Idiots Following Idiots


Quality metrics are unproven.  They are a moving target.  They are what’s wrong with medicine yet “physician groups are increasingly incorporating quality metrics into their internal reimbursement structure, according to an article published Nov. 25 in Medical Economics.”  Incredible.   It turns out that primary care physicians generated 3 percent of their total compensation last year based on quality measures (patient satisfaction, quality of care, and cost containment), while performance-based data were tied to 2 percent of total compensation for specialists.  This will only get worse.  My New Year’s wish is that PCPs grow some balls and fight back against this crap.  They will but not for another five years when it is too late. 

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] 

  3 comments for “Idiots Following Idiots

  1. Ken
    January 8, 2014 at 2:00 pm

    Of course, the administrators will never let their salaries be contingent upon their physician satisfaction scores

  2. macf
    January 8, 2014 at 12:52 pm

    This is a lost battle since the administrators for which doctors now work for (our bosses) have entirely sold themselves into this crap.
    The system is totally flawed from the standpoint that the standards for surveys are based on percentiles. Meaning that by definition there will ALWAYS be a 79% hospitals below the 80th percentile. Duh!
    In one facility I work, patients are asked to rate the ED from 1 (worse), to 10 (best). But they are not told that only 9 and 10 are considered a “passing score”. What a fricken joke. It seems that the government has completely rigged the system in order not to reimburse retained payments.

    Happy 2014…

  3. Stella Fitzgibbons MD
    January 8, 2014 at 12:26 pm

    We hospitalists have the same numbers racket to deal with. Presently I have a part-time job reviewing charts for a hospital chain–NOT for quality or anything related to it, but to help decide if patients should be inpatient or observation. The most common question from the beleaguered nurses is “Patient does not meet InterQual criteria for inpatient care–do you agree?” The govt. standards for how much care you have to need are so unreliable that the hospital saves big bucks by having actual DOCTORS decide if the patients need inpatient care. Of course, we still have to listen to flak from non-physicians about “length of stay” this and “patient satisfaction” that…

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