Defending Family Docs From Hospitals


As the number of doctors leaving independent practices increases, there has been more and more concern about the abuse they are taking from their employers (hospitals).  Since no one really represents doctors when they decide to work for these organizations, they unfortunately get bullied or get scared or get greedy and sign on for, well, anything. Now the AAFP is realizing that most of their members are becoming “employed” and are trying to come to the rescue.  Stop laughing. He are some quotes from the above article from a few months ago:

  • “We believe physicians deserve fair hearings when threatened by termination from a hospital and that fear of retribution may limit or prevent physicians from fully advocating for their patients’ best interests,” said Blackwelder.
  • Furthermore, “Physicians with due process rights are more likely to protest fraudulent practices that threaten the integrity of the Medicare and Medicaid programs,” he added.
  • “Physicians have a duty to advocate for their patients, even when such advocacy requires opposition to a hospital’s interests,” said Blackwelder.

So what is their plan?  Are they trying to figure out a way for doctors to survive on their own?  Of course not!  No, they are going home to tell their Mommy (the CMS) so they can revise the “conditions of participation” document that Medicare-participating hospitals sign.  Na, na, na-na-na-na.  You are in so much trouble, hospitals!

Ok, enough of teasing the AAFP.   The truth is, no one cares about you as an employed doctor other than you. Your peers don’t care about you and will walk the other way if you get into it with the administrators.  How do I know?  I worked for two hospitals for 15 years (one for ten and the other for five). I have been sued by one for a noncompete issue (lost that one but didn’t have to pay), I have been set up to be fired (they failed), I have been fired for not signing off on a third party to optimize my billing (I won), and been to the principal’s office more times than I can count. If you have read ANY of these blog entries over the years then you will know I am not a big fan of administrators.  The reason is that once you sign to be their employee then you are their bitch.  End of story.  You have no power.  The AAFP will not help you.

So what is the answer?  Don’t sign with them.  Stay independent.  Do DPC.  Do consulting. Do something other than falling for their trap.  It’s not worth it.


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] 

  6 comments for “Defending Family Docs From Hospitals

  1. E Alexander
    September 13, 2015 at 5:42 pm

    Now doctors are being treated like K12 school teachers. Everything is in the numbers.

  2. Ken
    September 13, 2015 at 2:26 pm

    Of course, I’m sure you’ve been labeled as a “whiner” and “not a team player” (I now look upon these as compliments) more times than you count. And I suspect you were rarely acknowledged for any lives that you saved or difficult diagnoses you made.

    The sad thing to me is that physician run groups like Kaiser can be the most sadistic of the bunch.
    So I raise my glass to DPC, starve the parasites, return medicine to doctors and patients

  3. Steve O'
    September 13, 2015 at 1:39 pm

    Other common words for this are “stooge,” “chump” and “fall guy.” If some underboss tells you to discharge the feverish patient, you do it. Meanwhile, they’re collecting enough HR dirt on you at the “scum factory” (I’m sorry, HR) to lay on you in case there’s a bad outcome.
    If this guy goes belly-up, why, they need to pin it on a chump with a license – and that’s you, hunnybuns. By the way, did you know you showed up a couple times late and smelling of liquor? That’s in your permanent record. The Snitch Patrol’s been watching you, and whoever reports on your performance is in effect your boss. That includes the evil nurse who hates you. She gets strokes to rat on you – prison run on snitches.
    And there in court comes one of the underbosses in his thousand-dollar suits, and his parasite lawyer burns you for “careless, careless, shocking and negligent treatment!” You rat! I hope they throw you in jail! say the people after they read about the trial in the newspaper.
    Welcome to American Healthcare Management. You’re a useable commodity, like a condom is for a prostitute. Feel the love.

    • Steve O'
      September 13, 2015 at 1:51 pm

      It’s not becoming like the Mafia. Don’t insult the Mafia, because the Mafia’s got principles, a code of behavior, some mutual self-respect. These are punks. In PunkAmerica, there’s nothing done for the long-term. Just grab what you can get your hands on today.
      Somehow, we bought this gig as a way to run things in healthcare. It’s not delivering, and there are a lot of mad suckers in the Ponzi scheme who are looking for whose fault it is. Ta-daa! Another stooge is born.
      Think of that when you remember how proud your family was on graduation day, when you became a doctor.

      • Kurt
        September 16, 2015 at 12:02 pm

        Steve O’. You didn’t become the “right” doctor! 🙂

        DPC is only great if one is careful to setup in an area that can support it. You see a lot of
        “Holistic” medical practices out there outside of the big cities? (I’m not blasting Holistic Drs.
        I’ve been to one of their conferences and found it very informative. They have my respect.
        Especially when some of their old practitioners cracked up over my “Eat S**t and Die! business card. I expected a huffy response, not a laugh.)

        From what Doug has posted, sounds like he did his homework and seems happy now. Some of us are close to retirement and can’t wait. Too late to change operations this late in
        the career.

        My view is if patients are going to be paying more, you may end up selecting folks who actually listen to your medical advice and make the lifestyle changes necessary for longevity.
        How refreshing. Currently the ivory tower bastards want to screw the Docs and the hospitals for our patients lousy behaviors. I can hand them 60 pages of stuff out of
        A.D.A.M. they probably use to light their wood stoves. None of the patients are held accountable and nothing is going to change. EHR, MOC none of it is going to improve the health situation in this country unless there are consequences to the patients for their poor behaviors. I tell students to get a set of marketable specialty skills and stay out of primary care unless they want to be a nursemaid, guardian angel, secretary and health policeman.
        We are not paid enough to do the first three and there are no tools to be a health policeman. Kurt

    • Perry
      September 14, 2015 at 10:35 am

      Maybe Orange is the new White…

Comments are closed.