77 Messages A day


A new study in JAMA Internal Medicine found that primary care physicians received an average of 77 inbox notifications a day from electronic health records in the first half of 2015, compared with 46 specialists who received an average of 29 notifications a day. The researchers said data extrapolation indicates PCPs spend about an hour a day processing the notifications.  Interesting.  Before I go off, let me say that this number (77) is probably too low.  One doc in an article talking about this stated, “I should be so lucky as to have only 77 in-basket messages; it averages way over 100 for me, more like 110 to 140”.  All this is time that gets sucked out of these docs’ lives.  Not me.  When you only have 600 or less patients in your panel then you can actually control your inbox and feel complete with patients.  Imagine that?  That is what DPC does for you.  So what is holding doctors back from bolting? Fear.

Isn’t it time to fight through that?

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] 

  2 comments for “77 Messages A day

  1. Kurt
    March 16, 2016 at 2:18 pm

    More power to you Doug and I’m glad you got in a great DPC situation. The bottom line is if one
    makes the mistake of setting up in the wrong geographical area, they will go bankrupt period.
    Just what a new Doc needs when coming out of training when they are in debt and have payments to make. You can see how they would settle for a “classical” position or do a specialty
    of your R.O.A.D. type. (I loved that anagram you came up with Doug.) DPC can be a financial risk
    if one is not careful.
    Took me 28 years to go from a positive to disillusioned attitude. I’m seeing younger FP’s who
    want to leave after 5 years in practice! (That of course is the time to do DPC when one still has
    quite a few years ahead of them. Me? my time is limited, my colleagues are great and the administration is tolerable and sympathetic.) Kurt

  2. Steve O'
    March 16, 2016 at 8:04 am

    It’s the new movement – to make medical practice as awful as everybody else’s job. The way most jobs work inside the iron walls of bureaucracy, everyone runs around chasing crisis after crisis. There’s no attention paid to the severity of the “crisis” – just its freshness.
    The workplace involves constant interruptions. People don’t have time to think, because, well, they’re not paid to think in most jobs. We’re getting that way in medicine, too.
    If I had five minutes after the patient leaves to just stop and THINK ABOUT THE PATIENT – quietly, alone, without getting bugged – I could be a better physician. But the EMR builders see this as wasted time, when I could be addressing why Mr. Jones has a sodium of 146.
    Hurry! Hurry! Mrs. X has an A1C of 8.7% That is not a crisis, but Mrs. X’s health IS. But we are all too busy hurrying up and doing nonsense, to fix anything.

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