty hard. They deserve to be criticized even more so here ZDoggMD gives his shot.
5. The Only Bright Light Out There by Pat Conrad MD
Sept 16, 2017
For decades, the American Academy of Family Practitioners has taken a leading role in selling out their members, those members’ patients and communities, and the state of U.S. health care in general. I trained in family medicine at a very good residency, where I truly received an excellent education from some outstanding physicians, to whom I shall always remain grateful. Yet the rapid self-abasement and degradation of this discipline has left me with a reflexive disgust. Esteemed colleagues here have sometimes agreed with my views, while others have thrown a barb or two at them. Hey, that’s cool, we’re big boys and girls here (hopefully all cis-) and Doug is honest enough not to sanitize away contrarian views like some social media physician voice leaders (ahem) I could name.
But this is nauseating, and I mean splat-all-over-the-rug, run-to-the-bathroom, bile conjuring, vomit-inducing stuff. One expects that outgoing AAFP president John Meigs Jr., MD was rushed to a local ER after dislocating his shoulder the other night, after the most aggressive display of self-back patting ever witnessed outside of an Oscar’s ceremony. He arrogantly worked a Bible quote into describing his defense of ObamaCare, while whining about the very electronic records that his establishment helped to force on the rest of us: “This is the day that the Lord has made. Let us rejoice and be glad in it.”
“’But God doesn’t have to use an [electronic health record],’ he quipped, or to ask insurers for prior approvals, when they think they are God.”
A little personal aside here: I don’t like it when politicians invoke the Almighty, as there is never, ever any evidence that Providence is on their side. And make no mistake; Meigs is a politician gaming for special interest gains while extolling his own beneficence. Meigs met with senators in D.C. this year to argue against repealing the ACA, and said: “From the beginning we said the ACA is a good start. It’s not perfect. Prescription drug prices are too high. We need incentives for young people who want to buy insurance.” This quote alone shows him to be an economic ignoramus, and possibly dishonest as all hell. Here is his quote: “We need a public option that will allow people ages 55-64 years to buy into Medicare or obtain a Medicare Advantage plan. We need to require all insurance plans to cover the essential health benefits so that they are available to all.” None of this would ever bring prices down for consumers, employers, or taxpayers. As we have seen, it would fatten the Big Insurance profits all the more, and worsen an already irretrievable national debt.
There has NEVER been any mechanism in the ACA that would bring prices down or incentivize millennial basement-dwellers to buy insurance (His panel colleague Hal Lawrence, M.D., CEO and EVP of the American Congress of Obstetricians and Gynecologists, said “The question is whether medical care is a right or a privilege. Most people would agree that it is a right and that we need to have universal access. We have to find a better way to cover that.” So these were a bunch of left-leaning huff’n puffs leading the fight to defend the ACA as a better path toward eventual single-payer, proving that they are all economic ignoramuses and dishonest as all hell).
So family docs, your outgoing AAFP president is a government health care stooge that has supported the very programs that have made life worse and more expensive for you, under the guise of promoting your interests. Meigs said so himself, bragging how the AAFP was the first specialty to require MOC, and that recertification is a founding principle of the AAFP. As Meigs explained, “the concepts of professionalism, continued professional development, commitment to lifelong learning and maintenance of certification are at their core principles that family medicine introduced and championed for our profession” (And Dr. Puffer at the ABFM will be glad to cash your check). And what has this shakedown gotten us, and what proof is there that any patient benefit has been achieved?
In one fashion or another, Meigs has been a supporter of mandatory EHR’s, expanded Medicaid/SCHIP programs, PCMH’s, self-abusive MOC garbage, value-based programs, and emphasis on “diversity and working on the social determinants of health.”
Then he gave as his swan song admonition: ”We must continue to be the disruptive innovators of our profession.”
There is only Direct Primary Care. In fairness to Dr. Meigs, I was pleasantly surprised to read his statement on DPC: “You’re not on the hamster wheel of getting paid based on the volume you do. Patient satisfaction goes up. Physician satisfaction goes up. Quality goes up and costs go down because you don’t have to prove it to Uncle Sam or an insurance company.” I can’t fathom how Meigs can square his support for so much of the government intrusions listed above with DPC, but if he wants an actual disruptive innovator, we know where he can look.
6. Friday Fun: Medically Inspired Wedding Gowns
Sept 15, 2017
When you know you won’t get much time off for your wedding why not get something that works for both? From the minds of the Placebo Journal (2001-2011)
7. Quote of the Week: Joseph Campbell
Sept 14, 2017
A hero is someone who has given his or her life to something bigger than oneself.
Editor’s Note: For those in the medical field, that’s you!
UNTIL NEXT TIME, KEEP SMILING, KEEP LAUGHING AND KEEP OUT OF THE SAMPLE CLOSET!
Douglas Farrago MDTweet