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.

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

  1. Steve O'
    July 5, 2015 at 8:46 pm

    All. Here. Now. Look it up, listen to the speech. We have become pathetic moral wraiths – collusionists and opportunists, profiting off the injustice that we not only tolerate, but endorse. We are not fit for Dr. King’s legacy. Dr. Tolbert says not to resist the suffering caused by ” change.” Shame on him, and U.S.!

  2. July 4, 2015 at 9:58 am

    Have a look at the Australian version of the AAFP the RACGP. They jacked up membership fees by 12 percent this year to pay for the campaign on prime time TV….

  3. Dave Mittman, PA, DFAAPA
    July 3, 2015 at 8:59 am

    Doug: Firstly, agree.
    Secondly, I want to point out that to the reader there are two bylines on these articles. It looks like it was written by Dr. Conrad and also by you. You also byline the bottom. It’s confusing to the reader. Can you make it clearer who the author is?

    • Doug Farrago
      July 3, 2015 at 11:02 am

      Yeah, nothing I can do about that. Sorry.

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