The Seven Sins of our Medical Leaders


In the latest AAFP Family Practice Management comes an attempt by Aaron Garmin, MD to modernize a 1948 article called the “The Seven Sins of Medicine”.  Obviously, the original was a play on the seven deadly sins and this one is a play on that one.  Anyway, I can just see this doc racking his brain to figure how these sins might apply in today’s environment but do it in a nice way so it gets published.  Hooray, he did so now let’s trash it.

Garmin had a shot to really make some great points about “industrialized medicine” but he missed the mark completely.  Don’t get me wrong, it’s not that some of his stuff doesn’t have a point but remember the title, SEVEN SINS OF MEDICINE as he relates it to TODAY’S ENVIRONMENT.

Here was his:

  1. Not communicating with leadership.
  2. Not putting patients at the center of care.
  3. Not building relationships with our team.
  4. Not practicing evidence-based medicine.
  5. Not investing in care coordination.
  6. Not using common sense.
  7. Not letting others help us.

Talk about your politically correct, ass kissing, drippy, and wimpy list.  Dude, grow a backbone!  With all that is wrong with modern medicine, these were your issues?

Let me help him name some sins and there are plenty more than seven:

  1. Not taking over the business of medicine and letting others do it for u.
  2. Approving the Affordable Care Act!
  3. Approving PCMH, ACO, and other initiatives.
  4. Buying into meaningful use.
  5. Not looking away from the EMR while with a patient.
  6. Treating patients as numbers and not people.
  7. Working for hospitals and getting treated like pawns by administrators
  8. Approving of Medicare!
  9. Following unproven quality metrics.
  10. Not fighting back against insurance companies

Please, feel free to add more and spread this around so somehow good, old Dr. Garmin gets a clue and stop being a wuss.


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] 

  13 comments for “The Seven Sins of our Medical Leaders

  1. Geno
    November 4, 2015 at 5:17 pm

    #14 Getting handed a bowl of alphabet vomit and then asking, “Please Sir, May I have some more?”

  2. Lady Di
    November 4, 2015 at 8:44 am

    The deadly sin that started this crap sandwich was Envy;pure distilled envy given full force via the sanctimonious legal bureaucrats: “Doctors have too much power.” “Doctors don’t respect nurses. . .don’t respect patients. . make too much money. . yada,yada.” Unfortunately, the payment codes, performance evaluations, peer reviews, and ” jump through hoops” recertification have been constructed by these desk jockeys, aided by our fellow physicians who continue to feed this Envy Monster.

  3. Kurt
    November 4, 2015 at 8:34 am

    Doug, you ought to email the guy what you think of his drivel. Kurt

    • Doug Farrago
      November 4, 2015 at 8:41 am

      I don’t have his email address

  4. Beth
    November 2, 2015 at 10:08 pm

    “The real reason for all this trying to “fix healthcare” is about how to “fix” healthcare so as to squeeze every possible penny out of it for the stakeholders’ bottom line.”

    I agree. The stakeholders do not include the doctors or the patients. They get in the way. Healthcare has lost its true purpose.

  5. politovski
    November 2, 2015 at 9:24 pm

    #13 allowing midlevels to siphon away our authority, respect, money, et cetera (and i’m talking to all the specialists with 3 PA’s working for them. we don’t send someone to a specialist for a PA’s opinion on something. wikipedia is often just as good.)

  6. Beth
    November 2, 2015 at 10:26 am

    You can now see what they have done to teachers in public schools. Some of the things they tell you is an insult to your intelligence and integrity, then some of it is that if you do one command it contradicts another dictum. No more professional to professional approach. That does not mean that there are not bad apples that need to be kicked out, but it does mean that treating all professionals as if they were is offensive. I felt like I worked under a slave and master regime.

    First they came for the Socialists, and I did not speak out—
    Because I was not a Socialist.
    Then they came for the Trade Unionists, and I did not speak out—
    Because I was not a Trade Unionist.
    Then they came for the Jews, and I did not speak out—
    Because I was not a Jew.
    Then they came for me—and there was no one left to speak for me.
    Martin Niemöller

    Wall Street has come for physicians

  7. Pat
    November 2, 2015 at 9:43 am

    # 12 Not refusing to to treat medical malpractice lawyers.

    • RSW
      November 2, 2015 at 1:09 pm

      #13. The population is more important than the patient.

  8. November 2, 2015 at 9:01 am

    Why? Why is it that the medical world keeps trying to figure out how to practice medicine? Is the art of medicine not good enough? Are the technical, medical advancements not an improvement? Does not the education that a doctor acquirers not good enough to practice medicine? What the Hell is all this trying to figure out how to practice medicine for? It’s not that doctors don’t know how to provide medicine… and it’s not that the patients don’t want them to… That worked when practiced. No, it’s got to be something else, because if that was what the motive was here, that isn’t so hard to just let doctors be doctors and treat their patients. That is the obvious real answer but that is Not what this about. The real reason for all this trying to “fix healthcare” is about how to “fix” healthcare so as to squeeze every possible penny out of it for the stakeholders’ bottom line. That’s why all of this fiasco won’t ever be resolved because too many people really think it’s about “fixing healthcare”. The confusion will go away when they call it what it really is, the conversion of American healthcare to big profit making “Toyota Assembly Line Medicine”. And all patients, doctors and medical staff will have to be controlled to make it work the way the Executives want it to. #BigMed #LetDoctorsBeDoctors

  9. Perry
    November 2, 2015 at 9:00 am

    Dr. Garmin obviously does not want to be considered a disruptive doctor.

  10. Steve O'
    November 2, 2015 at 7:47 am

    To translate out of Newspeak:

    Not building relationships with our team.

    Every team member has a vote on the medical care of the patient – but only one bears the blame.
    #12. “Responsibility is delegated without the means to achieve it.”
    I was banging my head against the wall on Friday, trying to “gain consensus” that a HbA1c of 8.8 required aggressive action. No, said the Team – it was Better. Sail on into substandard care, hold your course!
    BTW, when the performance metrics come around, whom do you think takes the rap for bad diabetes control?
    The story is a renunciation of the children’s fairytale about the Little Red Hen. Lie around when the work’s being done, and give advice – that makes you a Team Member!

  11. William Braswell
    November 2, 2015 at 7:13 am

    #11: Peer review is the evil antithesis of mentorship.

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