Going Upstream


I was recently sent this Sacramento Bee article by a loyal reader of AM.  It talks about being an upstream doctor and I will let you read about it to understand what that means.   There is some purity to the concept and it makes me nostalgic to a time when I wanted to become a doctor.   The physician highlighted in the piece actually switched from surgery to primary care and claims it’s a great time for others to go in to the field.  Listen, I love when anyone talks like this because being an “upstream doctor” is really what authentic medicine is all about.  That being said, the article misses so much.  In today’s insurance environment with behemoth EMRs that make you work for it instead of the other way around, this is no time to go upstream.  Instead, you drown along side the patient.  The only way to accomplish the goal that this doctor talks about is to work within the insurance model and go broke or go into Direct Primary Care.

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]