Material Insecurity


It turns out that “patients with diabetes need access to doctors and medicines to help them keep their disease under control”. I almost made this a “Ridiculous Study of the Week” but I just got hung up on the term “Material Insecurity”.  I just love when new phrases are created for political correctness. Anyway, it turns out that people need enough money in their pockets to pay for necessities like rent and heat or they won’t buy their meds:

Among a group of 411 patients being treated for Type 2 diabetes in the Boston area, those who suffered from food insecurity and those who tried to save money by skimping on their meds were only half as likely as their more financially secure counterparts to be managing their disease. This disparity turned up despite the fact that in Massachusetts, nearly everyone has medical insurance and prescription coverage thanks to the state’s universal healthcare law.

A couple points here:

  1. Once again this proves that guaranteed health insurance is not health care
  2. Skimping meds is bad for you, especially in diabetes
  3. Some aspects of health are controlled by factors outside the medical system

Now my favorite part:

The results, published Monday in JAMA Internal Medicine, underscore the fact that some. And yet, doctors are increasingly being held accountable when their patients miss their targets for things like blood sugar and cholesterol, the study authors noted.

Now who has been screaming about this last part for years?  Hmmm, oh that’s right, me!!  These worthless quality metrics are now even being mocked by the LA Times.

There is so much in this study and article that it basically captures everything I do in authentic medicine.  Read it and let it wash over you like a warm summer rain.  It’s called common sense.

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] 

  3 comments for “Material Insecurity

  1. Chris Rhody DO
    December 31, 2014 at 4:15 pm

    Isn’t this just Maslow’s hierarchy of needs. This is really about total reliance on government that way they keep all the power. And as the rich and poor diverge evermore they can blame their opponent.

  2. kurt
    December 31, 2014 at 3:38 pm

    All the more reason to stay away from primary care medicine. For the first 20 years I continuously reminded people of what habits one needs to develop to maintain nominal health. They listen? Fine they do O.K. They don’t listen? I did my best to pick up the pieces. Since I am going to be blamed for their indiscretions now, I no longer recommend F.P. or any primary care specialty to any students. I show them the uncompensateable work that I now have to do and tell them to get into specialty or profession where they get paid for their time.
    (Like a Law degree)

  3. Steve_O'_
    December 31, 2014 at 9:42 am

    The problem is, as always, the persistence disobedience of the masses when instructed by their betters. I cite Dr. Eric Topol’s message of 2015 to the unwashed:
    Another discovery about how to hold physicians feet to the fire in performance…
    “Although we usually ascribe the phrase “letting go” to critical end-of-life decisions, there is another meaning that pertains to how medicine is changing: the end of paternalism.”
    Dr. Eric Toprol has spoken on behalf of the Mere MD’s in citing our willingness to swear off the drug of paternalism, which in modern terms is the term for being responsible and accountable. What arrogance!
    “…in 2014, nearly 1 in 6 office visits switched from physical to virtual. So, beyond patients having medical information flowing directly to their mobile devices, the immediate access to doctors and nurse clinicians has been shown to be remarkably alluring.” So is the demand that the services be free; the billing structure around ‘virtual medicine’ makes it impossible to bill for services.
    As for medical records, Toprol chides the small-minded LMD for “the persistence of paternalism—”the records are mine since I created them.” Of course not! The records are the property of the patient, to be stored as though in a giant library/vault by the Federal government.
    As medicine has become rapidly a pink-collar profession, the gentlemen at the top are always willing to chide the front-liners for their lack of conformity. Corporate does not care for your paternalism, ladies.
    As any sense of power and control are beaten away from those who actually deliver care, the liability for success becomes stricter – the patient will have good numbers, it is the responsibility of the physician to deliver them!
    There is a reason why the old Soviet factory workers got drunk on the job. They were too intelligent to handle their managers while sober.

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