Big Data Making Doctors’ Lives Easier?

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Here is a knucklehead from an AAFP article on “Big Data” showing exactly why “Big Data” can be ridiculous:

With limited time and a heavy patient load, physicians face a daunting task trying to identify a patient’s multiple needs during a single office visit.  Now, growing implementation of electronic health records (EHRs) and other health information technology, combined with rapidly evolving clinical analytics techniques, promises to make this task easier. By collecting and analyzing data that present a more comprehensive, detailed medical picture of entire patient populations, physician practices can monitor their patient panels more efficiently — often without scheduling additional office visits.

Make this task easier?  Without scheduling office visits?  Yup.  That is the goal of “Big Data”.  Do away with the office visits.  Guess who wouldn’t be needed then?  You betcha.  The doctor.  You think I am crying wolf?  Here is what he says at the end of the interview:

The staff should work with the company that is responsible for collecting and providing the data, which should come to the practice in ways that make it easy to use.

Only a small proportion of the information will be given directly to the doctor. More and more primary care physicians are working in practices that are medical homes or medical home-like, and other people on the team should be able to access the data.

We physicians bought into this medical home crap and it will be the end of us.  That being said, the point these tech gurus are missing is that patients still trust and want to see their doctors.   So the race is on.  We need to push back against useless Big Data before there are none of us left to push back (and see patients).  It’s survival of the fittest and we are already behind.  By the way, I start my direct primary care practice next month.  I am digging in.  Are you?

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] 

  15 comments for “Big Data Making Doctors’ Lives Easier?

  1. Steve O'
    September 3, 2014 at 10:04 pm

    The society has surrendered to magical, romantic thinking, and the Will to Power. magic will see us through, and defeat the Forces of Dark Opposition. We are the Righteous! All that is needed is sufficient wrath. We are regressing quickly into a senile community in its second infancy. No magic exists; nothing can save us from Reality, it is pitiless.

  2. Sir Lance-a-lot
    September 3, 2014 at 7:07 pm

    Direct patient care, you say, Doug?

    Sounds great! I’m glad you’re stepping off the hamster wheel.

    As someone who is likely to make a move in a year or so, I am very interested in how this goes, from the naïf’s perspective, so I will be paying attention.

    Good luck!!

  3. Judy E.
    September 3, 2014 at 10:56 am

    Doug, I wish there were more docs out there that wanted to see patients at all. Where i live, all we seem to find are docs who don’t want to follow inpatients, don’t want to be in the clinic more than 4 or 5 hours a day, want a full week off every month with pay while we have to hire coverage for the inpatients, want a scribe to do their computer entry work, don’t keep their documentation timely or accurate or sometimes even relevant to the pt involved, don’t want to do any or very very limited community involvement work like speaking at a health fair, want 3 additional weeks of paid vacation annually at a minimum, and expect to exceed after-tax salary of > $200,000 with all benefits paid in total for them including family health insurance. Is it any wonder that we turn to NPs for coverage, and try to get their legal practice abilities maximized? I truly believe in physician-based and directed medical care, but I am nearing my fill of the medical profession. At least NPs are so far still willing to work to try to help patients meet their health care needs, instead of seeking more and more ways to get out of patient care and work and still draw down a salary that will allow you to live in the upper 0.5% in my part of the country. And to boot, I am not certain how some of them ever made it thru medical school much less passed a licensing exam!! Rant over for today…

    • Pat
      September 3, 2014 at 2:19 pm

      Judy, counter-rant: every entity you named wants a piece of the doc for as little as it takes. The hospital would love to have in-pt care done for free, and the major in-pt payers (Medicare/’caid) will pay as little as possible, making it economically stupid to take call and have an office.

      Want happy, busy, quota-hitting doc’s putting in 8 hours a day, and doing a lot of pointless documentation? I understand, it’s what pays the bills, and guess what? That’s why the doc’s are there at all – for the money. They are not there for any sense if professional obligation or enjoyment because it’s…not…fun. Most if not all of us went into medicine thinking it would be enjoyable. From the never ending new documentation requirements, to unrealistic patient demands, to being the grateful recipient of everyone else’s anger, it’s not fun at all.

      Like everyone else, the docs have families to pay for, medical coverage needs, and would like to take a vacation from work. It only makes sense in a time when every stinking administrator, clerical drone, lawyer, and greedy patient wants to take a bite outta them that they feather the best nest possible. Community outreach, health fairs??? Sure, with all the spare time docs have after yearly licensing, CME and moronic MOC requirements, why wouldn’t they want to sacrifice personal or family time in order to go do more work for free, in an environment where everyone from the President down to the latest welfare recipient drug addict thinks they ave a right to the doctor’s services.

      So NP’s and other LELT’s are easier to work with? I’ll bet they are, since I saw none of them in the room taking the MCAT decades ago, or behind me in line to apply for more student loans, or across the gurney of a puking drunk countless nights in residency. Yep, I’d be a lot less demanding too, but for those silly expectations that came with those experiences.

    • Randy
      September 3, 2014 at 3:26 pm

      Sounds like a good argument for more self-employed docs. If I don’t see patients and don’t do a good job, I don’t make a living. Too bad the country’s moving in the opposite direction

    • Steve O'
      September 3, 2014 at 10:17 pm

      After two decades of cartoonish bombast and scrutiny, we have produced what we select for; heartless and lazy narcissists. Doctors like our politicians and financiers, our salesman and our hucksters. congratulations! We have the chains we fired and forged, of bitterness and mistrust, but now in the “health industry.” Helluva job well done.

  4. September 3, 2014 at 10:07 am

    Best wishes on your new direct care practice. Looking forward to hearing about it.

    • Doug Farrago
      September 3, 2014 at 10:22 am

      Thanks! Fingers crossed.

  5. Chris Rhody D.O.
    September 3, 2014 at 9:42 am

    I wonder who is going to pay for all this work that the “staff” does? Who is liable for data the Doctor never sees? We are pushed to provide more and more with no increase in compensation to cover costs. We simply need to say no, I am not doing that! “Nobody rides for free.” Otherwise you will be a free ride.

  6. Randy
    September 3, 2014 at 9:33 am

    I’m not sure I have a good handle on what Big Data is supposed to accomplish, but off the top of my head I see two problems. One is that in order to have Big Data you have to have big data collection, which is a burden to physicians and staff. I guess they could just be working off diagnosis codes and hospitalization data which is mostly already being collected, but I think the advantages of that would be limited.

    The other problem is who pays for it. I could see a large medical system being able to use this and break even or make a profit, but at the office level it’s a system that might improve patient care (although I think that is debatable) but which the small office will lose money on.

    • R Watkins
      September 3, 2014 at 11:12 am

      To quote further from the article Dr. Farrago cites:

      “A doctor using an EHR will contract with a different company to meet their big data or analytics needs”

      That is, physicians will collect the data for free, and then be forced to buy it back. Of course, physicians will just be a small market for big data: the huge bonanzas will come from selling it to pharma, insurers, hospital chains, DME companies, etc. (all perfectly OK under HIPAA).

      And now we start to understand the push for EMRs. Just call it the Judy Faulkner Retirement Plan.

  7. Stella Fitzgibbons MD
    September 3, 2014 at 7:32 am

    You have one article bemoaning the fact that primary care doctors can’t handle all their patients without a layer or three of intermediaries, then a second saying that primaries are so ill-treated and poorly compensated that they are leaving the business. You are describing a vicious circle: primaries hate the lack of direct contact, they drop out or hire on with big groups that insulate them further from their patients, fewer primaries are available which increases the workload of those who remain…no wonder NPs and PAs are being called on to handle as much care as they are qualified for. Wish I had an answer, but primary care has never been a goldmine and never will be.

    • Doug Farrago
      September 3, 2014 at 8:38 am

      Oh, but there is an answer. Primary care needs to be deconstructed and then built back up using Direct Primary Care. I am taking only 600 patients. Problem solved.

      • DoctorSH
        September 4, 2014 at 6:45 pm

        Doug

        What model or system are you using for your DPC?

        You can reply to my email address if you prefer.

        Steve

        • Doug Farrago
          September 4, 2014 at 7:07 pm

          Atlas.MD

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