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:
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.