Value Received by Ted Bacharach MD (retired)

When we buy something we look it over and make a simple decision; is it worth what I will pay for it if I decide to buy it?  The relationship is a direct one between the buyer or supplier and the consumer. In the case of medical care this relationship was also simple prior to the establishment of the HMO’s, Medicare and “third party payers”. At the present time, since the consumer is no longer the one who pays the bill, the situation has changed. In the days when patients were treated by a physician, it was the patient who needed to be satisfied. The patient usually measured the care he received by the amount of attention he was given, the palliation of his or her symptoms and the empathy  of the physician (this of course was before he was turned into a caregiver}. The relationship was simple and the only one that had to be satisfied was the patient. In our present environment this relationship has been altered considerably. To begin with, not all patients can choose which physician they will see as their health plan or insurance will guide many patients. If the physician satisfies the patient this is all great, however, it is not the patient who determines whether the treatment he or she received is satisfactory. In most instances the insurance company,  Medicare or HMO that pays the bill is the entity that must be satisfied. These entities have no pain or suffering that can be used as a gauge nor are they present in the examining or treatment room. For these entities satisfaction and evaluation are based on the record generated and the justification for the charges that have been submitted. The result can easily be seen. The physician’s charges are best justified by paperwork. The resulting therapeutic result is that the patient gets slight attention but the record is bolstered by all means possible. Office visits must be kept short so that more patients can be seen. The older physician whose clientele is primarily Medicare is pushed quite hard to see enough patients so that he or she can justify keeping their office open.

The recruit in the military who is given a military haircut gets a foretaste of what to expect from “Governmental Medicine”. The relationship between the one who shears recruits and the recipient of this treatment provides a foretaste of what medical care can become. The recipient and the one who pays are not related and their goals are not always identical.


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 “Value Received by Ted Bacharach MD (retired)

  1. big picture doc
    July 26, 2012 at 10:59 pm

    Agree with your comments except the HMOs and other private insurances are not government medicine. We do need some type of insurance, because unlike in the old days, we have MRIs and space age surgical procedures that many cannot afford to pay out of their pockets.
    And don’t forget, a recent survey showed that a doctor’s popularity did not correlate with the provision of good medicine. Many patients just love their docs at the pill mills and even the kindly primary care docs that keep on writing scripts for those benzos and narcs and corticosteroids by the zillions.

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