AAFP Supporting DPC Bill?


The AAFP is a business who supposedly represents family doctors.  I don’t belong to this organization anhyomore because I feel they have never really represented me.  In fact, they have supported everything that I am against which tends to be the same things driving doctors into quitting or retiring from the profession.  This list includes Obamacare, all quality metrics and allowing midlevels to take our jobs.  So when I found they are “applauding a House bill that would enable physicians who practice direct primary care (DPC) to see more patients by changing the tax code so the model is not treated as a health plan or insurance”, I was excited.  Well, not really excited but at least slightly encouraged.  Then I noticed that they mention in the same  linked article above that also supported a companion bill:

The legislation calls for setting up a CMS demonstration project for practices that wish to participate. Medicare patients can obtain DPC services now, but they must pay the monthly fees out of pocket and can contract only with physicians who opt out of Medicare. If the legislation is enacted, CMS would establish an innovative project that would pay DPC medical home practices a “periodic fee” for treating Medicare Part B patients.

To participate in the demonstration project, DPC practices would have to meet performance targets established by Medicare. Qualifying practices would be required to offer enhanced services, including preventive care, wellness counseling, primary care, care coordination, appointments seven days a week, secure email and phone consultations, and 24/7 telephone access to consultations. If they failed to meet the targets for two consecutive years, they would be excluded from the initiative.

Once again the bureaucratic idiots couldn’t stop themselves from trying to play nice with the government.  They couldn’t just stay away from these useless metrics.

The AAFP almost had me interested again but they somehow extinguished out that interest in the same article. Nice job.


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] 

  5 comments for “AAFP Supporting DPC Bill?

  1. Perry
    October 2, 2016 at 11:12 am

    You can bet, if someone has a great innovative idea for making medical care more accessible and affordable, the government will find a way to butt its head in and f*** it up.

  2. Thomas Guastavino
    October 2, 2016 at 9:40 am

    Question. Is there anything that stops PCPs from setting up a concierge type practice that still participates in medicare as long as the subscription fee is paid out of pocket? I would bet that with fewer patients it would be a lot easier to hit “quality” and “patient satisfaction” metrics.

    • Steve O'
      October 2, 2016 at 11:17 am

      Question. Is there anything that stops PCPs from setting up a concierge type practice that still participates in medicare as long as the subscription fee is paid out of pocket?

      I would suspect that if you are enrolled as a Medicare provider, it would be dangerous. CMS has cracked down on Medicare providers who provide FREE SERVICES occasionally. If you provide free services to SOME Medicare patients, you must provide free services to ALL Medicare patients – otherwise you are discriminating. (’tis true.) You would likely have to disenroll from Medicare, and very possibly bar ALL persons enrolled in Medicare/Medicaid from the concierge practice. Damned if you do, damned if you don’t.

      Remember, the Feds don’t have to follow written rules, but only the rules as they think they exist. If you run afoul of CMS, it’s your problem – especially if criminal charges are considered.

      I suspect that DPC is on the enemies list. Anything that risks providing better care than the Corporate Retail Model is targeted for destruction. If DPC can’t be co-opted, or some straw puppet within the CMS structure can be erected to be called DPC, then they will blitz away the model entirely. As they own the ACA presence in the press, it’s not hard to castigate “criminal doctors.” It’s witchburning season, folks. Wear something flammable.

  3. Bill Ameen MD
    October 2, 2016 at 9:35 am

    Appointments seven days a week?? The AAFP just can’t resist getting into the pool and urinating. I’m only a member still because I get the journal and it’s a straightforward way to get the CME my state requires. Otherwise, they don’t do squat for me.
    Seriously, does any DPC practice see patients 7 days a week? Sounds like to me in DPC (or concierge) you just open yourself up to patient whiners who enjoy inhabiting doctors’ offices, particularly if they get X number of visits in a month. Hopefully you have a screening process to see if you and your patient are a good match.

    • Steve O'
      October 2, 2016 at 11:23 am

      Remember, they don’t have to change a whole process – just one critical part of the puzzle – to bring down the possibility of DPC. Those crazy docs want to do it? Okay, these DPC doctors are not allowed to dis-enroll any patients. Or make these quacks do obligatory home visits! Just add the right mandates, painted with an artist’s touch, onto the regulatory structure for DPC’s, that makes DPC horrible. Electronic EMR filing after every visit.

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