Day of Medical Infamy

Crying crocodile

So let’s mark down February 16th as a day of medical infamy.  This is when the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.  If you do not know what this means then you are not alone.  Without proof that quality measures improve care, the CMS and AHIP worked with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.

The collaborative announced core measures in seven areas include:

  1. Accountable care organizations/patient centered medical homes/primary care
  2. Cardiology
  3. Gastroenterology
  4. HIV and hepatitis C
  5. Medical oncology
  6. Obstetrics and gynecology
  7. Orthopedics.

If you have been reading this blog you know that I have predicted the problems of quality measures from day one.  I have pointed out the cost, the lack of proof, the way it takes doctors AWAY from patient care and how it is forcing doctors to quit or retire.  So, let’s note these groups who were involved in allowing this “collaboration” to occur:

  • American Academy of Family Physicians
  • American College of Cardiology
  • American Heart Association
  • American College of Physicians
  • American Gastroenterological Association
  • HIV Medicine Association
  • Infectious Diseases Society of America
  • American Academy of Pediatrics
  • American Society of Clinical Oncology
  • American Medical Association

Let’s hold their feet to the fire when this thing fails….again. Don’t worry, I will be there to bring this us when they cry crocodile tears and complain in the future that they were unaware.  Trust me, I will be there to shove this in their faces.

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] 

  9 comments for “Day of Medical Infamy

  1. March 25, 2016 at 1:53 am

    Dear Thomas G.,
    You might be confusing “medicine” and “primary care.” Few surgical specialties on the list, but I count 3 (really one and two halves) that might be primary care organizations. Out of 8. Last time I checked, Cardiology and Gastroenteroly were not considered primary care. And the AMA has been run by specialists for a long, long time…

    • Thomas Guastavino
      March 25, 2016 at 9:30 am

      One more time. I said the groups LEAN toward primary care. There is are no groups on this list that are primarily surgical or procedural. Certainly no groups who realize how bogus is the gatekeeper concept.

  2. mamadoc
    March 24, 2016 at 8:13 pm

    Crap. Don’t know whether to be relieved that I’ll be retiring in a few years or scared that as a Medicare patient I’ll be on the receiving end of some of these “quality” measures. At least that’s until the culture makes it a patriotic duty to accept euthanasia at 70.

    • Pat
      March 24, 2016 at 11:38 pm

      Logan’s Run 2.0

  3. Richard Faiola, MD
    March 23, 2016 at 12:01 am

    There is plenty of reason for paranoia, but Thomas Gustavino goes too far. Must not be able to read clearly the list of organizations provided through the anguished tears we all share. “Cardiology,” “Gastroenterology,” “HIV,” and “Clinical Oncology,” are not Primary Care. We should all be so lucky if PCPs really were the gatekeepers this time around. Only a fool would be that optimistic. The same pencil pushing non-clinicians of any stripe that have delivered this monstrosity to us, will be the ones controlling the cash flow to all of us.

    • Thomas Guastavino
      March 23, 2016 at 7:06 am

      First, I said these groups leaned toward primary care. There is little surgery on this list. (Anti procedure bias maybe ?) Second, we tried the “gatekeeper” concept during the late 90s and it failed miserably. Reason: There was no where near the amount of “unnecessary” care that justified having a “gatekeeper”, or for that matter the type of wholesale overhauls of the health care system that are being proposed. Thats why these overhauls are failing.
      As I said, what is the definition of insanity?

  4. Steve O'
    March 22, 2016 at 9:17 am

    “Trust me, I will be there to shove this in their faces.” Doug, turn the light out when you’re done. We’ll be missing you.

    PS: Having worked for a governmental agency in the past, I can add $6,000-per-year towards my retirement pension by taking a government job. ANY government job in that organization! I’m SERIOUSLY thinking about moving to the Sanitation Services Industry. Things are picking up, and I might get some respect for a change.

    • Kurt
      March 23, 2016 at 11:05 am

      Should’ve follow my Dad’s advice to go into civil engineering. I didn’t know what it was but
      later found out as long as there are people, there will need to be those how can come up
      with creative ways of dealing with their waste. Self fulfilling vocation if you ask me.

  5. Thomas Guastavino
    March 22, 2016 at 8:03 am

    Is it my imagination or do the groups that support these measures tend to lean toward primary care? Could it be that, like the failed capitation plans of the late 90’s, primary care envisions themselves to be the “gatekeepers”, collecting the ACO or bundled payment checks and doling it out as they see fit?
    What is the definition of insanity?

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