25% by 2030

Several family medicine organizations kicked off a long-term initiative dubbed the 25 x 2030 Student Choice Collaborative which is:

Simply put, they will work for the next 10-plus years to ensure that by 2030, 25 percent of combined U.S. allopathic and osteopathic medical school seniors select family medicine as their specialty.

In the picture above you can see AAFP Senior Vice President for Education Clif Knight, M.D. speaking at an event at AAFP headquarters, tells attendees about his first positive encounter as a medical student with the family medicine interest group (FMIG) on his campus. “Today at the AAFP, we love our FMIGs because this is where our medical students have an opportunity to connect with mentors and role models.”

My question is, how do you want to entice them?  Here are some things to dangle in front of medical students:

  1. Be one of the lowest paid doctors
  2. Work longer hours
  3. Do clerical work all day
  4. Be employed by a hospital and treated as if you could be replaced any day
  5. Be offended by NPs and PAs who state they can do the same job as you while the AAFP does nothing
  6. Burn out
  7. Be graded on metrics you have no control over

You can let them spend some time with employed or insurance billing family docs and let them see for themselves or you can let them spend time with a direct primary care doctor and let them see:

  1. Higher pay
  2. Work less hours
  3. Do little clerical work
  4. Be your own boss
  5. Still get offended by NPs and PAs who state they are “equal”
  6. Be happy
  7. Not be graded on bogus metrics

Hmmm, tough choice, right? Well, I could find NOTHING in this initiative that talks about Direct Primary Care.  Any thoughts to why?

Hire Dr. Farrago as your next Keynote Speaker

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] 

  7 comments for “25% by 2030

  1. Kurt
    September 13, 2018 at 10:00 pm

    AAFP = Academic A–holes and eeFffing Pri*ks
    ABFM = Academic “Bastids” and eeFffing Morons

    Respectfully, DPC will not work everywhere. I don’t care what Doug says. Go to an area where they are too used to sucking off the government teat and you’ll go bankrupt just like many private practices did in the recent past. That said, find the right place and it has it’s advantages like giving the one finger peace sign to most regulating groups and higher practice satisfaction. Nice work if one can get it. Will have to be in an area where there are hospitalists to do the inpatient stuff so one can’t be bothered.

  2. Pat
    September 10, 2018 at 9:53 am

    I would advise any student asking my advice to avoid medicine entirely, primary care especially. The trade is pushed by twerps like the AAFP who sell self-abuse as some sort of perverted nobility.

  3. Mario
    September 10, 2018 at 8:21 am

    My understanding of the events that preceded this boondoggle, IMHO. Our youth is being groomed to be part of the collective, an employee, a team member, a provider. We, in an effort to ensure patient care and expedite the learning curve, did it our selves. Over the years we have demeaned medical schools and placed all our eggs in residencies. Let me explain my theory. At the turn of the century we recognized that the profession was going the way of the snake oil salesman. The Flexner report and initiative gave way to residencies. Medical school were no longer expected to train physicians, but residents. Medical schools began to kick the can down the road. Let the residencies pick that and this up. This progressively developed weaker and weaker interns. At the same time a healthcare industrial complex began to emerge. They recognized that death and illness made for a captured audience and perfect cash cow. After all , saving lives should mean cost is no object, right? Physician have always been thought of as benefiting from someone else misfortune. The “business “ of medicine was taboo. Physicians were even ostracized for even advertising. That was beneath a physician and the profession. Little by little we gave up the reigns. Most of us during that time we’re confident that we would still remain the main cog. After all, they were still standing when we walked into a room. To justify our pay we progressively gave residency more and more importance. To the point that nowadays we are not considered a physician until we have finished a residency and pass their boards. Over a short period of time even that was not enough. We had to continue to prove that we were worthy. MOC was born. Human nature being what it is, it didn’t take long before even that was seen as a cash cow. This meant huge amount of money. Was it used to further medical education or residencies, I don’t thimk so. The certifying organization got richer and more politically influential ($$$). Through all this…..the band just played on. This cash cow was also recognized as a powerful political weapon. Control it, you control the masses. Especially after they get hooked on the insurance game. Creating indentured workers and voters. Then our children’s education became a political football and an easy gateway for post modern, socialists, but that’s another story.

    • Steve O'
      September 10, 2018 at 9:40 am

      Brilliant comments! One of the turning points took place around 1992, when the county hospitals changed from resident-run facilities to attending-driven facilities. By the time one graduated medical school in the early system, one was considered ready for the year’s training that would make them competent for inpatient work – internship. The period afterwards turned residency into babysitting and note-taking, kicking the competence can down the road to fellowship.
      Some 20 years ago, some folks decided that medicine should transition to a corporate-factory model. Who were these folks? I’m not exactly sure. But the people at the patient interaction were seen as the equivalent of clerks at a pricey mall. Sell the product!
      The AAFP (American Association of Factory Practitioners) promised to deliver the workers to HR. But there’s not enough workers? Consider that in Central California, avocado pickers are paid up to $60/hour*, the thrill of sitting in a cubicle processing humans isn’t what it used to be. The heat’s going up on the AAFP – deliver the workers!
      The patients continue to clamor for accessible, affordable healthcare. It was that pressure that has accelerated the transition into factory medicine by the self-interested, and the worse the pressure got, the more opportunity came onto the national players to sell their product. I suspect that EMT’s will be licensed and thrown in the practitioner box within a few years, when the AAFP fails to fill the cubicles.
      *Ruben Navarrette: Farmers have little reason to trust Trump, Washington Post Aug 2, 2018

      • Pat
        September 10, 2018 at 2:08 pm

        “Factory practitioners”…????????????????

    • PW
      September 10, 2018 at 9:50 am

      Yes, I think you hit the proverbial nail on the head. This modern crew just wants to go to work, follow the guidelines, pick up a paycheck and have a happy life. There is little or no independent thinking anymore. Physicians will just become drudges in the health care factory.
      This being the case, no one is interested in putting themselves out on a limb for DPC, it’s too risky and you might actually have to do something.

      • Kurt
        September 13, 2018 at 10:04 pm

        Yeah, Pick the wrong place and you’ll lose your shirt not being able to pay back
        your student loans. “Choose FP and we’ll pay everything.” Might be the only enticement to work besides killing off MOC.

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