Quote of the Week

“When you stop doing things for fun you might as well be dead”.

Ernest Hemingway

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] 

  2 comments for “Quote of the Week

  1. Doug Farrago
    December 20, 2012 at 6:51 pm

    i appreciate the thoughts. It means a lot….especially with what I am going through now. Long story short I really am contemplating going on my own in practice soon. Even saw a rental space today. And then I read this….hmmmm. A sign?

  2. David Block MD, PhD
    December 20, 2012 at 3:38 pm

    Then…why are you still practicing medicine?

    Look…you, and many other doctors, want to BE in business but you don’t want to HAVE a business. You want to see more patients and get paid one ‘acute care episode’ at a time but you don’t want to work more hours. You want to get more respect from folks but you don’t want to give more respect to folks. You want to be treated honestly but you don’t want to deal honestly. You think that because you flubbed your way through medical school and residency and even your practice without getting caught, you will never be discovered. You don’t want to clean out your profession for fear that you may be part of the problem.

    You want to go on television and prattle on about how you just LOVE medicine, but you really don’t LIKE medicine. You beam about how you ‘LOVE your colleagues as people’, but you HATE the people who are your colleagues.

    You moan about what you have become, but you very likely were exactly that same person from the time you were a pretty small kid.

    Son, as we say in the south (i.e., south Brooklyn), you been fucked over. By yourself. You lied to yourself about the life you desperately wanted, you think your teachers lied to you about what they had and were willing to give, you think your patients lie to you because they’re afraid to tell you the truth, your wife and your girlfriend both lie to you, and your kids won’t talk to you so you don’t actually know if they’re lying to you or not. Your radiologist tells you to do more tests – it’s a lie; your neurologists tell you to EMG everybody who walks and sleep-study everybody who sleeps – that’s a lie; and your gastroenterologist tells you…that’s right…just bend over. You’re doing the bending, son.

    Your dog just hangs around because you feed her. No lie.

    You really can’t drive that badass Porsche you bought by making all your 99213’s into 99214’s. And, no, messing around with the Review of Systems really doesn’t do it. That’s what you thought that schmuck of a CPT consultant said over Chicken Cordon Bleu when the hospital CEO really thought, based on his MBA, that the way to your heart was through your stomach and your balls rather than…oh, Lord, no…really through your heart. You let him lie to himself, and you let him lie to you. That was bad, son.

    You want R-E-S-P-E-C-T but you are so terribly, frightfully, horribly afraid that you are being done wrong. (Thanks, Aretha).

    And so every day, you do exactly the same thing. Say the same thing to yourself, your patients, your kids, your wife, even to your office nurse and your office manager – who know you better than anybody. You do the same thing and expect a different outcome. And so the fault must be with “them” because you just about have your little shtick down perfectly.

    Doug – may I call you that? – my heart goes out to you and to so many of my own kind. At least, to the ones who actually know how to remain true to the silent oaths they made the night before the first day of medical school, when – drunk or sober, orgasmic or celibate – they swore to be true to themselves, to each other, to their kind, and to their species. My heart goes out to the ones who honestly think, who honestly feel, who honestly accept the joys and the burdens, the terror and the humor, of what they see, or SHOULD be admitting that they do see, each day.

    It’s enough. Don’t practice medicine. Practice being a person. A human. Then try being a doctor. Not a rock star (“But I could sing in high school”). Not a pro athlete (“They said I had a future….”). Not the savior of the planet, nor the fair-haired little kid who won the science fair in middle school. Be a doctor. Which is to say, a teacher – you know that’s what ‘doctor’ means. So learn faithfully and then teach with genuine heart.

    The time for mourning is over, the time for your sackcloth and your hair shirt is done. The time for your self-deprecating rhetorical questions is past. The time for torturing yourself is…well, you fill in the answer. I really do have confidence in you. Really.

    Get up. Ask the right questions. Question the right answers. If you had yourself as a patient, what would your diagnosis be?

    Son – and I am old enough to be your dad, at least your Dad-in-Arms – you don’t seem to be doing what you’re doing for fun. And I’m afraid that you will be dead by the time you think you should start living.

    Best wishes for this new year.

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