How to be an Authentic Doctor #11: You Are Not Guilty


There is an assumption that doctors are doing bad things.  It is as if we are guilty until proven innocent.  Did you ever notice that?  Even the whole Medicare billing disclosure incident was a way to show how physicians are gaming the system.  The truth is that other than a rare few, doctors are just doing their job.

I don’t know why this attitude exists.  Maybe it is because others are jealous?   Of what, you ask?   Well, survey after survey says that being a physician is still one of the most highly respected professions while politicians and lawyers are two of the least.   You might as well add hospital administrators to that second and sad list.  Is it any wonder that those three groups are the impetus to most of the mandates that have made this career of ours so impossible at times?

In an article titled “How Becoming a Doctor Became the Most Miserable Profession” the author stated:

The meme is that doctors are getting away with something and need constant training, watching and regulating. With this in mind, it’s almost a reflex for policy makers to pile on the regulations. Regulating the physician is an easy sell because it is a fantasy—a Freudian fever dream—the wish to diminish, punish and control a disappointing parent, give him a report card, and tell him to wash his hands.

Who perpetuates this crap?  Well, that is where conspiracy theories come from and I don’t want people to think that I believe there is some sort of a covert plan to destroy us doctors.  For a conspiracy to occur, more than one party would need to be working together.  I can’t prove that.  No, what I think is going on is that there are multiple parties who may or may not be working together but all of them do have an OVERT plan to destroy us doctors.  There, I said it.

Why do I think this?  Look all around you and you will see that there is a constant campaign to drive a wedge between physicians and patients. The fact that 79% of patients trust their doctor does not sit well with other professions and this drives them wild.

The other parties need to break our trust with our patients because this trust limits their power with patients.  Those other groups, who are making most of the money in the healthcare system, do this by creating new language, uncovering new controversies and fabricating new problems to cause doubt in the patients’ minds.

It is so easy for them to do this, too.  Don’t we see this happen all the time, anyway?  Everyone wants to see a hero fall (fill in any athlete or celebrity of choice).  So these other groups are able to manipulate the media and help them create negative headlines to make doctors look bad.  Remember, the goal is to break our bond with our patients so they do this by creating mistrust, which takes control away from us.  Not that we physicians didn’t help them over the years but that is another story.  Other than power, what is in it for these other groups?  Oh, that is easy: money.

As I have said many times before, administrators have been multiplying faster than Tribbles over the years.  See the chart.  Remember, these administribbles produce NOTHING.   They offer no wares that bring in any revenue.  They depend on us.  So…they must make it feel like we depend on them.  In essence, they try to convince the world that they need to watch over doctors in order to validate their own existence.  If they don’t, they risk us getting smart and trying to get rid of them.

Politicians and lawyers (the ambulance chasing ones) can be, and are thought of as, lowlifes.  That doesn’t sit well with their egos so for the politicians, they are always looking to make examples of those “crooked” doctors.  They grandstand whenever any bad outcome occurs (usually brought to their attention by lawyers) and then create mandates and hoops for doctors to jump through.  The lawyers, on the other hand, continue to put out ads asking people to sue their doctors who were obviously out to hurt them.  Then the lawyers become politicians and the cycle perpetuates itself.

There are many other ways to break up the patient/physician relationship.   Just watch the headlines:

  1. Doctors need new guidelines.
  2. Doctors doing a poor job with x disease.
  3. Surgeons making more mistakes.
  4. Physicians not treating patients’ pain adequately.
  5. Physicians the cause for the pain medicine addiction epidemic.
  6. Doctors need oversight from gifts given by pharmaceutical companies
  7. Do patients trust doctors too much?

Did you ever notice that the older TV shows always made us look good?  How about the newer ones?  Not so much.  Doctors are doing drugs, or are having major personal problems, etc.  That is what we are dealing with.

No, we are not perfect.  No one is.   But we are also not guilty.  We need to stop feeling like we are.  Enjoy the fact that what we have those idiots can’t get.   There is a connectedness between patients and their doctors. That bond cannot be translated or defined or stolen.

Be aware.  Be aware that these headlines are just for selling advertising.    Be aware that there is an overt push to break us up from our patients.  Be aware that you may be starting to believe these things.  Don’t.

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] 

  11 comments for “How to be an Authentic Doctor #11: You Are Not Guilty

  1. DrPhil
    April 17, 2014 at 5:12 am

    You forgot the other group that doesn’t like doctors, the Medical Boards

  2. LaRayne
    April 16, 2014 at 12:05 pm

    This is almost the classic bullying situation … lets take the bully ( government, and other like minds) and then let’s find a target … hmmm how about medical professionals, working to keep the bully’s in the life style they enjoy. So then it begins the bully must destroy the target because they are more educated, and people appreciate and love them ( unlike how people view the bully). So when do we as professionals say NO to the bullying?

  3. Lisa
    April 16, 2014 at 9:19 am

    Hospital administrators multipying faster than tribbles- great image! So sadly true. They get paid ridiculous salaries (how in any sane universe can they be paid more than doctors??) for what, exactly? Same situation is true in education, unfortunately. Doctors and teachers, who the ones actually contributing to society are vilified while administrations are become increasingly top-heavy and sucking away the bucks available for health and education.

  4. Sir Lance-a-lot
    April 15, 2014 at 5:46 pm

    Thanks, Doug! Excellent post, and a fine message.

  5. Ben
    April 15, 2014 at 1:27 pm

    Even the specialists are unhappy. I spent 4 hours of time on a child mauled by a dogbite. United Health paid $250. That comes out to $60 an hour for the stess of dealing with the family (no miracles done), waiting for the OR, EPIC medical records, and includes the follow up visits. My overhead is $150 an hour. My attorney charges $300 an hour and his overhead is $50 an hour, and charges for phone calls, paperwork, and does not do emergencies.
    If a patients requests a specialist for a laceration, the payment is now $45. Yes, $45. The hospical pays nurses $57 an hour to be called in, and a $50 bonus, plus call pay. They have no overhead. The current CEO of United made $110 million in one year, the one before him was paid one billion dollars, and he had quit being a pulmonologist because it was too hard.
    I have tracked every service call I pay, they are almost all elective and all average $100 an hour. None of them have the 15 years of training after high school.

    • jim
      April 15, 2014 at 2:09 pm

      60 dollars an hour is good pay, ,… in many american’s opinion. The average emergency room true billing here is 800-1000 dollars a visit. The hospital charges about 500, but the doctors and nurses group charge seperatly on top for an er vistit, 250-350 dollars, depending on time of day, and what the feel like billing you. They make a killing. It seems. Maybe it is not what it seems to be. But when an ER has 100 patients in it, each paying 900 av eraged, avedraging about 8 hours a shift, 3 shifts a day,… thats 270,000 a day, for maybe one docvtor, 2 nurse practioners, and the hpospital, to divy it up , and that doesnt include what specialists and radiology charges,…… you go to the er from a broken wrist, its 3500 dollars, cause the othopedist the call in to rwead an xray and tell you your wrist is broken, chages 2500 dollars for 2 minutes of work, on top of what the hospital charges for the er visit, and what the doctors/nurses group charges to take care of you.
      I’m not saying it is a rip off,.. i’m just saying it like it is,…. be careful, dont fall and break your wrist

      • Pat
        April 15, 2014 at 5:25 pm

        What the orthopedist is charging and what he is paid – along with any other entity – are two different things. In early 2009 Obama made a moronic speech claiming that if diabetes were managed unsuccessfully and “that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed.” You can YouTube that for yourself, and easily find that a surgeon gets about $1,500 for the procedure (otherwise I would have gone back to residency to be a foot choppin’ doc and work two days a month!)

        The worry isn’t that a politician exhorted a mob with veiled class envy – the scary part the applause that line received, and how many idiots believed it.

        Both my orthopedist, and a family member who is an ophthalmologist of many years, have taken a 50% haircut in the past 15 years. I’m not defending outrageous hospital or insurance charges /salaries, but I am reminding all that these determinations take place in the hallucinatory, funny money economic acid-trip that is medical economics.

  6. jim
    April 15, 2014 at 11:27 am

    Just like in anything else, some doctors are really good, some are just ok, others not so excellant. My mom a monbth or so ago had a flair up in the bottom of her legs and it was diagnosed as an infection. Thbe first doctor prescibed 2 antibiotics per day, the 2nd doctor 3 anti biotics per day, and the 3rd doctor 4 antibiotics and day and stockings, and wash your feet reguraly. The 3rd doctor did the trick and the flare up went away. The 3rd doctor was an infectious desease doctor that works out of the hospital here in the wound center and the hospital has an office area too, where she works one day every 2 weeks. Technicaly there was nothing wrong with the first 2 doctors, but the 3rd doctor fixed the issue and explained it well to an elderly person.
    The first doctor had said to me and my mom that medicine is not an exact science, and not really a science at all, but an art. People have to be careful about being over-tested because they worry and read the internet, especialy elderly people. Doctors are very good at eliminating possible causes through tests and examinations, but are not always very good at finding out the cause of your pain.

    • jim
      April 15, 2014 at 12:11 pm

      Just to follow up on what I wrote…… Elderly people that have suffered traumatic injuries and have since somewhat recovered, but disabled in some way, often suffer from a myriad of health issues because of their circumstances. Medicaid pays doctors to treat elderly people that have medical issues pop up in their lives.
      Doctors have to cover their A. ( to be blunt). The best doctors do not order/prescribe, un-necesaary tests. But sometimes testing is un-avoidable.
      For my mom’s flare up in the bottom of her legs the first doctor ordered STAT imaging testing at the radiology center for her legs to make sure there was no blood clot. That was not an unnecesaary test billed to Medicare.

      Background- On August 30, 2008 my mom was involved in a double fatal car accident that left every bone in both her legs, smashed, shattered or gone,, including a thigh musclle ripped out of her leg, among other injuries. Aftyer several years she recovered to walking on a cane. In Novemeber of 2013 she broke her leg in a wheelchair at an airport.
      She went to the orthoppedic surgeon that had been monitoring her legs ever since the accident here ( not the surgeon that did the surgery 2 states away). Anyway, she went about 6 times over the course of 4 1/2 months. The first time she came in on a stretcher, the 2nd 2 times on a wheel chair, the next 2 times with a walker, and the 6th time with a cane.
      Each of those 6 visits was billed to Medicare.
      Is that what the governemnt is complaining about? The number of times elderly patients visit doctors and specialists because the art of practicing medicine requires it?

      (on a side note, all the money that Medicare paid out from the 2008 incident was paid back to them through the law suit as per federal law, the would not even negotiate).

  7. Drbonz
    April 15, 2014 at 7:14 am

    When are they going to publish how much each lawyer makes a year? Oh that’s right, NEVER because they make the rules. Talk about the wolf guarding the henhouse.

    • April 16, 2014 at 11:31 am

      I wouldn’t have a problem with lawyers publishing but I would MUCH rather that the admin levels in hospitals, groups, etc. all the healthcare admin people have to have their salaries published. Forget the lawyers, give me those figures FIRST.

      Same for insurance companies. There is bloat right there we could ditch.

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