Our Corrosive Culture of Quality


The article in the WSJ was called White House Review of VA Finds “Corrosive Culture”.   Here are a couple of highlights:

  • A White House review of the VA health system points to a culture that degraded the timely delivery of care and requires a restructuring to improve transparency and accountability.
  • It found what Mr. Nabors described as a “corrosive culture” that affects employee performance and patient care. He added that the Veterans Health Administration structure has “impeded appropriate management, supervision and oversight.”The review also found the VA’s goal for scheduling many medical appointments within 14 days is “arbitrary, ill-defined and misunderstood.” That goal had been set in 2011. The VA recently eliminated that 14-day target.

Really?   So, the 14 day rule was “arbitrary, ill-defined and misunderstood”?   Of course it was!   In fact, those three terms are the definition of QUALITY and this 14 day rule was what was put in for quality reasons.  What’s funny is that you will see the first highlight uses the administralian terms I pointed out the other day (transparency and accountability). They love this crap.  Why didn’t they put in my favorite bogus term – quality?  Because that is what made them create the 14-day target!  So, they subtley removed it.


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 “Our Corrosive Culture of Quality

  1. R Watkins
    July 11, 2014 at 12:28 pm
  2. Michael Gorback
    July 10, 2014 at 3:43 pm

    Does anyone think for one second that most socialized health care systems aren’t like this? Do you really think for one second that Spain or Italy have better health care, or is it just institutionalized corruption and falsification of data? Anyone else remember the story about the Greek hospital that had several gardeners on the payroll but no gardens? How about the Charite’ artificial lumbar disks that worked so well in Europe? How many of those do you see being implanted these days?

    • Pat
      July 10, 2014 at 10:35 pm

      Right on! C’mon AM readers, chime in – why do you think government will do a better job if they are just put more in charge?

  3. R Watkins
    July 9, 2014 at 1:48 pm

    “arbitrary, ill-defined and misunderstood”

    Let’s see. That would be MU, ICD-10, P4P, PQRS, PCMH, MOC, ACO . . . .

Comments are closed.