Dr. Tolbert and the AAFP: You WILL Change (and like it!) by Pat Conrad MD

“It is the peculiar quality of a fool to perceive the faults of others and to forget his own.”

– Marcus Tullius Cicero

For a nearly defunct organization, bereft of principle or original thought, the American Academy of Family Physicians still keeps stepping on the rake in the most high-handed manner. They gave some blog space to a Gerry Tolbert, MD another hapless FP, whose lead off is that you are going to get the change, ready or not.

The title “Change Isn’t Optional, but Making Progress Is” presumes that the author’s “progress” is of the best kind, and puts the reader on notice that he had better assume it. Tolbert immediately waves the recent Charleston, S.C. shootings and the Supreme Court decision on gay marriage over his head as talismans of change, connecting them to a diabetic patient, and reassuring us that the “results often more than offset the difficulty.” Out of the gate, this sorry attempt at a connection is insulting. The author has already decided for the reader what the proper “change” is in national issues, and attempts to link it to modern medical practice. Tolbert proceeds to describe change as a constant in medicine – commits a meaningless Game of Thrones name drop, I guess to show us all how hip he is – uses public sanitation as a justification, and tees the reader up for…

…ICD-10…and MOC…and a Medicare ‘value-based’ payment structure. Oh, he doesn’t come right out and embrace any of those, but his sly tone states, “readily admit when you don’t know something” before recommending “Make informed decisions.” In his timing, Tolbert is telling us that admitting our ignorance first will then make us more informed. That may be true in the general, but who is an AAFP disciple to tell the rest of us that? What if we actually do know more than he? Many of us for instance already know that neither ICD-10, nor MOC will lead to any improvement in patient care, and that “value-based payment” is just a shell game method of not paying doctors. Tolbert advises, “Change is hard, but even small changes can make a huge impact. Don’t fear change, but don’t change merely for the sake of change.”

Okay, maybe I’m being tough on Dr. Tolbert. Maybe he offers this column with a non-judgmental, ‘follow-your-own-course’ sort of intent. Like hell he does. His Twitter feed re-tweets the propaganda of AAFP prez Reid Blackwelder, the current U.S. Surgeon General (himself a pro-nationalized health care stooge), and of course, Pres. Obama. Tolbert is an AAFP apparatchik who’s lead-in paragraph and pop-TV reference indicate that he thinks he is playing to the crowd, and wants to sell his readers on embracing destructive interference in their professional lives as inevitable, and therefore healthy. He is siding with those who are telling you and I what to do, and advising us to like it.

His last sentence: “Make the changes that make you better, healthier and more well-rounded, and help your patients do the same.” Taken utterly out of context, this makes a great encouragement for giving the finger to the AAFP and the corruption of Medicare/Medicaid, and progressing to Direct Primary Care.