Chronically Unhappy

unh

I saw this article from Tamara Star on Huffington Post.  What caught my attention was that I had all 7 habits of chronically unhappy people.  Here are the seven from the article and how they related to my job:

  1. Your default belief is that life is hard – yes, because the job was hard.
  2. You believe most people can’t be trusted – yes, because the insurers, the government and the administrators could NOT be trusted and proved that every day.
  3. You concentrate on what’s wrong in this world versus what’s right – guilty but the world of medicine has so much wrong that you just get caught up in the crap.
  4. You compare yourself to others and harbor jealousy – I was jealous of specialists, friends in other jobs, the mailman, and anyone not in medicine.
  5. You strive to control your life – that defines being a doctor.
  6. You consider your future with worry and fear – I was beyond worry and fear.  I was convinced there was no hope.
  7. You fill your conversations with gossip and complaints – that is what my partners talked about every day.  We bitched.  I wrote about it in this blog.  It consumed me.

Here is the good news.  I have changed in the last two months.  Doing Direct Primary Care has almost made it hard to continue this blog.  Life is easier.  I trust those around me since I do not deal with the insurers, the government or administrators. I can see what is right and no longer compare myself to others as much.  I have control over my life and the future is bright.  I no longer talk to my physician friends about what is wrong with our job.  I have left that job.  I still speak to my former partner, who also started his own practice, and we are both amazed how relaxing life is now.  I have found a path to happiness.  That doesn’t mean it’s perfect but I recommend that everyone consider walking off the grid of industrialized because it is damn close to perfect.  I enjoy being a doctor again.

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 “Chronically Unhappy

  1. Lisa Gwin
    December 17, 2014 at 8:31 am

    Doug, I’m so happy for you! Congratulations on escaping!

    • Doug Farrago
      December 17, 2014 at 8:46 am

      Thank you!!

  2. tad hominem
    December 16, 2014 at 12:01 am

    Doug: PTL (praise the Lord) !!your transition to constant rants was noticeable, and depressing. Hope ur feeling better is reflected in the commentaries. But I’m not entirely convinced. Like a bad case of acne, scars may remain.

    • Doug Farrago
      December 16, 2014 at 6:12 am

      Tad, I am not perfect. The system is broken and is destructive to patients and my fellow docs. So….I still will rant. I have 20 years of scars.

  3. Scott
    December 15, 2014 at 4:41 pm

    Direct primary care fascinates me. I would love to hear more details about call, patient numbers, overhead, vacation time, etc.

    • Doug Farrago
      December 15, 2014 at 5:49 pm

      Call 100% but hardly anyone calls. Patient number – eventually 600. Overhead 20% or less. Vacation time – none until you get an associate.

      • Steve
        December 17, 2014 at 7:47 am

        Ummm. Doug!
        Now that you have all this extra time and control, perhaps you should use it to check for typos.
        6000 patients in your DPC ??

        Steve

        • Doug Farrago
          December 17, 2014 at 8:45 am

          Which typos? Usually my wife checks but she is working at my practice now.

          • Steve
            December 17, 2014 at 8:56 am

            Do you plan on having 6000 (six thousand) or 600 (six hundred) patients in your DPC practice?
            If you don’t know, maybe you should ask your wife?

            ; )

            Steve

  4. Dave Mittman, PA, DFAAPA
    December 15, 2014 at 12:13 pm

    You sound good. I am glad for you.
    Nice……..
    Dave

  5. Steve_O'_
    December 15, 2014 at 8:43 am

    And….to embrace every misery without dispute is the morality of the little man. Little men, resentful men, strike at the professions – they are jealous of the honor and skill accumulated by will and sweat.
    They confuse the fact that a Black Belt is but a piece of cloth, to be purchased for a few dollars. And medals and badges are shiny and silver – they bedeck themselves with them like harlots.
    According to Nietzsche, “they cry for a good opinion of themselves–not being able to set their own value. The slave morality is subject to flattery — such persons know they do not deserve praise yet they believe it when they are praised by the master since they have not the abilities to create value. Vanity is a consequence of inferiority.”
    Now, much of Nietzsche’s philosophy is rubbish – but the wrath and resentment shown by the little men towards the able, is inarguable. To be a physician and stand in awe of a brilliant and skilled colleague, and wish to learn and take on one’s own skill – that is the mark of the professional, the noble.
    Boards and publications and universities once existed for those thirsting for the rush of self-improvement. But the morality of the herd is that the slaves are liars and slackers – they must be watched, so they do not cheat! Slaves reject any moral responsibility for what they do – everyone knows that the slave despises the rake and shovel, of course!
    The slave morality, the little man’s morality, lies in the oxymoron “to create frustration.” They insert their own will into the creative process, demand that the drive towards the goal be interrupted to take notice of their little vanities, to seek their approval. Victory, to the little man, is the ability to frustrate, to make sure that the surgery is not done, the medication delivered, the patient healed or comforted.
    We live in such a world today. Perhaps 150 years ago, America admired the doer, the maker, the innovator and the brilliant and capable. Now, we worship the herd, the incompetent and dull – the mean, in all senses of the world. Outliers are a threat, and lockstep mediocrity is called Best Practice.
    The “Seven Habits” are simply glimmers of insight common to those who are not mean. To see each one, and despise it – there is hardly anything to criticize there! It is what one DOES with one’s insight – that is the choice of whether one is noble, or a slave.
    “Doing Direct Primary Care has almost made it hard to continue this blog. Life is easier. I trust those around me since I do not deal with the insurers, the government or administrators. I can see what is right and no longer compare myself to others as much. I have control over my life and the future is bright. I no longer talk to my physician friends about what is wrong with our job. I have left that job. I still speak to my former partner, who also started his own practice, and we are both amazed how relaxing life is now. I have found a path to happiness. ”
    My only fear about DPC is that the little man, the slave, will sniff it out and murder it – for all mean men are enraged by anyone who achieves JOY at WORK. To have delight in the product of one’s own hands, that is the mark of the artist – and the Art of Medicine is largely vanished behind the regulations designed to “create frustration.” The ugly and the wicked will not allow DPC to survive, even if it saves lives and ameliorates suffering – that makes it even the more enraging to them. I hope I am wrong, but I expect DPC practitioners to be hounded by the IRS and the HHS, and to be forced into the electronic medical records trap, and crushed into the current movement to eliminate the “independent practitioner” who does not belong to a Medical Factory. Enjoy the ride while it lasts.

  6. Sir Lance-a-lot
    December 15, 2014 at 7:40 am

    1. Your default belief is that life is hard –
    That’s because, unless you’re Dermatologist to the Stars, in Medicine, you see, every day, that life is hard for the vast majority of your patients. It’s the human condition. Duh. What do you think doctors who work in Africa believe?

    2. You believe most people can’t be trusted – Does this imply that Ms. Star believes that most people CAN be trusted? Really? I learned very early that if the patient’s lips are moving, he’s lying.

    3. You concentrate on what’s wrong in this world versus what’s right – Nobody comes to the office to tell me that they’re feeling great.

    4. You compare yourself to others and harbor jealousy – Considering how much specialists make, not to mention my former high school and college classmates who went into banking, stocks, the military, and civil service, how can I not?

    5. You strive to control your life – And fail. I went into Medicine because I thought it would give me more control over my day-to-day surroundings, and find myself at the mercy of hospital administrators, who control every aspect of my day, with no input from me.

    6. You consider your future with worry and fear – Yeah, because what with all my loans, there is no way I can ever afford to retire.

    7. You fill your conversations with gossip and complaints – At work, that’s all we do. There’s nothing else to talk about.

    • Steve_O'_
      December 15, 2014 at 9:00 am

      Good points, Sir L. I don’t know when you did residency – regrettably, mine took place at the transition from training professionals, to training slaves. Once, it was a solitary operation, where your conscience took the brunt of doing everything you could for the patient – and still fretting that it was not enough. Then, it merely became keeping your lips soft and moist enough to flatter the attendings – and blaming others. I have seen those skilled at both. In the latter, our former Chief Resident failed the boards – and had to be made an “Adjunct Instructor” at the University until subsequent attempts at examination could be made! The shame of not being an Assistant Professor!
      A crucial point in creating slaves is to cause them to doubt their own judgments about quality, and replace them with a blind trust in the Brand. How do you know if your doctor is any good? You must first trust in yourself and your OWN judgment to decide. If you buy into the worldview that everyone is sh*t, a criminal and a thief, then you trust nobody but the Brand. And other slaves will snarl jealously at your Brand, Reebok or Mercedes.
      DPC cannot be sold to the slaves – they will want to see Mayo, Stanford or Harvard stuck on the label! DPC can only work in the care of the intelligent and free-minded patient. There are so few these days.

    • Pat
      December 16, 2014 at 10:10 am

      Excellent points Lance. The scars referenced by Doug are, for me, patients. Every one of them has the capacity to turn vindictive on a dime, and I’ll never trust any of them again. It is they who threaten to assault us with lawsuits, a misplaced sense of class envy, and daily constrain us with government chains forged in their name.

      Medicine today means constant conflict, where the mistrusted doc has to constantly defend his recommendations against a non-compliant patient, or his relative who read a better idea on the Internet, or a coder drone with no medical knowledge, or government core garbage forcibly supplanting one’s own judgement. It beats one down, and replaces good will with a hyper-alert, survivor’s instinct. Surviving medicine means thinking well of your self not because of what you do, but in spite of it. It is not an honorable profession.

      Physicians can still take satisfactions from a job well done, and the camaraderie of working with great staff. Those, and physical survival are the remaining rewards for most of us. These are still important positives for which I remain grateful. But for my own piece of mind, I long ago discarded the notion that I was doing some great good. The pervasive angst and futility in medicine leaves me wondering that most physicians don’t end up as alcoholic Irish poets.

      • Doug Farrago
        December 17, 2014 at 5:49 am

        Pat, I cannot tell you how weird this is but when it is your business and you are offering a service to people, things change. The patients are paying above and extra over insurance in DPC and so my mindset is different. The patients have been great.

Comments are closed.