The AAFP Marathon Parking Lot

A lot of people sent me this AAFP piece called “Clinical Practice Culture: Moving From Surviving to Thriving” for me to poke fun at.  I thought it was a parody already and had to read it twice to make sure.  I mean, c’mon, the AAFP couldn’t have made it this easy, right? Look at this stuff:

They actually simplified our whole lives and put it into a graph!  I guess we are that simple to manipulate?  But wait, there’s more:

  • “You’ll never provide five out of five care if you’re functioning as a one or two out of five,” Greenawald notes. “The math doesn’t add up.”

In my Placebo Journal days I would have made stickers that doctors could wear which would show how well we were functioning that day.  Everybody in the ad would have a 1.

  • Greenawald has coined an approach to shaping an optimal practice culture that identifies six components for consideration, using the acronym STARRS
    • Service
    • Teamwork
    • Attitude
    • Reflection
    • Renewal
    • Self-care

I was thinking more like:

  • Sadness
  • Tiredness
  • Alcohol
  • Recruiter (as in find one)
  • Retribution
  • Self-pity

Wait, for a limited time, and if you order now, you can get this:

  • Conduct “State of the YOUnion” assessmentsDeveloped by Greenawald and it’s basically his STARRS thing again.
  • Have clinical huddles. A way for the care team to check in with each other personally.
  • Get a PeerRXRegularly check in with one another to offer support, advice, and a listening ear.

I am going to let you, my reader, have fun with his YOUnion and PeerRx stuff.  I don’t know Greenawald but at a quick glance he is a career educator who rarely, if ever, worked much in the real world.

When I first read this all I could think of was Planes, Trains and Automobiles with Steve Martin and John Candy.  One of my favorite scenes is when Martin’s character (Neal Page) was trying to get a rental car.  Watch it above.  We are Steve Martin and the AAFP is the rental car agency.  The lady behind the counter is Greenawald.  When he offers to help us we want to say:

“You can start by wiping that f&cking dumbass ass smile off your rosy f&cking cheeks.”

Then we would complain about how the AAFP left us out there without a means of surviving and then the conversation would go something like:

Us: Then you can get me a real job. Without f&cking metrics, without f&cking administrators, without f&cking prior authorizations, without f&cking insurance companies, and without dealing with the f&cking government!

Greenawald (AAFP): I really don’t care for the way you’re speaking to me.
Us: And I really don’t care for the way your organization left me in the middle of f&cking nowhere with no f&cking way to be the doctor I dream of being. And I really didn’t care to f&cking watch you agree to every f&cking government mandate that allowed to the system to f&ck my life while you smile here at my f$cking face. I want my f&cking life
Greenawald (AAFP): Oh, boy.
Us: Oh, boy, what
Greenawald (AAFP): You’re f&cked!
And we are f&cked until we take control back.  That would be control of the system and our lives.

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] 

  6 comments for “The AAFP Marathon Parking Lot

  1. Bob Riley
    July 25, 2018 at 7:57 pm

    Well, no wonder I never had a chance. I didn’t have an accountability partner to tell me
    where the hell I was on the wellness spectrum.

  2. Kurt
    July 25, 2018 at 2:44 pm

    Wow, I don’t feel so guilty now with all the colorful language I used here in the past that Doug
    had to cen”sore”. 🙂 I love it!

  3. bbneo
    July 25, 2018 at 11:42 am

    Can always use a chuckle in these humorless hard times in healthcare today.

  4. RSW
    July 25, 2018 at 10:20 am

    Would be great if you could overdub your script into the Steve Martin scene, and add an AAFP nametag to the woman behind the counter.

  5. PW
    July 25, 2018 at 10:11 am

    Anything to do with an acronym these days in my mind needs to be trashed.

    • Steve O'
      July 25, 2018 at 3:30 pm

      What you need to remember when considering the relevance of an AAFP acronym is “FLaMiNG FECES.” No, that’s not an acronym. It’s an observation.

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