Fragmentation of Care

Here is another example how we have lost our way in medicine.   The article in the WSJ is entitled Doctors Move To Webcams and it tries to introduce you to the era of virtual medical visits.  In fact, WellPoint, “the nation’s second-biggest health insurer, plans to offer a new service in all of its employer and individual plans that will allow people to consult with physicians on-demand, using laptop webcams or video-enabled tablets and smartphones. The insurer says the video consults will appeal to clients looking for “convenience and accessibility of care”.  What a crock of shit. Though I am not against technology, virtual visits via webcams only work if it augments the relationship between a patient and their OWN doctor.  What the media is missing is that theses types of trends just adds to the fragmentation of healthcare.  Going to the urgent care for issues that are not urgent is inappropriate.  Going to the webcam for issues that should be dealt with by your primary care doctor is inappropriate.   It is not good in the long term.   The naysayer’s response will be  that your family doc is just too busy so things need to be done to help offset the load.   Exactly!   But not by fragmenting care.  There needs to be a paradigm shift where family docs have only 1/3 of the amount of patients that they have now and they can do their own virtual visits only if there is an emergency which then could be followed up the next morning in their OWN office.   The only way to do this is to take the WellPoints and other third-party idiots out of the equation and go back to a direct pay system.

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] 

  5 comments for “Fragmentation of Care

  1. Anydoc
    December 29, 2012 at 10:35 am

    You are so right. I have a problem with Walgreens walk in clinics whose sole purpose is to sell what is on their shelf and patients go there for colds that they should not even visit a doctor for and walk out with 4 prescriptions all filled of course at Walgreens.

  2. Pat Conrad
    December 27, 2012 at 1:42 pm

    Doug, lets combine that with your recent post on insurance companies trying to sell consumers on 24/7 access to their doctor…a buzz in your ear at 3 AM, the red light above the camera blinks on, and yippee, you can sit up in bed out of a dead sleep and counsel a nervous patient with the flu. And not, of course for anything as dirty as cash, but for the privilege of being an open-end comfort to mankind.

  3. mamadoc
    December 26, 2012 at 8:11 pm

    Ken: As above. Our hospital actually has a robot which is supposed to do neurology consults with a distant neurologist in case ours is gone. After a demo one of the (layman) hospital board members asked how an exam could be done without touching the patient. The neurologist in the robot replied that diagnosing a stroke and making a decision about TPA didn’t require touching the patient. They are talking about using it to bring a psychiatrist to ER for psych patients…..I can’t even imagine, since half of those patients already think they’ve been invaded by aliens..

  4. Suzy Ramos
    December 26, 2012 at 3:53 pm

    Now exactly HOW does one do apelvic and rectal exam via webcam?

  5. Ken
    December 26, 2012 at 1:01 pm

    Just counting the seconds until I can retire.

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