Motivate Yourself!

American Academy of Family Physicians

Below is what our glorious leaders are teaching us in these trying times for family docs:

Dear Colleague,

Engaging patients in self-management is a critical step in PCMH transformation.

Develop the skills you need by participating in the remaining 60-minute webinars in the AAFP’s PCMH series on Patient Self-Management.

Register today for:

Health Coaching: Practical Lessons from the Field
Amireh Ghorob, MPH and Lauren Scherer, MS
June 26, 1:00 p.m. CT

A Team Model for Integrating Self-Management Support into Patient Visits: Skills, EHR Applications, and Training
Berdi Safford, MD and Larry Mauksch, MEd
July 24, 1:00 p.m. CT

This was sent to my by Greg Salard, MD who responded:

What a crock of sh*t.   A webinar on how to “self-motivate” my patients.  Here’s what I tell my patients:
“I’m a doctor and you are an adult.  My job is to give you advice on what is best for your health.  As an adult you can choose to take that advice or not.  You don’t have to agree with me, and I won’t think less of you if you don’t.   All I ask is that you be honest with me and tell me if you are taking your meds and following that advice or not, so that I will know if we need to make any changes in our plan.  That way we don’t waste my time or your money by making changes that are not needed.”
I couldn’t have said it better myself!  Thanks Greg.

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 “Motivate Yourself!

  1. Rick Pollak, MD, MPH
    June 12, 2013 at 11:47 am

    Doug, while I appreciate your keen and critical eye towards how the bureaucracy distances medical practice from what patients want and what wise physicians want to offer, in this case you are selling the wise physician short. Motivational interviewing is a discipline that makes us more effective and less likely to burn out. It gets beyond “do what I say because I said so” medicine. By learning to explore our patients’ ambivalence with them, and evaluating the simple importance/confidence question, we can substantially improve our patients’ adherence to our advice, while enhancing trust and enjoyment in practice. While I can’t speak for these specific webinars, I can vouch for MI as a terrific career-prolonging way of approaching medical practice.

  2. Pat
    June 8, 2013 at 2:45 pm

    And any of this foolishness is an inducement toward a career in primary care?

  3. Stella Fitzgibbons MD
    June 8, 2013 at 7:54 am

    The mention of EHRs is the big giveaway. These are the same people who told me, when our hospital’s crappy EHR was costing me an extra hour and a half a day, that “It will get easier to use after YOU’ve worked with it longer.” In other words, every thing in medicine that doesn’t work the way it should can be blamed on the laziness of doctors.

    • Kurt
      June 12, 2013 at 4:43 pm

      Hospital EMR makes it so no one can see patients expediently anymore and FP’s give up hospital care. Greedy hospital administrators can hire their own “house slave MDs” to type the orders in all day long. Vis a’ vis continuity of care goes in the crapper. No more hospital involvement and Viola’, no difference between an FP and NP.

      F-you. What’s there to motivate? Simple, you can take my advice and live longer or you can continue eating shit, being fat and not taking care of your diabetes. I wish you will do the right thing but “I” nor it seems “the government” can make you. Now maybe if they kick you in the balls of your pocketbook maybe you’ll change.

      You know, I sent an email to the ABFM about this MOC crap they essentially told me and I paraphrase, “We went to bed with a bunch of psychologists and they said this is the best way to teach and learn.” I say send ’em all to Siberia to an old Gulag.

      How to change things:

      Make patients accountable and stick’em in the pocketbook if they don’t achieve a modicum of change. THEN, they will flock and listen to us and be open to change their habits.

      Continuing education 50 hours a year, test every 10 years on the basics. CME is what I need for my PRACTICE not what some fuckhead board head thinks I need.

      Cut out this money-making bullshit the ABFM is coming out with. Do the basics and stay the fuck
      out of the members way so we can work. I run out of CME money now since all this additional shit
      requirements. I wonder how much the head of the ABFM makes to torture us.

      Do this and I will likely take satisfaction in the practice of primary care again. Don’t and I’ll do what I can to dissuade a bright young person of making the mistake of going into a profession that will be supplanted by NP’s.

      The way they talk about “splitting the pie” means the non-compliant people are going to cost the hospitals and primary care Drs. money. Best to specialize and get a billable set of skills than be blamed for people’s poor outcomes.

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