High Output Failure by Stephen A. Vaughn MD PhD


Regarding administrators – look at how militaries act on the field. Military staffing measures the number of support personnel to the number of combat troops. The target is about 1:7. The North Koreans and the Vietnamese against the French made do with an incredible 1:2 or even 1:1 support/combat. In the current US military, I understand it’s 30:1, which is often seen in bloated administrations.

If the analogy is extended to medicine – if 1 physician has 1 support person on their back, that’s a 50% productivity. If it’s 30:1, that’s 3% productivity. There’s no way to sustain that- it’s high-output failure.

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 “High Output Failure by Stephen A. Vaughn MD PhD

  1. RWatkins
    December 5, 2014 at 6:37 pm

    Agree completely. Just wanted to make it clear that WHO is not the bad guy here: we’re completely capable of screwing ourselves.

  2. Pat
    December 5, 2014 at 11:01 am

    Hello ICD-10. Thanks a lot WHO, you worthless &*#%$^@ ‘s.

    • RWatkins
      December 5, 2014 at 1:13 pm

      I know it’s fun to hate on WHO – kind of furrin and UNish – but their version of IOCD-10 is quite flexible and simple. The governments of most other countries have designed their own versions of ICD-10 that generally contain about the same or fewer codes as our ICD-9. It’s only the good old USA that vomited up the 64K code monstrosity that’s being forced up our asses.

      • Pat
        December 5, 2014 at 4:44 pm

        Hey, good for them, and no, no surprise at all that our own government would take a bad idea and expand on it.

        But so what? Why should any U.S. physician have to spend any extra time or money complying with a “world” system? There is no justification for our government to impose any coding system on physicians once foolishly regarded as private citizens. Worse still, our government should never have used the sanction of the WHO as a basis for ramming something down our throats.

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