Authentic Medicine Gazette

Enjoy our most current issue of the most popular medical e-newsletter on the internet.

Blogs and Thoughts for June 7th to June 13th, 2018

Here is what we had this past week:

  1. Your AMA …Cover for the MOC by Pat Conrad MD
  2. How Hospitals Think They Can Fix Burnout
  3. Cigna Making Your Life Easier
  4. The Health Insurer Rate Hike Tracker
  5. Bourdain, Suicide and Sadness
  6. Friday Funny: Test
  7. Quote of the Week: Adam Gropman


1. Your AMA …Cover for the MOC by Pat Conrad MD

June 13, 2018

Anyone wishing to cure an overabundant zest for living need only spend a few minutes reading AMA House of Delegates committee resolutions.  The formal tone attempting to dress up a truckload of self-important swirl not nearly dignified enough to be called bullshit is…Contemptible?  Loathsome?  It sure is boring.

Remember when the AMA came out against MOC in 2016?  Of course you don’t, because in the end they predictably backed off and went back “for more study,” the politician’s way of saying he ‘wants to spend more time with the family” right after his latest DUI.

The AMA has worked diligently AGAINST the interests of patients and physicians for decades, and like the ABMS, has made a boatload of money in the process.  Yes I know, the ABMS doesn’t really answer to the AMA, but the latter is a powerful voice for all physicians, and could help us in this fight against the Maintenance of Certification gangsters.  Wouldn’t they want to?

This week the Vichy sellouts of “The House of Medicine” met at their AMA ego orgy in Chicago.  Could this really be the year when they finally came out and opposed the MOC extortion racket?



Madam Speaker, your Reference Committee recommends that Resolution 316 be referred.

HOD ACTION: Resolution 316 referred.

Resolution 316 asks that our AMA call for an end to the mandatory American Board of Medical Specialties “Part 4 Improvement in Medical Practice” maintenance of certification requirement.  Your Reference Committee heard mixed testimony regarding the Part 4 requirement for American Board of Medical Specialties (ABMS) maintenance of certification (MOC). There was testimony concerning the relevance, burden, and cost of the MOC Part 4 process in addition to the other requirements physicians are required to fulfill for meaningful use, MACRA, etc. However, it was also noted that the broadening range of acceptable activities that meet the Improvement in Medical Practice (MOC Part 4) component has made this activity acceptable for other national value-based reporting requirements and continuing certification programs. It was also noted that the boards are implementing a number of activities related to registries, systems-based practice, and practice audits to show improvement in practice. The ABMS Multi-Specialty Portfolio Program offers health care organizations a way to support physician involvement in their institution’s quality and performance improvement initiatives by offering credit for the Improvement in Medical Practice component of the ABMS Program for MOC. Due to the Council on Medical Education’s ongoing work with the ABMS and the ABMS member boards to improve this process, your Reference Committee felt that this issue should be referred for further study. Therefore, your Reference Committee recommends that Resolution 316 be referred.”

If you couldn’t read the preceding statement without looking for the whiskey or a rusty knife, here are the low points:

  • The AMA will not oppose MOC
  • The “mixed” testimony included pro-MOC agents that (easily) seduce the AMA traitors with language regarding “value-based reporting requirements”, “systems-based practices”, and “audits to show improvement in practice.”  The AMA is using the phony, unproven quality-value based lingo to push their tacit support of the ABMS thieves.
  • And for some moral veneer and a wink, this report cheers the ABMS’ support of forcing physicians into “quality” initiatives forced on them by non-physicians.
  • “Since the Council on Medical Education is already working with the ABMS to screw all physicians for a fee, we don’t think the AMA should interfere.”

The AMA delegates, as a body, are traitors to anything decent in medicine.  Most of this already knew that, and now we have their support for the MOC in black and white.

Hear our podcast on the MOC here


2. How Hospitals Think They Can Fix Burnout

June 12, 2018

I know that many of you cannot read this article in the Wall Street Journal but I still think there is a need to highlight what was said in it. The online version is called:

Hospitals Address Widespread Doctor Burnout

To address an epidemic of physician stress that some say puts patients at risk of medical errors, hospitals are making changes

Okay, where do I begin?  First, I need to take a deep breath.  Look at the sub headline. Patients at risk? Medical errors?  Umm, what about doctors killing themselves or quitting?   To be fair, at least this issue is being talked about. Let’s move on.

The article highlights how some hospitals are creating a new position called “Chief Wellness Officer”.  What’s your thoughts when you first hear that?  I hate that more administrators are created but I do like that someone is going to bat for the doctors.  Anyway, the doctor doing this job was interviewed and said this:

“Telling doctors to eat granola, do yoga and be more resilient isn’t going to address this problem,” says Tait Shanafelt, who was appointed chief wellness officer of Stanford Medicine a year ago.

Ok, he gets a pass on this because I think he is right.  The rest of the article talks about things I have been saying FOREVER:

  • One priority is reducing clerical duties. A leading cause of physician distress is electronic record-keeping, which requires doctors to do clerical and billing work, and cuts into time with patients. It has also increased “Pajama Time,” the hours doctors devote at home to electronic charting that wasn’t finished during the day.
  • A related problem is managing electronic in-baskets filled with patient demands. “A typical physician nowadays gets bombarded with tasks.”

But the recommendations given were questionable:

  • He envisions a team approach where doctors focus on clinical care and leave some tasks to others. By shaving administrative minutes here and there, Dr. Ripp aims to reduce nightly electronic work by an hour.
  • Hiring staff to sit in on appointments and take notes is cost-effective, he says, because it frees up doctors to see more patients.

The answer, in my humble opinion, is not hiring more people but destroying the system that created these tasks in the first place. Direct primary care is one way but I understand that this may not work for specialists. We cannot keep trying to follow the demands of third parties and think we can win at this game.  That is a dog trying to catch his tail.  This system needs to be blown up.  The bandaid approach won’t work.

My favorite part of this article, and I am not being sarcastic, was this:

As an example of frayed bonds, Dr. Shanafelt points out that hospitals’ physician lounges, where doctors could meet, unwind and discuss cases, have largely vanished. While two new Stanford hospitals have them, Dr. Shanafelt, associate dean at the Stanford School of Medicine, would like gathering places for doctors throughout his institution and at other hospitals as a low-cost effort “to help drive community.”

I love the idea of a Doctor’s Lounge again!!  Love it.   But who would be allowed in?  Doctor of what?  DNP?  Ph.D? There is no way this would hold.  I could see this politically correct culture of ours watering that down so much that ANYONE would be allowed in and then doctors wouldn’t show up anymore.  And then the administration would close it.  Oh yeah, that is how they got rid of them in the first place.

What is your thoughts on all this?  I would love to hear it.

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3. Cigna Making Your Life Easier

June 11, 2018

This was emailed to me:

I don’t know if you saw the email Cigna distributed this week.

They started strong:

“We’re committed to making it easier for you to do business with us.”

And then immediately disappointed:

“Our new Precertification web page is one of the many ways…”

It’s almost like a giant insurance company has no idea what a physician’s office does all day.

Thought you might be interested in this bit of hypocrisy.

Editor’s Note: Just another day in the life of a doctor.  

Get one our t-shirts and feel happy!

4. The Health Insurer Rate Hike Tracker

June 10, 2018

Did you hear the news?

Obamacare premiums set to soar in 2019

Before you start blaming the right or the left, I just want you to know that it doesn’t matter.  I believe I am the ONLY written/blogger that follows this.  I mentioned this farce last year.  The idiotic article above says:

Many insurers cite two key drivers of the increases: Congress’ elimination of the penalty for the individual mandate — which requires nearly all Americans to have coverage or pay up –and the Trump administration’s expected expansion of two types of health plans that don’t have to adhere to Obamacare’s regulations.

We need to stop letting the media hypnotize us.  As I have been tracking this for almost a decade, here is what the media says every year:

  1. Health insurers seek big premium increases (2017)
  3. More Health-Care Insurers Seek Big Premium Increases – WSJ (2015)
  4. Health Insurers Threaten To Increase Premiums, Even As Profits Soar (2013)
  5. Health insurance costs rise again | Star Tribune (2012)
  6. Health Insurers Seek Higher Premiums – The New York Times (2011)
  7. Health insurers seek rate hikes, citing new reform law – The Denver Post (2010)

I put the year these articles were published in parenthesis but just know that they’re forecasting or warning about the rates for the following year.   So, I have them all in order. Can you see any commonalities?


It’s the insurers who continue to make more and more money yet somehow get away with passing any expenses onto us.  They “feed” the press whatever the want and these idiots buy it. They cry poor mouth but their stocks and profits keep going up and the media is too busy with personal grudges to report what is really going on.

So, I’ll report it.  The truth is that EVERY YEAR we will have the same headline as shown above.  This is not new.  How about for ONCE it says Health insurance to lower premiums next year?

What a joke.

Buy Diary of a Drug Rep by Dr. Farrago Here. 



5. Bourdain, Suicide and Sadness

June 9, 2018

I was really sad when I heard the news about Anthony Bourdain.  It is the same way I felt when I heard about Robin Williams.  I never heard of Kate Spade before so it didn’t hit me as hard.  Why am I so sad?  Obviously, I am bothered that their recent suicides left young kids without a parent forever.  That being said, I didn’t know these people personally.

Bourdain had the job EVERY guy wanted.  Travel. Eat. Make money. He was also cool even if you didn’t agree with some of the things he said.

My friend said this to me:

“And he was a recovered heroin addict who’d known some dark times, though all that supposedly was behind him. Spade had been dealing with demons for five years, according to her sister and her husband. But Bourdain? Whatever it was, it’ll probably emerge in the next few days or weeks. Seems like no amount of self-awareness is enough to protect some people from making that choice.”

I guess. There’s also the fact that suicide has gone up 30% since 2018 (WSJ article on 6/8/18) and there is a massive epidemic of white, middle aged men offing themselves.

Maybe Kate Spade’s death gave Bourdain social proof to do it (he probably knew her)?

So why am I so bothered by this?  Maybe it’s because I know people in my life who are at risk and I worry about them? Maybe because we always worry about ourselves and our own thoughts.  I really don’t know.

But in the end, I am just sad.



Click Here To Comment


6. Friday Funny: Test

June 8, 2018

I find this funny.

Get one of our t-shirts here

Comment Here


7. Quote of the Week: Adam Gropman

June 7, 2018

“Here’s some advice: At a job 
interview, tell them you’re willing to give 110 percent. Unless the job is a statistician.”

Comedian Adam Gropman

Hire Dr. Farrago as your next keynote speaker 

Comment Here



Douglas Farrago MD

  80 comments for “Authentic Medicine Gazette

  1. Wandal
    January 31, 2018 at 10:57 am

    Love the Gazette, Doug. One thing: We see lots of fads in society, including in medicine, and the latest one is “physician burnout”. Seems every medical publication now has to have a feature on that . . . or at least a comment or letter to the editor. I’m sure there is an element of truth in all of that BUT part of me wants to say ‘what a bunch of cry babies’. There are a LOT of people out there that just don’t get it: They see the salaries of physicians consistently near the top (especially specialists!!), look at the income they and their friends/family/neighbors have and get pissed off. Life and work are hard on a lot of people; more so than on physicians. Income disparity is very wide and growing in this country and it is causing a lot of ??? anger, envy, voting for Trump ??? Just saying . . .

    • bobby garrison
      February 7, 2018 at 3:30 pm

      up yours. way to blame the victim. I can’t have a problem ’cause other people have problems too?? I can’t have a problem ’cause other people don’t make as much money as I do?? Are you out of your mind? Please tell me you are not a physician as you seem to have lost all empathy (and possibly sympathy.)

    • Frank J. Rubino MD
      March 8, 2018 at 10:48 pm

      I don’t think “burn out” is the issue. It is anger. Deep seated anger to the nonsense in health care.
      Meaning less metrics , meaningless MOC crap, Quality measures, etc. ANGER.

      • Mary Lang Carney, MD
        March 28, 2018 at 9:38 pm

        Frank: I totally agree with you!! When will the stupidity end?

        • Frank J. Rubino MD
          April 16, 2018 at 7:38 pm

          Hi, good to hear from you.

  2. Dennis Kabasan
    April 27, 2017 at 10:23 am

    I ordered the Cryohelmet for my sixteen year old daughter, who sustained a concussion, with brief loc, after being struck in the forehead by a soccer ball, in a school match, two weeks ago. She’s been wearing the helmet, as recommended, one hour at a time, since it arrived three days ago. Her pediatrician is following her. She only tolerates a few classes each day, d/t frontal and temporal headaches and extreme tiredness. Sleep helps her. Is there any benefit to longer wear-time? Thanks.

    • Doug Farrago
      April 27, 2017 at 10:31 am

      See my email to you

  3. April 12, 2017 at 2:52 pm

    For some reason, my version of Authentic Medicine is delivered with comments from 2011 and 2012.

    Any notion of what may be going on?


    • Doug Farrago
      April 12, 2017 at 3:55 pm


  4. John Comis, DO
    May 30, 2012 at 11:34 am

    Please encourage the KOM to join his friends at QC13.

    (…of the lemons)
    PS the healthcare system is so terrible it is beyond any further comment.

    • Doug Farrago
      May 30, 2012 at 12:27 pm

      I will try.

    • au-digit
      January 26, 2017 at 3:33 pm

      The Bush you quote was #41.

  5. Gary Gaddis
    May 20, 2012 at 7:43 pm

    Regarding our Federal government, Centers for Medicare and Medicaid Services (CMS), Secretary of Health and Human Services Kathleen Sebelius, and the growing gap between CMS perceptions and reality, here is my sarcastic “Sound Bite” suitable for the brief attention span of our electronic news media:

    “Since the Department of Justice is headed by an attorney, and the leader of the Federal Reserve is an economist, then how is it logical that the Secretary of Health and Human Services is also headed by an attorney?”

    Does anyone else agree with me?

    • Kristina Berger MD
      May 21, 2012 at 7:31 am

      There are too few physicians in politics. Is it because we dont have the stomach for it, or another reason? I know if there were more of us as policy makers, the healthcare system in this country would improve greatly.

      • Simon Cummings
        May 23, 2012 at 8:59 am

        My vote is for Doug and not the type of physician represented by the Cardiologist who told me that he wasn’t interested in cardiac rehabilitation cos there’s no money in it!

    • Judy
      May 24, 2012 at 8:58 pm

      No, I think that it is correct for a lawyer to head the Department of Health & Human Services. Only a lawyer can read the volumes of crap they put out as regulations and find a loophole way to still make a living; only a lawyer can repeatedly find a way to let someone die and it be due to no fault attachable to him; only a lawyer can write voluminous policies that effectively help only a select few of his supporters and require the rest of the populace to pay for it except himself; and only a lawyer can sit passively by and provide no useful assistance to a group of sick, needy people but still require them to pay for his service. If you will think on these comments for a few minutes, you may change your opinion.

      • Bill
        June 4, 2012 at 9:22 pm

        Hey Doug ! I am a lawyer. never made more than $85K /year and spent my entire career in trenches helping people, most who did not have much money, with problems, many of them caused by their own bad decisions and choices. and I love your journal.
        Given the wide range of attitudes, opinions and incomes among doctors do you really want a politically-connected MD in charge ? maybe an orthopedist ? xoxo

        • Doug Farrago
          June 4, 2012 at 10:43 pm

          The description “politically-connected” should remove that person from contention immediately.

        • Dr Bonz
          June 21, 2017 at 8:29 am

          Dear Bill.

          F*** You.


          An orthopedist.

    • Jeff
      February 22, 2017 at 3:14 pm

      I agree, absolutely, that HHS should be headed by a physician.

      What about having an advanced practice nurse in that role?

      But (God help us) not an attorney, a chiropractor, a homeopath, a naturopath, a shaman, or a faith healer!

      On second thought, a shaman would be better than a lawyer any day.

    • Jeff Palmer
      February 22, 2017 at 3:16 pm

      I agree, absolutely, that HHS should be headed by a physician.

      What about having an advanced practice nurse in that role?

      But (God help us) not an attorney, a chiropractor, a homeopath, a naturopath, a shaman, or a faith healer!

      On second thought, a shaman would be better than a lawyer any day.

    • John A Goldman, mD
      March 4, 2017 at 3:10 pm

      thank goodness in 2017 it is a physician

  6. Alan Levine
    May 9, 2012 at 9:03 am

    You have bemoaned our lowly position in hospitals, commenting how few recognized our contributions on Physician Recognition DAY. In what I feel is a further diminution of what we do, my hospital is now celebrating Nurse Recognition WEEK!!!! How far we have fallen………….

    • Doug Farrago
      May 9, 2012 at 2:53 pm

      I agree

      • Jack Forbush
        May 23, 2012 at 12:10 pm


    • Common Sense
      May 30, 2012 at 4:54 pm

      So you’re denigrating nurses in an attempt to rally support for your plight? It is just as easy to argue that since nurses spent 7 times more time with patients, theyre deserving of their week.

      Or, you know, we could all just stop getting butthurt over who has the longest display of solely symbolic “appreciation” and get back to working as the team we were intended to be.

      We’re your knights and you’re our Earls. There is nothing to be gained by making besouring diatribe. Be good to your staff and your patients and you’ll have more appreciation and recognition than your little heart can handle.

      • Doug Farrago
        May 30, 2012 at 5:11 pm

        You really need to have read the thread completely before making that comment. Please check out the blogs on how Doctor’s Day has been totally dismissed. Maybe then you will understand how we feel. This is NOT about doctors against nurses. It really is about administrators.

      • Doug Farrago
        May 30, 2012 at 5:12 pm

        You missed the point on this. It is about Doctor’s Day being totally dismissed by administrators. Please read those blogs.

        • Alan Levine
          May 31, 2012 at 8:56 am

          That was exactly my point. In recognition of out efforts several years ago my hospital–a level 3 teaching hospital–gave chocolate bars (small ones) to the docs. Nurses this year received flowers and other shows of appreciation.

          • JoAnne Fox
            June 8, 2012 at 7:23 pm

            Acknowledgement of a job well done would have been nice. I got a scoop of hot cocoa mix, repackaged in a baggie, with a little note attached telling me how wonderful nurses are.

  7. Doug Given
    April 25, 2012 at 5:29 pm

    What a screw job from the lovely IRS on the Mandate.

  8. Judy
    April 18, 2012 at 10:05 am

    think you should run for President, as long as you will continue to keep up this site after you win!

  9. Dave Hoffman
    February 29, 2012 at 11:20 am

    Great thoughts as always, Doug!

    Is there a way to start new comment threads each time you post a new entry?

    • Doug Farrago
      February 29, 2012 at 12:31 pm

      Each entry is a blog and has their own comment section

      • t mcglone
        April 4, 2012 at 8:25 pm

        Having “served” for 15 years, those are finely edited comments fit for civilian consumption .

  10. February 29, 2012 at 8:53 am

    today’s (feb 28, 2012) gazette was one of your best. some might say that your gazette is merely entertainment. i however, enjoy the articles with their kernel of truth/fact at the center and your encouragement for us to critically examine the field of medicine that we are a part of. the top ten signs that a hospital stay isn’t going well is what we see all our careers. uphoric for gout patients who like beer and ujerky for cardiac patients and the statin report were particularly good reading. i don’t know how you find the time or energy to do this. i was usually totally exhausted by the middle to end of my workday. thanks again.

    • Doug Farrago
      February 29, 2012 at 9:06 am

      thanks, dennis! I appreciate the feedback and I am truly flattered.

  11. Angi Wall DO
    February 9, 2012 at 9:18 pm

    I’m with Doug on the dietary/diabetes. It’s not often you catch those guys looking good in a bikini and munching on carrots.

  12. Dr. Veronica Friel
    January 25, 2012 at 4:20 pm

    More! More!! Doug, keep it coming!!!

  13. Robert Bosl, MD
    January 25, 2012 at 1:27 pm

    Regarding relationship of AD & DM, and comment that DM is dietary–too simplistic and likely wrong. We know about dysmetabolic syndrome & PCOS etc. which is genetic, DMS causes weight gain and subsequent DM. Consider whether strong relationship of DM to increased risk of AD is also genetic predisposition to both rather than one causing the other.

    • Doug Farrago
      January 25, 2012 at 2:06 pm

      100% disagree. Predisposition is not a certainty. How can you NOT think DM is dietary related?

      • Robert Bosl, MD
        February 1, 2012 at 4:12 pm

        My earlier comment may have been oversimplified–just tried to point out that some legit. MD’s believe in insulin resistance as a cause of some obesity issues than the result thereof, and it is conceivable that the “insulin resistance gene” may also play a role in development of Alzheimer’s.

    • Bridget Reidy
      March 8, 2012 at 6:49 am

      Ever consider the relationship between Alzheimer’s and diabetes might be iatrogenic brain damage from hypoglycemia? I’m always shocked at how lightly my patients consider the risk of it.

      • March 16, 2012 at 12:13 am

        May I suggest that the dementia with chronic diabetes isn’t Alzheimer’s, it is more likely to be due to the vasculopathy that accompanies non-well controlled diabetes or elderly age + diabetes. So the relationship is between DEMENTIA and diabetes, not Alzheimer’s Disease and diabetes. The fact that most elderly diabetics are vasculopaths, and the recurring theme in medicine that the brain depends on a constant supply of glucose and oxygen to function well, and that vasculopathy impairs oxygen and glucose delivery, is much more plausible than recurrent hypoglycemia.

  14. Scott Miller, MD
    January 25, 2012 at 12:34 pm

    I work in urgent care and when I get home at night I am too tired to exercise. I find that the exercise I get from going back and forth in order to finish the articles in your journal gives me the physical exercise I need to stay healthy and sane. Thanks, Doug! Could you get me a beer when you go to the kitchen?

    • Doug Farrago
      January 25, 2012 at 2:08 pm

      You got it!

  15. Allyagottadois
    January 18, 2012 at 8:55 am

    If I can print it out in its’ entirety, I can leave it casually around the hospital. Mailroom, Medical floors, ICU, ER, surgical suites, administrative offices, JACHO. Because All I’ve got to do is: everything everybody tells me to do.

  16. Dr. Bill Ameen
    January 1, 2012 at 11:31 am

    Hey Dr. Doug,
    To start the new year right, this ticks me off! I was belatedly reading the 11/4/11 issue of THE WEEK, an article about the Top 1% wage-earners. It takes annual earnings of $516,000 to qualify. Guess what? One out of six of the Top 1% is “in medicine”…I suppose some could be CEO’s of Big Pharma, but I suspect a large number are like the pediatric surgeon who heads the AMA and lives overlooking Central Park, and probably every orthopedist. Sorry, but I believe that anybody who makes that kind of dough either 1) inherited it, 2) stole it, or, as with most surgeons, sports figures and actors, 3) was grossly overpaid (as by insurance companies).

    • Doug Farrago
      January 1, 2012 at 12:32 pm


  17. bill lorentz
    December 28, 2011 at 11:25 am

    I am a recent professor emeritus from a well known university medical school. For a number of years I worked with administration as an associate chief of staff. We spent considerable time and effort reviewing patient satisfaction scores using a well known national company and were quite excited that ours were consistently higher than most othere and certainly higher than I thought was reasonable.
    Bottom line-we discovered that the administrator in charge of managing the satisfaction suvery was “doctoring” our results. When we changed over to a more honest effort our scores dropped significantly. However, no one in administration was happy with our new lower scores and the subsequent need to address the outcomes.

  18. David Devonis
    December 16, 2011 at 11:17 am

    Impressed that a lot of teachers are reading this material. Your site is the Writing on the Wall. Keep it coming!

    • Doug Farrago
      December 16, 2011 at 1:35 pm


  19. Dr. Bill Ameen
    December 15, 2011 at 10:46 pm

    Hey Dr. Doug, Heard that due to droughts affecting the peanut crop the price of peanut butter will go up. There’s a worsening shortage of PCP’s, so guess what? They’re paying us less..and less…and less. Also, latest Medical Economics has lead article about MOC. I was gritting my teeth reading remembering when you published the ABIM chief’s salary at $600,000. I’m sure ABFP CEO’s isn’t far behind. Where are the studies showing MOC (or even boards) make any difference in our performance? Finally, get “The Parking Lot Movie” on DVD. It’s a hysterically funny documentary about the parking lot behind The Corner at U.Va that will remind you of your days there!

    • Doug Farrago
      December 16, 2011 at 5:04 am

      Thanks for the great points, Bill! Will need to get that DVD, as well. On one of my first dates with my future wife she remembers me checking all over the ground for parking lot tickets that were cheaper than the one I had in my hand. I was a class act.

    • Dr. Veronica Friel
      January 25, 2012 at 4:16 pm

      Peanut butter prices going up? At COSTCO, the price of the large-size Jiffy Peanut Butter remains the SAME – the large-size is simply 8 oz. smaller.

    • Connie Severin
      February 8, 2012 at 1:06 pm

      Thanks so much for adding that bit about the movie. I just ordered it off Amazon. I worked at UVa Med Cen from 1980-1985 and remember the strip and the parking behind it (apparently pre-Farina days). I remember some sort of parking honor system and some lot Nazis from back then too, but obviously predating when this documentary is set. It was about the only parking within a mile of campus too, so finding any spot at all was a miracle. I’m looking forward to the video. Thanks for the heads up.

  20. Mary K Freel
    December 9, 2011 at 7:08 am

    RE: Grading Dr. on patient performance. Can you grade me if I work in a factory stamping out parts? Absolutely!! If the part doesn’t meet specifications then I’ve failed. Can you grade me on my patient’s health performance? Absolutely not!! I can only control a small part of what goes into a patient’s health and as studies have shown patients often pay for the dr. advice and then do nothing or the opposite. What a wonderful world it would be if when the dr. told his patient to lose weight and quit smoking they went right out and did those things. I was a nurse for 22 years and a teacher for 10 and in both professions I was the one who got blamed for whatever didn’t go right–whether it was poor scores on tests and the patient not getting better faster. Until people take ownership in their own health and realize that they are the number one reason that their health doesn’t improve the overall health of this nation will not improve and so our health care costs will continue to rise.

  21. Bridget Reidy MD
    December 8, 2011 at 10:44 pm

    I agree with the teacher and have always been suspicious of both of our “quality” grading.

    The recent issue of AMA News gave opinions of practicing docs on lots of little issues but NONE on their main article on why small practices (aren’t they usually run by docs?) aren’t getting EMR’s. Gee 15% more pay for 50% more work – why wouldn’t we bite? I wonder if it’s a censored rag. Thank you Doug for validating our voices.

    • JoAnne Fox
      June 8, 2012 at 7:32 pm

      Where do you find doctor owned small practices?? Most everyone around here is owned by one of the two hospital systems, and one has the gall to proclaim itself “not for profit” – I guess if you don’t mention the wholly owned subsidiaries they don’t count.

      • Doug Farrago
        June 8, 2012 at 8:27 pm

        Hopefully you will find them in the future

  22. Pat Nagle
    December 7, 2011 at 11:45 am

    I enjoy your site. I appreciate your heartfelt concern for patients and your irritation at the “solutions” suggested/mandated by outsiders (e.g. politicians). What strikes me most of all are the similarities between the world of medicine and the world of education, in which I spent 40+ years, working from K-graduate schools.

    Although the history, dynamics, and focuses are different,
    healthcare and education get pushed around by folks who don’t know what the hell they’re talking about, from Presidents, Congresspeople, media, on up, and the bottom line is always the bottom line, not the needs of patients and students.

    Your tirades against administrators parallel my feelings about the “consultants” and “foundations” who infest educational policymaking at every level. The last ones consulted are the frontline teachers and docs. And of course, the politicians and business moguls take no responsibility for the culture and economy they’ve helped create which lead to the problems in both areas.

    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.

    • Doug Farrago
      December 7, 2011 at 12:39 pm

      Thanks for some great feedback! And the similarities are eery.


    • Frank J. Rubino MD
      December 14, 2011 at 6:55 pm

      We do have much in common. “No child left behind” where the teacher is held responsible for the sucess of each and every child no mater how functional or dysfunctional is the child’s family.

      “Pay for performance” reguardless of how cooperative a patient is with diet & exercise and with their medication regimine for hypertension, diabetes etc.

      If one wants to make a lot of money in a short period of time, one should become a “consultant” to to school districts or to health care organizations. Expensive advice with out the responsibility. Charge a lot and then get out of town.

    • pat nagle
      December 21, 2011 at 12:50 pm

      Pardon me for doubledipping, but I forgot to mention that no legislator/congressperson has ever begged to be put on merit pay/pay for performance. Obviously, legislating doesn’t lend itself to factory models of evaluation. So why do medicine and education? The things that count aren’t measurable, and the measurable things don’t count.

      • Judy
        January 4, 2012 at 9:26 am

        hey, Pat, hope you don’t have a patent on your last line! that is about to become my ‘signature statement’ on my sign-offs!

        • Richard W. Mondak
          March 28, 2012 at 1:56 pm

          I think several of us are going to “borrow” that line (of course we’ll give credit to whomever coined that phrase — whoever that is)

  23. John Chase
    December 7, 2011 at 9:11 am

    I would prefer your stories to run in their entirety rather than “read more”. Very irritating to have to go back and forth

    • Doug Farrago
      December 7, 2011 at 10:08 am

      Ok, will work on it.

      • Greg Salard
        December 8, 2011 at 2:35 am

        I have to agree. Not only is it irritating, it can be confusing when you have to …

        Read More >>>

        • Doug Farrago
          December 8, 2011 at 3:31 am

          LOL. Will work on it

          • thea
            December 14, 2011 at 8:00 am

            Would like more written stories/blogs etc, do not have sound card on computer so can’t hear any of these videos..they kinda lose their punch without sound?

          • Doug Farrago
            December 14, 2011 at 8:14 am

            Understandable. I had some videos done already and needed to get out a few extra this week. Won’t always be like that.

          • Chris
            December 15, 2011 at 11:20 am

            Dear Doug,

            Not only do I want full articles on the page and written articles instead of videos, but I also want to have $100 deposited into my bank account each time I click onto your sight. And world peace.

          • Doug Farrago
            December 15, 2011 at 11:25 am

            Done and done.

          • tom walsh
            January 11, 2012 at 7:52 am

            These same people who can’t fathom going “back and forth” to read an article are the same ones who had difficulty with ‘butterfly” ballots in the 2000 elections in Florida.
            I have been enjoying your articles for quite a while and have no problems with the layout. Keep up the great work!! And, thanks.

          • Doug Farrago
            January 11, 2012 at 7:54 am

            Thank you, Tom!

          • Connie Severin
            February 8, 2012 at 1:09 pm

            Thanks for the new format! Jumping between responses and articles was a nuisance. I like being able to read everything in only one, maybe two spots at one read. It also makes it easier to check on new entries to the comments all at once, rather than having to check for each separate article.

        • Richard W. Mondak
          February 22, 2012 at 12:21 pm

          I have a short attention span, so reading part of the article and assuming I know what is being stated is par for the course for me. I often shoot par – 36 on the first 5 or 6 holes – so why play more?

          I don’t mind procrastining to READ MORE>> later

      • Ariel
        December 8, 2011 at 8:58 pm

        Agree with Mr. Chase. Thanks for looking into it!

        • Sharon
          December 28, 2011 at 10:10 am

          I totally agree with Chris!

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