The Sorry State of Medicine by Mary Helen Morrow, MD

I have a “Cash-Practice”…the original DPC. I charge fair prices for excellent care. Seven years ago I decided I could no longer be hostage to insurance companies telling me what my care was worth. I have one staff-person besides myself. We love our patients, our practice and our small rural community.

I have watched the state of medical care deteriorate around me especially over the last 5 years. It used to be that “horror” stories of bad care were spoken of in hushed tones once a quarter or every six months. Now, I can honestly say that I hear such stories at least monthly (and sometimes more). I strongly advise anyone who needs to be hospitalized to have someone stay with them (for safety).

We have been lied to. Electronic records and checklist/protocol medicine are not the panacea to better patient care. They are not about the patient. Those are about the payer…better outcomes, less cost, and ability to mine data later on. In the rush to be liked and prove that we are not the horrible murderers that the media and medical boards would have us believe, we have pointed and clicked our way to horrible care and allegiance to the protocols first and foremost.

This path caused the following appalling results:

  1. An elderly patient with multiple medical problems who had a high fever sat in an ER with no fluids of any kind for 12 hours.
  2. The ordering physician was not called for 22 hours about an alarming foreign body in a patient’s lung. The excuse was that the hospital no longer supplied support staff to help make the calls.
  3. Hospitalized patients regularly do not get requested medication because it has not been ordered, and then the doctor orders it, the order still has to go to to the pharmacy. Then the pharmacy has to load the medicine into the “diebold”. Then the nurse has to have time to give the medicine.

Sound awful? It is!!

If it is a simple issue like a mild headache then waiting 2 or 3 hours maybe annoying but tolerable. What if your child has a high fever that has not broken with Tylenol and she needs some Motrin? And you have to sit and watch your child suffer. And you cannot do for her what you would do at home! Been there. Done that. I finally got my thermometer, pulse oximeter, Tylenol and Motrin from home. And I wondered why I was paying through the nose for horrible care.

Being a doctor is a sacred trust. I promise to help keep my patients healthy. I took the Hippocratic Oath. I promised first to do no harm. I can’t just say, “not my problem, it’s 5 o’clock and I don’t have staff to help me make those calls.”

What we are losing with the “Taylor Approach” and EMR’s and protocol driven medicine is the reason we got into medicine in the first place…taking care of patients… who are our friends and neighbors even if it is on a macro or global sense. We owe each one of them our best, every day. When we find we can no longer do that, we either need to fix the system so we can do it again, or get out of medicine.

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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 “The Sorry State of Medicine by Mary Helen Morrow, MD

  1. Kurt
    August 23, 2017 at 4:28 pm

    “Being a doctor is a sacred trust. I promise to help keep my patients healthy. I took the Hippocratic Oath. I promised first to do no harm. I can’t just say, “not my problem, it’s 5 o’clock and I don’t have staff to help me make those calls.”

    WTF? You promised to keep your patients healthy? You running around and pulling
    the MacDonald’s, pizza and other S**t foods out of their mouths? You throwing a bucket
    of water on ’em when they light up a cigarette? Hell no, you got that wrong! Only thing we can do is advise. The patients have to put the advice into action. That’s where the problem is.
    They pay lip service, go home and do whatever the hell they want. If that wasn’t going on and
    everyone did everything they were supposed to do, there would be more less preventable
    disease than there is now. Nope, this is not the time to go into primary care.

  2. Mary Carney
    August 20, 2017 at 7:48 pm

    I so agree.
    The EHR has taken us hostages and will not let us go.
    A hort SOAP note usually suffices if you, the physician, actually talk to the patient.

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