Fostering Well-Being and Other Laughable Buzzwords

The AAFP is going all in on saving their members. In another propaganda piece titled FP Finds Resilience in Reflection on Setbacks they point out some easy steps another doctor (David Loxterkamp MD) uses after two physicians left his rural practice. It is almost like a religious leader claiming to heal their sick.  The keywords that the AAFP are using are:

  1. Resilience
  2. Well-Being
  3. Reflection
  4. Fostering
  5. Healing
  6. Perspective
  7. Re-focus
  8. Teamwork
  9. Mindfulness

See, it’s that easy!

Now if you read the original article they reference in Annals of Family Medicine you will see that the AAFP fails to mention a few things that the author says:

  • “Four years ago we sold our practice to a federally qualified health center (FQHC). The usual factors went into that decision: aging owners, the increasing complexity of insurers’ demands; disinterest among our younger colleagues for an administrative role or “buying-in” to the practice. A year later we moved into a new facility that doubled the size of our staff and tripled the office space. The new floor plan included a pharmacy, physical therapy department, and care management office, and allowed us to expand behavioral health services. We qualified for NCQA Level III status. Although we had given up obstetrical and hospital privileges a few years earlier, we imagined ourselves as the new breed of full-service health center, meeting the non-medical needs of our patients through team-based care.”
  • “But we forgot about the law of unintended consequences. The new administrative offices are an hour’s drive away (in good weather). Decisions in our organization are seldom made by those who implement them, and often without their input. As with many large networks, communication trickles through the proper channels. The growth of our health center has led to a loss of intimacy; we no longer know, let alone greet, each other by our first names. There is more emphasis on the policy than the person for whom it was created. Of course, medicine is a business, but business people forget who does the real work or what rewards them. Not (only) money. Not (only) a yearly barbecue or certificate of recognition. No matter how many virtuous employees are hired (and I am surrounded by them), an emphasis on efficiency and productivity will bury their better instincts, our deepest humanity. Sadly, when that is gone, there is little to sustain us through the drudgery.”
  • “It’s hard to know exactly why my colleagues left the practice, or if anything could have been done to “save” them. That they failed to meet management’s expectations is highly probable; that management failed to meet theirs is self-evident. More than anything else, it represents a failure of community in the tribal sense.”

Umm, Dr. David Loxterkamp, I know why your colleagues left.  It is because they were working for administrators who made them into RoboDocs.  It is because they were spending their time coding, clicking and becoming clerks.  It is because you sold out and they were not working for themselves and patients but instead to appease a “suit” who knows nothing about treating patients. THAT’S THE REAL STORY YOU SHOULD HAVE TALKED ABOUT!

I know because I too worked for an FQHC in Maine for 15 years and it made me hate my job. The funny thing, Dave, is that you could have scaled back instead of adding overhead and bureaucracy and become a DPC doc.  You would have been able to get all the things that you wanted as an FP like intimacy, friendship, relationships, and great care.  If you are reading this, Dave, send me your ex-colleagues’ names and I can try to help them start a DPC practice or get in with another DPC doc. Hell, I have been full for a year and would consider hiring them.  Would they like a warm weather state like Virginia?

Or, we can just keep playing these same old games and let the AAFP uses buzzwords to pretend to help their members.

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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] 

  11 comments for “Fostering Well-Being and Other Laughable Buzzwords

  1. William Douglas Given MD
    November 30, 2017 at 12:02 am

    I worked for a fqhc. They suck your soul and you are never good enough on the metrics. Then they dump you for rookie docs and mid levels and steal your practice you built over 30 years of being underpaid in a rural area. DOC is basically illegal in WV.

    • William Douglas Given MD
      November 30, 2017 at 12:03 am

      DPC that is

      • Doug Farrago
        November 30, 2017 at 6:15 am


  2. RSW
    November 27, 2017 at 10:35 am

    From the original article:

    “We could sponsor moments of restoration during the regular workday, including mindful meditation or a group walkabout.”

    You couldn’t make this crap up if you tried.

    • Perry
      November 27, 2017 at 11:53 am

      I would say substitute Mindful Revolution and Group Walkout, and those would be more appropriate responses to this garbage.

  3. November 27, 2017 at 9:42 am

    Acerbic. Accurate. Opposite of happy talk. Approved.

  4. Mark O'Brien, D.O.
    November 27, 2017 at 9:12 am

    I work in a FQHC. At first we had a dynamic CEO who was into serving the community. When he left, It was all about numbers. I would suggest a new/better way to serve our populations and hear,” Sounds great, now GO SEE MORE PATIENTS. I left for solo practice shortly after that. The independence is immeasureable

  5. RSW
    November 27, 2017 at 7:33 am

    I thought the original article was one of the worst things I’ve ever read – I had absolutely no idea what the author was trying to say.

    Love it when people describe the “completely predictable if you had thought about it for two seconds results” of their actions as “unintended consequences.”

    There is no life form lower than a family physician who sells out to corp med and then whines about how mean the administrators are.

  6. Pat
    November 27, 2017 at 7:17 am

    Damn Doug, that was one funny start to a week, thanks! My favorite quote: “We imagined ourselves as the new breed of full-service health center, meeting the non-medical needs of our patients through team-based care.” Didn’t we all as med students and residents dream of the day we could go “team-based”?

    And “Resilience in Reflection on Setbacks”?? That’s how the French army dealt with the aftermath of May, 1940. It’s a special sort of functional dementia that allows people to even write this hilarity.

    • Perry
      November 27, 2017 at 9:27 am

      The law of unintended consequences is killing the practice of medicine. What we need are more “outlaws”.

    • RSW
      November 28, 2017 at 10:50 am

      “meeting the non-medical needs of our patients”

      Buy their groceries? Clean their houses and mow their grass? Cook their meals? Help their children with their homework?

      WTF is he talking about?

Comments are closed.