Putting Doctors Back in Charge


In response to an op-ed in the February WSJ, Dr. Phyllis Hollenbeck, M.D. decided to give her own two cents. Again. She was one of the three VA physician whistleblowers who were honored by the Office of Special Counsel in December 2014 after they helped shine on a light on the crisis going on there.  Her entire response is here but here I wanted to show you some bullet points:

  • Marginalizing physicians is the same playbook the Department of Veterans Affairs has used for years. Most medical center directors aren’t physicians (mine has a civil engineer in charge); many clinical departments don’t have doctors as chiefs (our compensation and pension head is a respiratory therapist with management training, and our mental-health service is run by a psychologist).
  • We have lost many physicians in multiple departments due to resentment and blowback when doctors have brought ideas on how to best care for veterans.
  •  I asked the deputy secretary of the VA to “bring the doctors back in close. We understand the processes of life and death, and we know where the snipers are.” We understand the complex variables and vulnerabilities of the body and mind.
  • Physicians take a sacred oath to hold the life of a “whole soul” in our hands. And we know how to make medical care happen, from the daily flow of a clinic to diagnosing and helping human hurt. It’s what we studied so hard and long for, and ache to do as well as we can.
  • “The current absence of such leadership is shocking.” And without changing that in the VA system, more doctors won’t sign up.

Here is someone who gets it.  What she doesn’t understand, however, is that the covert mission by administrators in healthcare has been to undermine the trust patients have in doctors.  The goal is to call themselves and their facilities  “providers” and therefore take control away from doctors.  By doing that they can fire doctors at will, higher lesser trained and lesser educated caretakers and make themselves more money in the process. What happened at the VA continues to happen everyday and at every hospital around the country.

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] 

  2 comments for “Putting Doctors Back in Charge

  1. Mel breite md
    March 13, 2015 at 9:25 am

    I Have a new word for you to describe the plethora of prior authorizations needed now my secretary is suffering from priorrhea

  2. Steve O'
    March 8, 2015 at 10:05 am

    The goal of any bureaucracy is magical, effortless change; change without change, the wave of the wand of the Good Fairy to bring silence upon any unwanted criticism. Since few bureaucrats understand even the system they are embedded in, not knowing right from wrong, efficient from inefficient, courtesy from criminality, they would not know how to enact meaningful reform anyway.
    Perestroika was that, in the old USSR – let’s change everything (because we’re dying) but not shake even gently the foundations of power. And, by good Leninist theory, the roots of power were firmly bedded in scientific socialism that were proven by the dialectic to be eternally right. “Don’t change the power, just the reality, now! What we want is reform, not revolution!!”
    But somebody left the back door open, and everybody quit. In the movie, Tom Hanks should play Gorbachev – “There’s no QUITTING in COMMUNISM!”
    The nightmare of the Fall of the Berlin Wall strikes unending terror into bureaucrats around the world. Freddy Kruger, to the bureaucrats, is not a midnight slasher but far worse; a Pied Piper that leads all the competent suckers far away from the looters and moochers and vampires of the world. Don’t worry, they HEAR Dr. Hollenbeck. She haunts their dreams.
    No matter how smugly the bureaucrat smirks, taking power away from the competent and capable, it makes for restless sleep. The Piper may some day come…….WILL someday come….,.

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