You’re Not Like Them

Here is a nice letter letter from a reader who shares his soul.  He gave permission to put it out on the blog:

Dear Doug,

I just wanted to write to you about the medical profession from the viewpoint of an outsider. True, I have an MD degree and have worked for years mostly in urgent care, but I admit that I don’t fit. I have officially been told that.

After having a malignant melanoma and being lied to about a contract at the HMO I was working I decided, while waiting to see if I would die or not, to work at something I have always loved, the bicycle business. I am pleased to report that I did not die or even have a recurrence and so decided to resume my career. But I wasn’t allowed to do that because doctors don’t work in bicycle shops as the medical board told me. Was I on drugs or something? I had shown that I wasn’t devoted enough to be a doctor, but they would maybe, just maybe let me practice if I paid for what turned out to be a year’s worth of psychiatric evaluation, an MMPI, and a SPEX exam, all at my expense of course,

On one of my last visits to the psychiatrist who had been chosen by the medical board (his practice was seeing physicians) I noticed that his diploma was from my medical school, and, taking a chance because of that and the fact that he seemed to be an honest guy, I asked, in effect, why the board were being such a bunch of assholes. After all working in a bike shop isn’t exactly like being a pedophile. And he revealed the truth.

You are not at all like the usual physician, he told me, and you threaten them. My MMPI was that of a creative person and physicians were selected essentially to be OCD so as better to deal with the myriad of facts and details. Mostly this was done by looking at college subjects that had little to do with medicine, like higher math, but were associated with OCD. But OCD comes with a dark side and that’s what I was seeing. Control, money, and paranoia with long memories for perceived slights were part of the deal. Being a caring person wasn’t.

He also said that people who tested like myself almost never went into medicine, and, simply speaking, though I was smart enough, my SPEX scores were high, I wasn’t crazy, but I wasn’t one of them.

I bring this all up to suggest that perhaps one of the larger problems in medicine is the physicians themselves, and how they are chosen. If so the problem is very, very deeply rooted.

I am again pleased to report that everything went well, my license was reinstated, but initially, though I paid for it all, the board actually refused to share the results with me! Eventually, when I complained about it, they did.

Just something to think about.  Today, I am out of medicine. Turned 65 today and have had enough.

Scott Miller, MD

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 “You’re Not Like Them

  1. Bill Ameen, MD
    November 11, 2012 at 12:53 pm

    Hi Doug,
    That was a great post from Dr. Miller. I myself would love to open a railroad shop! Or a science-fiction/comic book store. Or a model kit shop…But I digress. The Boards assume we are guilty until proven innocent. They are NOT on our side. They let shady characters give HCG shots for weight loss and do chelation and block doctors from getting licensed who just want to practice honest medicine. And God forbid you should have a patient overdose on your narcotics. The NC board chastised a doctor for giving his nurse a Z-pak apparently for not having a record for her (I think a former employee reported him). And I’m not even getting into board certification by OUR specialty. OB-Gyns are certified for life. We have to do SAM’s and take an exam for $100’s every 7-10 years (which I refuse to do any more) [show me the evidence].

    C’ville was wonderful last weekend. Man, I could move there!

  2. james Biggerstaff MD
    November 9, 2012 at 12:02 pm

    If anyone needs a reminder about what a Gestapo the BOM can be read this letter. A physician is NOT innocent until proven guilty. And some say we don’t police our own. BS!

    Medicine is better for having had you. Always remember that.


  3. big picture doc
    November 9, 2012 at 1:53 am

    Great essay! As I’ve said here before, the reason that most MDs cowtow to bit pharma is because of the way that they are chosen for med school

  4. rokosz
    November 8, 2012 at 2:46 pm

    Is this really what the one truly noble human art has become?

  5. Kerry Willis MD
    November 8, 2012 at 12:00 pm

    awesome letter and I spent more than a few minutes LOL at the sad truth of your letter. I long ago realized that the goal of moist schools was to select folks who act like them for admission

  6. DrOCD
    November 7, 2012 at 11:25 am

    My kid is OCD, brilliant and creative. He wants to be a music teacher when he grows up. I don’t want him to be a physician. The medical administrative types are soulless, and are guiding the profession in that direction.

  7. Jon Pangia
    November 7, 2012 at 8:45 am


    Yet, the patients seem to love doctors like you. Had you just worked in a bicycle shop and then decided to go to medical school, you might have skipped all the psychiatric scrutiny. Sorry you had such an ordeal.

    I can’t help to mention that Osteopathic (D.O.) schools put a little less emphasis on math/science numbers in favor of life experience of their applicants. Of course I’m biased, but I’ve met more charismatic D.O.’s than M.D.’s in my travels. It’s only the ivory tower doctors who seem to thumb their noses at us as if we couldn’t get into a “real” medical school (not even true in my case).

    Before you give up entirely, consider how you’re practicing medicine. Real doctors have a hard time giving up on taking good care of good people. Don’t be too scared to start a concierge-type practice. Enough people still have more value for a good doctor than a good bicycle man. You may find great reward that will make you happier than you’ve been for years.

    Jon Pangia, DO

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