Blasting the Bogus PCMH Concept

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I need to give props out to Amy Rosenthal MD from NC.  This was a letter to Medical Economics in October where she shreds the PCMH concept.  Above is the screen shot but the highlights are:

  • In my experience what was supposed to be patient centered was actually data centered
  • It put layers of staff between me and my patients
  • Dr. Holly highlighted “listening to a patient and treating the whole person” as key to the medical home.  This is absurd. A practice does need to have a PCMH label to treat patients with respect and as individuals
  • While PCMH sounds like the latest, greatest thing, it is much ado about not much, and in my experience impedes the doctor/patient relationship

Great job, Amy!  How about you leave the dark side and join the DPC movement where you will actually accomplish the right goals with the right values?

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] 

  3 comments for “Blasting the Bogus PCMH Concept

  1. RSW
    December 23, 2015 at 2:23 pm

    The AAFP’s unceasing, mindless promotion of the PCMH is probably the best example we have of a medical society declaring open war on its membership.

  2. Perry
    December 23, 2015 at 2:08 pm

    No smaller practices could possible afford this program even if they wanted to at $100,000 to maintain. And is there any evidence that this is so much better than a good established family practice? Don’t think so.

  3. Steve O'
    December 23, 2015 at 8:10 am

    MiniLuv. The Ministry of Love, in Oldspeak. Orwell created this organ of the State for correction of error by the populace.
    When you see propaganda – often disguised as helpful advice for idiots too dumb to pour mud out of a boot – you can look beneath it to see some grisly facts. Something is going on that has frightened the Leadership, and they need to enforce something too perverse to come out and say directly.
    “PCMH” is just that sort of propaganda. It pretends to teach doctors and healthcare workers a “new way” not to treat patients like sh”t. The pretense is that doctors and healthcare workers DO treat patients like sh”t because of ignorance. That pretense saves the Leadership from having to speak the truth.
    Dr. Holly highlighted “listening to a patient and treating the whole person” as key to the medical home. That advice is as useful as some overstuffed Doctor Phil advising in relationship counseling, “Never, never strike your partner with a closed fist.”
    If you ARE striking your partner in a relationship with a closed fist, is is usually the sign that the relationship is terminally ill and should end. It is not from the lack of information.
    The pretense in the “Dr. Phil” example is that spousal abuse is a relationship error, not criminal violence. The pretense in the PCMH concept is that the process of the care of the patient in American healthcare is not being destroyed by great forces for incredible profit, and this process is not permitted to be interrupted.
    Given that American healthcare is being torn apart, what merry dance should be done to make it better? Such questions are unpleasant, even to the most indoctrinated – and that’s why Propaganda exists.

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