The AAFP Strikes Again

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The AAFP is proposing that the Health Care Exchange include primary care visits and other services as covered benefits before application of a deductible.  I just want to give my quick two cents here.  If you add all primary care visits before the deductible then there wouldn’t nearly be enough family docs to see these patients.  Secondly, this would just get passed on to the rest of us in the form of higher insurance premiums.  Instead of scrapping this piece of crap, the AAFP continues to support it in the wrong way.  Complete morons.

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] 

  1 comment for “The AAFP Strikes Again

  1. Steve O'
    December 26, 2015 at 9:37 am

    Jeepers. IAAFP Board Chair Robert Wergin, M.D) noted that covering some essential services with no out-of-pocket cost to patients likely would serve as an incentive for them to seek preventive care and chronic care management from their primary care physicians.

    OK – my patient who presented to the ER and got a triple-vessel MI balks at the followup with cardiac surgery and cardiology. Hey, no problem! We’ll just see her/him here in the office for continuing chest pain. There’s no co-pay.

    I’m already seeing people “self-triage” and wait in the parking lot at 4:30 AM with 24 hours of chest pain. We open up, bring ’em in, call 911 against their protests. That’ll cost thousands, they gripe. But you could die, I offer. For some, that’s a close call. But, the customer’s always right, they tell us.

    What else?

    He encouraged CMS to automate the method by which physicians and other providers update their directory information. “Entering provider information should be web-based, allowing the provider to log into a secure website to make changes,” said Wergin.
    He also recommended that CMS “immediately establish and enforce a provider network adequacy standard,” and pointed to a 2014 study(oig.hhs.gov) released by HHS’ Office of Inspector General that found only about half of physicians listed in official plan directories were, in fact, taking new Medicaid managed care patients.
    Furthermore, among those physicians who were taking new patients, about 25 percent disclosed a one-month wait time for a new-patient appointment.

    Wow. A WHOLE month wait time for a new-patient appointment? Just pass a mandate that new patients be seen within seven days of making their first appointment. The long-standing patients will be shuffled back down the queue. We’ve got to find a way to punish THAT decision, too.

    So, we’ll have a carousel of patients skipping from primary-to-primary so that they can be seen for their viral URI within a few weeks, rather than waiting a month, to get antibiotics. As the carousel spins faster, more patients will be flung off into the McMedicine world of national retail pharmacy providers, sitting in a little office in the pharmacy, giving patients scrips to fill – why, right here in the pharmacy, OK?

    Another spooky-sounding thing is Essential Community Providers. Your care provision is essential for success, doc! But what does that mean? For plan years beginning on or after January 1, 2018, multiple contracted or employed full-time equivalent practitioners at a single location will count toward both the available essential community providers in the plan’s service area and the issuer’s satisfaction of the essential community provider participation standard; Fed. Reg. cit.

    A recurring health reform theme over the years has been the “essential community provider.” Originated as an aspect of President Clinton’s health reform plan, the term has been used by policymakers and researchers alike to denote health care providers that through legal obligation or mission, organizational and service structure, and patient population characteristics, play a significant role in health care for patients and populations at disparate risk for inadequate access. (REF: http://www.healthreformgps.org/resources/essential-community-providers/)
    So far, the term has been used to describe organizations, , federally qualified health centers (FQHCs), all organizations receiving grants under Section 330 of the Public Health Service Act (PHS). But the Federal Rule refers to providers as people like, umm, me.

    What if I’m unessential where I am, but there’s a crying need for someone in East Buttslap, North Dakota? If I go there, and see patients, they don’t have any co-pay. Hmmm….

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