Two Headlines of Lunacy

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Here are two headlines which I think help capture the lunacy of my profession:

One could debate that the first headline is in response to the second headline.   Maybe.  While it is true that wait times are one metric to grade doctors, it is also true that there are so many other metrics tied to the bogus quality scores that doctors can’t get through a visit without being distracted by this crap.  Since the idiots in charge want to move away from fee for service (because being compensated for the value of the service you give is wrong?) then they will continue to increase wait times as doctors try to game the system by treating numbers and not people.  For example, seeing patients who we need to get their numbers (glucose, blood pressure) to look good, whether the patient cares or not, is first priority while those patients with bronchitis or ear infections can wait or go to the urgent care.

Once again, what we have here is the medical version of No Child Left Behind that has failed so miserably for teachers.  Is there any chance that the same morons who started that garbage just moved over to the healthcare system?

 

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] 

  2 comments for “Two Headlines of Lunacy

  1. July 29, 2014 at 9:46 am

    Hate to double-post, but here’s a few effective tips for you surgical duds from Slimon Reynolds on Forbes: How To Work Much Faster (7/27/14)
    Working quickly is one of the most important characteristics of the high performing business person.
    You can be highly intelligent, motivated and experienced, but if your output is slow then you’ll never reach your potential. Speedy working is a craft well worth learning, but few executives spend any time developing their skills in this area.
    1. The 80% Rule
    Invented by well known Canadian business coach Dan Sullivan, The 80% Rule suggests you should do tasks to about 80% of excellent standard, then move on to another task. It’s extremely effective because it’s often the last 20% of the task that takes much of the time. Yet in general doing that last 20% is not appreciated by other people, nor is it necessarily particularly useful to you that you got it done. You finish the job to an 80% excellent standard. Perfectionism tends to destroy productivity.
    2. Rush The Unimportant
    You can usually achieve twice as much if you rush jobs that aren’t crucial to your business. Most tasks don’t really matter, but many people give trivial tasks the same care they give important jobs. The net result of that attitude is they no longer have enough time available to do the vital jobs superbly. Take it from me, you do not have enough time in the day to do everything well. Pick your battles and rush the rest.

    [That’s as far as I read – I’m in a hurry. I’m running the Random Number Generator for the patient satisfaction scores today.]

  2. July 29, 2014 at 9:30 am

    Finally! Let’s do something about these surgeons and their OR schedules! I’m assuming that’s what the complaint is.
    I’m not a surgeon, but I occasionally see them on TV on the medical channels that show surgeries, and on daytime TV. They do a surgery, and then they stand around mooning and poking this way and that at the operative site after they’ve finished. It’s like they’re looking for a new organ or something! And the rest of the staff is just standing around, looking bored and getting paid on the clock. When you’re done, you’re done, so move on!
    Perhaps we could get some faster way to open and close surgical access to the operative site. It doesn’t take a highly-trained expert to do a laparotomy incision down to peritoneum, does it? It could almost be done by robot guidance, faster AND cheaper. What about putting in staples – a techno-stapler would make a straighter line than a human being, and way faster too!
    Perhaps OR’s could be set up on a carousel/helterskelter pattern, so when a surgical team is done, the patient’s moved over to the next station for closing.
    It would help CQM/UA to have the patient advocate present during the surgery, so that after the surgery, the surgical team could roundtable with the patient present, and critique the surgical team’s performance, and add constructive suggestions for performance improvement. Right after surgery would be best – a whiff or two of oxygen, a little squirt of Narcan, and the patient can be right there to add client-centered feedback.
    There’s no excuse for the current inefficiency in surgical suites. The patient’s surgery starts at 7:00, and the next one’s at 9:30 – but come 9:30, the surgical team’s still futzing around and counting utensils. Come on! 20 minutes for a team of five people to count, what, $50 worth of surgical supplies? And the surgical suite’s already running behind!
    Give bonuses to the team that finishes before the deadline. That way, the nurses and other personnel can encourage the pokey slow-lane surgeon to get a wiggle on, and make those fingers fly!

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