After Hours

A recent study in the journal Health Affairs concluded that:

When patients have access to after-hours services with their primary care provider, emergency room usage is significantly lower and fewer patients go without needed medical care.

Chalk that up to NO SHIT, SHERLOCK.   The issue is that doctors don’t want to work 24/7 because they are human and have lives of their own.    How about using texting, emailing, or calling?   That, too, is a burden and doctors don’t get remunerated for their work.  Trust me, the government’s answer to this study’s findings will be to DEMAND doctors offer more after-hours services, which will just make more physicians hate their jobs and/or quit.

The only answer is to remove the middle men and have patients pay their doctors directly.  This will lead to physicians doing after-hours care as part of his business.   The physician would do this because he has one-third the patient panel and is doing what he can do to compete and make his patients happy.

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] 

  4 comments for “After Hours

  1. phil
    December 20, 2012 at 10:47 pm

    As a psychiatrist in private practice, never empaneling w/ anyone, I’ve always been on call for my patients 24/7, and in the world of cell phones and notebook computers, I even prefer to be available when out of town/on vacation.
    By turning off my phone — which is also my office phone — at night and using a beeper for emergencies, I get woken up 1 or 2 x’s a year for someone’s crisis.
    I do have less patients, but I have a lot more time for my life, don’t have the hassle and make as much money as many of my beleagured colleagues who sign on but then grouse about their managed care contracts.
    We — as physicians — started thinking about clocking out when our profession started being managed by others, stopped being a “calling” and started being just a job.
    Treat us like employees, and we’ll end up acting like them.
    I prefer to avoid others controlling me, and I love my boss!

  2. Marco
    December 20, 2012 at 10:48 am

    I am sure that a Oxys vending machine would bring the ED visits down too.
    Should we try that instead?

  3. jb
    December 20, 2012 at 8:37 am

    You want more primary care? Pay more and reduce paperwork. I did rural primary care for 9 years. Now, I work in the ER only. I make more. I work fewer hours. I have less paperwork. I will never go back. I hear “experts” talk about recruiting kids from small towns and paying loans will be the answer. Hogwash. In the small town where I worked, I wrote many recommendations for kids to get in to medical school. Six of them are now doctors. Not one is doing primary care.

    • Pat Conrad
      December 21, 2012 at 1:35 am


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