The Only Bright Light Out There by Pat Conrad MD

For decades, the American Academy of Family Practitioners has taken a leading role in selling out their members, those members’ patients and communities, and the state of U.S. health care in general.  I trained in family medicine at a very good residency, where I truly received an excellent education from some outstanding physicians, to whom I shall always remain grateful.  Yet the rapid self-abasement and degradation of this discipline has left me with a reflexive disgust.  Esteemed colleagues here have sometimes agreed with my views, while others have thrown a barb or two at them.  Hey, that’s cool, we’re big boys and girls here (hopefully all cis-) and Doug is honest enough not to sanitize away contrarian views like some social media physician voice leaders (ahem) I could name.

But this is nauseating, and I mean splat-all-over-the-rug, run-to-the-bathroom, bile conjuring, vomit-inducing stuff.  One expects that outgoing AAFP president John Meigs Jr., MD was rushed to a local ER after dislocating his shoulder the other night, after the most aggressive display of self-back patting ever witnessed outside of an Oscar’s ceremony.  He arrogantly worked a Bible quote into describing his defense of ObamaCare, while whining about the very electronic records that his establishment helped to force on the rest of us:  “This is the day that the Lord has made. Let us rejoice and be glad in it.”

“’But God doesn’t have to use an [electronic health record],’ he quipped, or to ask insurers for prior approvals, when they think they are God.”

A little personal aside here:  I don’t like it when politicians invoke the Almighty, as there is never, ever any evidence that Providence is on their side.  And make no mistake; Meigs is a politician gaming for special interest gains while extolling his own beneficence.  Meigs met with senators in D.C. this year to argue against repealing the ACA, and said:  “From the beginning we said the ACA is a good start.  It’s not perfect. Prescription drug prices are too high. We need incentives for young people who want to buy insurance.”  This quote alone shows him to be an economic ignoramus, and possibly dishonest as all hell.  Here is his quote:  “We need a public option that will allow people ages 55-64 years to buy into Medicare or obtain a Medicare advantage plan. We need to require all insurance plans to cover the essential health benefits so that they are available to all.”  None of this would ever bring prices down for consumers, employers, or taxpayers.  As we have seen, it would fatten the Big Insurance profits all the more, and worsen an already irretrievable national debt.

There has NEVER been any mechanism in the ACA that would bring prices down or incentivize millennial basement-dwellers to buy insurance (His panel colleague Hal Lawrence, M.D., CEO and EVP of the American Congress of Obstetricians and Gynecologists, said “The question is whether medical care is a right or a privilege.  Most people would agree that it is a right and that we need to have universal access. We have to find a better way to cover that.”  So these were a bunch of left-leaning huff’n puffs leading the fight to defend the ACA as a better path toward eventual single-payer, proving that they are all economic ignoramuses and dishonest as all hell).

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So family docs, your outgoing AAFP president is a government health care stooge that has supported the very programs that have made life worse and more expensive for you, under the guise of promoting your interests.  Meigs said so himself, bragging how the AAFP was the first specialty to require MOC, and that recertification is a founding principle of the AAFP.  As Meigs explained, “the concepts of professionalism, continued professional development, commitment to lifelong learning and maintenance of certification are at their core principles that family medicine introduced and championed for our profession” (And Dr. Puffer at the ABFM will be glad to cash your check).  And what has this shakedown gotten us, and what proof is there that any patient benefit has been achieved?

In one fashion or another, Meigs has been a supporter of mandatory EHR’s, expanded Medicaid/SCHIP programs, PCMH’s, self-abusive MOC garbage, value-based programs, and emphasis on “diversity and working on the social determinants of health.

Then he gave as his swan song admonition:  ”We must continue to be the disruptive innovators of our profession.”

There is only Direct Primary Care. In fairness to Dr. Meigs, I was pleasantly surprised to read his statement on DPC:  “You’re not on the hamster wheel of getting paid based on the volume you do. Patient satisfaction goes up. Physician satisfaction goes up. Quality goes up and costs go down because you don’t have to prove it to Uncle Sam or an insurance company.”   I can’t fathom how Meigs can square his support for so much of the government intrusions listed above with DPC, but if he wants an actual disruptive innovator, we know where he can look.

 

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] 

  3 comments for “The Only Bright Light Out There by Pat Conrad MD

  1. RSW
    September 16, 2017 at 1:49 pm

    Completely unfair to the AAFP. If you read the proceedings of the current annual meeting, you will find that one of the distinguished delegates is proposing that the epidemic of burnout ravaging our specialty can be solved by teaching family physicians better typing skills. Talk about disruptive!

    • M. Carney
      September 16, 2017 at 4:12 pm

      Oh my!!
      Better tying skills!!!
      Is the AAFP “family Physicians”
      Not “family practitioners”

  2. Seneca
    September 16, 2017 at 8:18 am

    “And what has this shakedown gotten us, and what proof is there that any patient benefit has been achieved?”

    Well said. We have been submitting data for over a decade now as well as upending our coding–can anyone give me even one reasonable example of how that has made things better? The delusion that big data will save us is not only limited to medicine. The attempt to achieve some economy of scale that all the B school people want always breaks down when the ultimate delivery of medical services anywhere boils down to one doctor (er, I mean “provider”) and one patient.

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