You got to love when a cardiologist working at a medical school has an epiphany on how to fix the primary care shortage.   His concept is simple.   Create a position called Grand-Aides.    Who they are?   Well, students getting a grand-aide certificate would do coursework that “covers protocols for 26 primary care conditions, such as the common cold, rashes, and vomiting, that can be used in telephone triage, home visits, or office and ED visits. Each protocol begins with 20 to 30 questions about the condition that are answered with “yes” or “no.” On the basis of the answers to these questions, the nurse supervisor decides whether the patient needs to see a physician or nurse. The protocol also includes home-care instructions that the grand-aide shares with the patient. Everything is laid out electronically and in cookbook simplicity on a mobile computer or smartphone.”  You see, what we do as family doctors is so simple that anyone can do it.  At least this is what this cardiologist thinks.   Unbelievable.   As the reader who sent this in wrote, “Will this have its own board certification?  Will there eventually be a Grand-Aide assistant?”  Very funny.  The answer would be yes and yes.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  7 comments for “Grand-Aide

  1. Steven
    May 18, 2012 at 10:33 am

    The military had been doing this for years, treatment algorithms, so medics can screen for the provider.

  2. May 18, 2012 at 1:19 am

    As a medical student, we were taught not to ask yes-no questions, but rather open-ended questions will provide more information to correctly diagnose and treat the patient’s problem. We are still admonished to do so, in order to receive better scores from our patients.
    The cookbook method will bring many complaints.

  3. mamadoc
    May 17, 2012 at 8:58 pm

    Oh, for pity’s sake.

  4. carolyn.goldstein
    May 17, 2012 at 3:53 pm

    i always suspected that i was an expensive indulgence.

  5. Mark C
    May 13, 2012 at 9:36 am

    Someone has been drinking the Grand-Aide Kool-Aid…

  6. May 12, 2012 at 10:30 am

    Doesn’t this sound like the “telephone nurse” some health care facilities used to employ for to answer after-hours questions?

    You could almost hear them paging through the scripts to find the correct response, which usually boiled down to take two aspirin and call the doctor on Monday.

  7. May 12, 2012 at 1:17 am

    Wow. Just…wow.

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