Is This What All Hospitals Think of Primary Care Docs?

Becker’s Healthcare spoke with Cathy Jacobson, president and CEO of Milwaukee-based Froedtert Health, prior to speaking on a panel at Becker’s Hospital Review 7th Annual CEO + CFO Roundtable titled, “The Digital Imperative: The Open & Shut Case for Innovation”.  All this gobbledygook means she is a pretty big deal to other administrators.  I was tipped off by Shane Purcell MD about her thoughts on primary care physicians highlighted in the piece:

Q: What’s one conviction in healthcare that needs to be challenged?

CJ: That every patient needs a primary care physician.  As we start stratifying our patients into distinct populations based on their health needs and develop that insight further into consumer driven wants, we are finding that a substantial sector of the population does not want or need a primary care physician relationship.  People need primary care but not necessarily a physician relationship. We need to stop trying to fit patients into our health system-driven model and develop the means to serve their health needs on their terms.  If we don’t, someone else will.

How does that make you feel?  Pretty crappy, right?  I have known this for a long time.  Hospitals want patients to be linked to THEM and not you as a doctor.  You should have noticed their commercials over the years with hospitals saying “as your healthcare provider”, etc.  It is about wordplay and confusion to make patients feel that the hospital is the doctor and the doctor is the hospital.   We know that this isn’t true. If doctors and nurses left the system then they pretty much just have an empty building.  In fact, if a doctor is missing for a day there is panic and mass hysteria.  If a CEO or other administrator goes missing for a month no one notices.   But the patients don’t know this as no representative organization (AMA, AAFP, ACP) has made a campaign to push back (Thanks, guys!).  Linking patients to a hospital and not a doctor has been the goal for years because hospitals want the patients’ loyalty (and money) so that their doctor has to refer to them and if the doctor leaves they can just replace her with another doctor or MLP.  We are being treated as pawns in a chess set.

The sentence “People need primary care but not necessarily a physician relationship” is very disturbing to me and goes against EVERYTHING I believe in. With one sentence she wipes us out totally. With one sentence she disrespects 2/3 of all doctors.  And there will be no repercussions for this.  None.   But you want to know the truth?  The truth is that she and other administrators are afraid.  They know they’re the ones who are not really needed.  If the future leads to doctors unhinging themselves from the hospitals then we take back control of our future and the reigns of healthcare.  The ones who serve the patients’ “health on their own terms”  will be us.  We are the “someone else” she is worried about.

It’s time we shake the box.  It’s time we free ourselves from being shackled to hospitals.  It’s time for a physician ONLY revolution.  What are we waiting for?

Here is the link to the #1 DPC Book on Amazon

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] 

  4 comments for “Is This What All Hospitals Think of Primary Care Docs?

  1. Kurt
    July 18, 2018 at 11:01 am

    It is a non-argument that DPC Docs cherry pick. If a non-compliant (ie. patient who doesn’t follow your advice) keeps coming in and continues to pay their monthly fees, there’s no problem.
    Most DPC docs are office only and are not responsible for patients who keep going down the
    toilet due to their own stupidity. The thing that likely irks these ITB’s (ivory tower bastids) is they
    can’t “make” DPC docs take care of these people if the patients don’t pay their monthly fees.
    The DPC docs can rightly drop them and aren’t held accoutable for the patients crappy behaviors.
    The ITB’s and government want to blame doctors for all the ills of the land and not the patients who are eating themselves to death. No metrics either for DPC. Don’t mean nuth’in anyways.
    I’m too old for DPC but am a fan of those who can do it. I believe it is mandatory for any young doc consider this if stuck in primary care.

    • Joe Smegma, DO
      July 21, 2018 at 7:41 pm

      Kurt. You provided a mixed message. I too am an older Family Doc. DPC is fantastic care compared to the current insurance based system. I did Family Medicine for 20 years in an FQHC. No physician should be responsible for patients who end up in the hospital due to noncompliance or stupidity, DPC or Ivory Tower. Yes, patients don’t follow commands or suggestions. The Medicaid crowd takes poor care of THEMSELVES, DPC provides great care. DPC spends more TIME with patients. Tell me you don’t do a better job with plenty of time for a given patient, especially if they are a train wreck. DPC is a way for primary care to offer great care to whomever signs on. Also, DPC is a way for an older physician to survive the assault from the hospital and the insurance morons. Cherry picking is a joke. The cost of DPC is less than cigarettes or a Starbucks Latte for the year by far. Don’t get me started. As far as patients “don’t need primary care physicians” , a more moronic statement has never been uttered. You can measure all the quality measures that these small minded administrators can muster.They are tainted by economics and have sold their souls to SATAN. How they sleep at night I don’t know. Shameful. But, you can not look me in the eye and tell me that you would rather have your mother see a mid level provider instead of a residency trained physician with YEARS of experience. Unfortunately, TRUE primary care is dying a slow and painful death. Marcus Welby is rolling over in his grave. Primary care/ DPC is the only chance this health care system has for TRUE quality care, (not pseudo quality/metrics). Cost containment can only happen with a quality PHYSICIAN evaluating a patient and making a diagnosis. Not shotgunning with tests and referring to multiple specialists. Lordy Lordy. This system is failing. Get ready.

  2. PW
    July 17, 2018 at 8:23 pm

    Clearly she’s FOS????

  3. Debbie Nickels Heck, MD
    July 17, 2018 at 8:12 pm

    I finished FP residency in 1995. Our THEN wonderful local Midwestern hospital was just starting to buy up independent practices. Being 40, I was old enough to have been aware of the negative things that happened to such practices on the West coast. I knew many of these Drs personally. I predicted they’d be happy for perhaps 2 yrs but by the third year they’d find they’d lost control of their practice and their staff but nobody listened. Guess what? My prediction was exactly on target. Staff members lost the retirement benefits they’d built up in their former benefits packages. The personal relationships the Drs had with their patients was not the same as they were triaged differently now as defined by their new owners. Instead of always seeing their own Dr, they might see whoever was available. “Happiness” was a bygone description, again as I’d warned several Drs before they’d taken this step. I never joined their club. I remained independent and solo.

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