Medical Care 2012 by Ted Bacharach MD (retired)

The past few years has seen a gradual increase in the type and expertise of the medical care available. The result has not been an improvement in all of the care that is available. Some aspects of medical care have improved remarkably while at the same time some aspects have been neglected to a large extent. The provision of well equipped and staffed emergency rooms has resulted in far better care for injuries and many acute illnesses. Automobile accidents, gunshot wounds are given exemplary care in most situations.  Acute illnesses, acute myocardial infarctions, strokes, pulmonary emboli and many other acute situations are handled in an exemplary fashion. Acute exacerbations of chronic illnesses are also generally well managed, continuity of care for these patients is one aspect of the things that have received less than optimal attention.

The management of chronic disease is often complicated and there are no simple answers. The literature regarding most chronic illnesses can be found easily, however, interpretation is not quite so simple. One of the first requirements in managing a chronic condition is objectivity. The ability of the patient to do this is extremely poor. Over the years I was able to provide care for many of my colleagues who as a rule were not able to provide good subjective evaluations when it came to their own illness.

Increasingly the burden of care for chronic illnesses has fallen into the hands of the patient or administrator. Many aspects of management can be difficult and the patient’s own evaluation is usually not very good. The physician still provides many factors and help in decisions that are required in the management of any chronic condition.

Chronic illnesses are common and frequent and should not get lost. Management and recognition of chronic illnesses is an important part of the practice of medicine even if our administrative overseers don’t understand it and don’t want to pay for this type of care.


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] 

  1 comment for “Medical Care 2012 by Ted Bacharach MD (retired)

  1. big picture doc
    August 1, 2012 at 2:06 pm

    The reason we do not do well with chronic illness is because primary care docs as well as the specialists treat it by writing out reams of prescriptions for narcs, corticosteroids, and benzos.
    It’s time to start thinking outside of this sorry little box.

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