Saving Doctors From Burnout?

I mock the AAFP hard when they attempt to “fix” our burnout?  They are a joke. Why?  Because they agreed to everything that has caused our burnout and they have no new answers.  On the other hand,  Katherine Restrepo wrote this great piece in Forbes called Direct Primary Care: Saving Doctors From Burnout  and you should read it. Why is it so great? Well, because it shows that DPC is an answer. Yes, she references me a lot but don’t let that get in the way as the rest of her article makes some great points:

  • I’ve written a lot about the benefits DPC offers to patients, but not enough on how it’s a way to save doctors from burnout.
  • A major cause of burnout is “bureaucratic drag” – a toxic amalgamation of administrative demands that erodes the physician-patient relationship. It’s time spent on getting approval from insurance companies to prescribe medications or request an MRI. It’s time wasted by physicians proving to the Center for Medicare and Medicaid Services (CMS) that their government-certified electronic health record (EHR) is effectively tracking patient care. It’s frustrated clinics waiting to receive either a bonus or “negative payment adjustment” on quality metrics submitted to Medicare. It’s the pressure to see more patients in less time.
  • A traditional physician’s workday is now evenly split between actual patient care and work outside of the exam room, reports a Health Affairs study. This is one of the reasons why nine out of ten physicians do not recommend others pursue medicine. Almost one in two experience exhaustion, cynicism, or hopelessness.

There’s more so go ahead and read and share, please.  Help spread the DPC virus!

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 “Saving Doctors From Burnout?

  1. Craig Netzer
    November 8, 2017 at 8:48 pm

    “I mock the AAFP hard when they attempt to “fix” our burnout? They are a joke. Why? Because they agreed to everything that has caused our burnout and they have no new answers.” (Doug) I like that sentiment. Then I got this email yesterday: ” Seeking Well-being Champions for ACP Hawaii: ACP is committed to supporting its members in multiple ways, including enhancing their well-being and professional satisfaction.” Makes me want to hurl. AAFP and ACP are in bed together. I am a BC FP and IM and I seem to get double emails from both groups which are almost identical. They write that benefits of becoming a well-being champion include: 1: Opportunity to build their CV. Really?! I thought becoming and MD and practicing medicine and caring for people was the top. 2) Free training to enhance their own wellness. Anyone who can do this without fixing the underlying problems in medicine is not fixing anything – they are delusional. 3) Free access to the ACP PRACTICE ADVISOR (r) tool. What’s this? Another opportunity to be pulled away from patient care? Great ! 4) Opportunity to help others thrive. What?! Is this a commercial for Kaiser Permanente? 5) Develop meaningful connections with colleagues. Like hanging out with others obfuscating their duty to treat patients by patting themselves on the back. 6) Help strengthen chapters. Because that is why I went into medicine – to support a group that daily makes it harder for me to practice my profession. And finally, 7) Have fun and be creative. Really – like spending time with family, or fishing or going out or having some semblance of a life should be frowned upon so you can spend more time in a kumbaya session. All these groups talking about how to fix physician burnout miss the point utterly and completely. They need to fix what caused it. The massive reporting requirements, EHR drain, “preferred medicine …with prior auth”, and more crap that has invaded our profession. I liken this approach to burnout to treating a patient with a knife in his stomach by wiping the blood away as it trickles out, being quite meticulous to be sure you get it all. Eventually the patient dies. You need to PULL OUT THE KNIFE AND SUTURE THE WOUND ! Fix the problem.

  2. November 5, 2017 at 12:01 pm

    The amount of work done by those not involved (or technically necessary) for medical care is so large that now entire industries are built on them. They will not go away voluntarily but if the market changes and they are unnecessary, it won’t matter if they don’t want to go away. I’m sure some buggy whip manufacturers transitioned to making car parts, but many probably didn’t.

    Maybe the best way to solve physician burnout is to leave the environment that causes it when you can and giving those who are considering a career as a doctor true ‘informed consent’ before they launch headlong into medical school time and debt. The method employed by the establishment is too pretend burnout is caused by technology or other unchangeable developments and through coaching and other feel-good initiatives the problem will stay at bay and the checks will continue coming in and then one day everything will be fine.

    Doctors who are now in burnout mode may continue to practice and once they are retired they will be replaced by doctors who have grown-up in the ‘new normal.’ It’ll be like in 1984 where only a certain amount of the older population remembered a time before the revolution, and even then they can’t be sure what it was like.

    • Steve O'
      November 5, 2017 at 1:49 pm

      As we saw recently with CVS acquires Aetna (see CNN Money story, Link) the industry will stabilized in a vertical silo. The coders and billers will go away and each monolith will have its own method of tracking services, and thus, payment, before ICD-12 rolls out.
      Once the “buyer beware” model gets in place, placing the liability on the customer, you can use a nifty app to design Mom’s chemotherapy for her breast cancer, and go to the drugstore to buy it. Considering how many billions are spent convincing the public to spend money on useless nostrums for the common cold, we’ll have lots of different approaches to treating real diseases – withthe burden on the buyer. Will Echinacea, Zinc and Soy Root cure ovarian cancer? Betcha someone will run commercials touting this, and buy it at the pharmacy at your own risk. The public already endears itself to the loudmouth tout who berates the medical establishment for not using his Super-Miracle cure.
      There will be a few dozen top-end hospital and healthcare centers for the Saudi and Wall Street royalty that hire actual doctors working professionally for their client patients. They will be a stealth medical system treating the important people. For everyone else, it’s the national retail pharmacy model with advising and dispensing pharmacists, and no “prescription only” drugs. Go to Guatemala, Bolivia, and the Congo and see the future of American medicine.

  3. Steve O'
    November 5, 2017 at 9:05 am

    It will never happen, because when bureaucrats and politicians read “intermediary,” they see “jobs.” Why should the big sluice of money in healthcare just go to a select few who actually do something?

  4. November 5, 2017 at 8:20 am

    My favorite word to describe the
    “bureaucratic drag” on the practice of medicine is intermediation.

    Healthcare suffers greatly from this and the need to disintermediate has never been clearer, especially in primary care.

    80% of most individual’s medical needs can be met at the primary care level, which not only lowers the cost of care at that point but can significantly lower “downstream” cost.

    Perhaps more important is that the care can be delivered more effectively and personally by the removal of the “intermediaries.”

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