Self-Hating Family Doc Strikes Again


There was a nice article in the AAFP website about a recent conference on Direct Primary Care.  No, I am not a big fan of the AAFP nor am I a member anymore.  That being said, it is nice to finally see a glimmer of hope from a dying organization.  They seem to be embracing DPC more and more.  Then I read the comments.  There I saw the same self-hating family doc that I keep seeing any time the term direct primary care comes up.  Mike Oppenheim takes it upon himself to disrespect any family doc NOT dying in the field like he is.  I called him a royal douche over a year ago when he said,”Concierge medicine is sleazy. It aims to maximize income and personal convenience. I’m comfortable labeling doctors who claim otherwise as hypocrites, and that includes several I know personally.”  The AAFP removed my comments and life went on.  This new article, however, enabled good old Mike to come out from the shadows once more and say this:

When doctors talk about a cash-only practice under circumstances when the general public may listen in, they talk about the vast amounts of time they spend delivering superior care to a grateful clientele. Around the lunch table with only colleagues present, they talk about the money. Following AAFP guidelines, I write — respectfully — that DCP physicians are a disgrace to our profession.  Sorry, I meant DPC physicians. I sometimes get you mixed up with chiropractors.

Mike is living proof of that age old maxim that once a douche always a douche.  You see, Mike is a self-hating family doctor.  One who so miserable in life that he cannot stand anyone or any colleague who gets ahead.  He is filled with jealousy and spits venom because he can’t stand what he does or who he has become.  He is embarrassed about his profession, his career choice and about himself.  I feel for him.   Unfortunately, I cannot leave comments on the site because you have to be a member to do so.  But if you feel bad for Mike, like I do, and are a member of the AAFP, won’t you leave him some warm words?  For me?

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] 

  9 comments for “Self-Hating Family Doc Strikes Again

  1. mamadoc
    November 26, 2014 at 8:25 pm

    This guy clearly has had extra helpings of the AAFP Koolaid.

  2. Stella Fitzgibbons MD
    November 26, 2014 at 4:54 pm

    I don’t mind the idea of FP’s and other primary care docs getting paid. Not a bit. But who is gonna take care of the patients who can’t pay your annual fee? And for that matter, since you refuse to participate in federal programs you can’t get hospital credentials. How do you explain to your patients that you’re only their friend when they’re well enough to stay in the outpatient setting?

    • Doug Farrago
      November 26, 2014 at 7:14 pm

      1. $75 a month. Half a cell phone bill. Not much money.
      2. Hospitalists
      3. More and more docs would go into family practice if Direct Primary Care works. Who wouldn’t want to make a nice living seeing patients for longer periods of time and being more complete. I have no guilt for doing a better job and being the doctor I always wanted to be.
      4. This is a game changer. If other doctors want to continue to be abused by the insurers and the gov’t then it is their choice.

  3. Bridget Reidy MD
    November 24, 2014 at 11:08 pm

    This reminds me of the quote from the AAFP in the article about your new practice, Doug. I noticed they said it was a possible model for those in areas too small to have PCMH’s, which of course had nothing to do with what they were asked about in your article but everything to do with revealing their agenda in making these the only option, at least in communities large enough to make it feasible. I also noticed they took the “patient-centered” out, PC now stands for “primary care”, and in Canada the CCFP has started pushing PMH, the Patient Medical Home. (It would be really hard to explain the idea here in Canada, where every patient and every patient’s specialist already thinks of their FP office as their medical home, but no doubt the Canadian equivalent of the AAFP has something much more bureaucratic in mind, and is more influenced by the AAFP than by Canadian culture.)

    • R Watkins
      November 25, 2014 at 7:43 am

      Check out this piece of cant from the policies section of the AAFP website:

      “The DPC contract fee structure can enable physicians to spend more time with their patients, both in face-to-face visits, and through telephonic or electronic communications mediums should they choose, since they are not bound by insurance reimbursement restrictions. For these reasons, the DPC model is consistent with the AAFP’s advocacy of the PCMH”

      Even though DPC has nothing in common with the god-forsaken PCMH.

  4. R Watkins
    November 24, 2014 at 2:44 pm

    Dr. O-Hole’s self-loathing aligns nicely with the psychopathology of the AAFP leadership: a willingness to take blame for all the problems in medicine caused by others; a total inability to distinguish between what benefits patients and what benefits insurers; and a masochistic delight in accepting any and all bureaucratic tasks.

    It’s a little strange, to say the least, to see the AAFP gingerly begin to support DPC, as this practice style is based on totally rejecting everything – PCMH, MU, PQRS, etc. – that they have been shoving down our throats for the past decade.

  5. Pat
    November 24, 2014 at 1:28 am

    Oppenheim exemplifies those traits which convinced me to permanently leave that field. His ilk are Stockholm Syndrome practitioners for whom repeat beatings are just new opportunities to try and please their tormentors.

    Society has repeatedly made choices that will harm patient care and the doctors that provide it; Oppenheim and the AAFP drones believe that it is our obligation to participate in our own harm.

    Other comments on the linked site noted that DPC models were “unfair” to patients. Would a physician who came to hate their profession and walked away from medicine to something more rewarding likewise be regarded as “unfair”?

  6. Steve_O'_
    November 22, 2014 at 7:40 am

    Divide and Rule! I am very pessimistic about the DPC concept, not because it is in some way sleazy or inefficient, but quite the opposite. It is simple and sensible, and devoid of authoritarian control and guidance. To treat the individual needs of the individual patient has now fallen to a level of respect as prostitution and drug trafficking – as is inevitable in a collectivist society. It will be crushed, firmly! The pimps and cartels of AmHealth will permit no other solution.
    In our rapidly-collectivizing world, Dr. Oppy is particularly useful as the “Judas Goat,” lest common sense prevail and break out. Enslaving the incompetent is very easy – but worthless. The paradox is how to find people capable of independent thought and scrutiny, analysis and reason – and then sell them Shinola.
    Much of the Communist era in the last decade was spent during a time when not only the intelligentsia, but also the workers and peasants knew the score – they were controlled by weak and cowardly bullies. They had Dr. Oppy’s by the thousands – and nothing but abject cynicism prevailed, like here, about the whole operation.
    The “Syndicate” – to use a word that dignifies them too much – this power cluster knows better than to alllow unlimited patient care in a community. Collectivism not only CAUSES shortages – it THRIVES on them. Obedience is otherwise impossible to demand, except from the abjectly incompetent-who needs them anyhow?
    Dr. Oppy exists to remind us that DPC can be crushed in a fortnight.

    • Steve_O'_
      November 22, 2014 at 7:43 am

      And sorry for the blunder – I meant the heartless, cruel, psychopathic and ignorant FOREIGN totalitarian bullies of the last CENTURY.
      My apologies for the misprint go out to the heartless, cruel, psychopathic and ignorant AMERICAN totalitarian bullies of the last DECADE.

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