The Golden Seal Scam

This is where the free market has work to do:

California is the only state with more than 1,000 surgery centers that has given private accreditors a lead role in oversight. Those accreditors are typically paid by the same centers they evaluate.

That approach to oversight has created a troubling legacy of laxity, an investigation by Kaiser Health News shows. In case after case, as federal or state authorities waved red flags, state-approved accreditation agencies affixed gold seals of approval, according to a KHN review of hundreds of pages of doctors’ disciplinary records, court files and accreditor reports — which are public only for California surgery centers.

Listen, we need to do better.  We can’t let bogus 3rd parties, who are paid off by the people they work for, be in charge of giving out these golden seals of approval.

How do we fix this?  Looking for your thoughts, Keith Smith MD.

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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 Golden Seal Scam

  1. L. J. Sloss, M.D.
    September 24, 2018 at 3:27 pm


    … nothing new under the sun to see here

  2. Steve O'
    September 24, 2018 at 10:21 am

    This problem belongs on Pete Stark’s doorstep. He set up harsh criminal laws to break up doctors’ financial involvement in hospitals, which found to be a conflict of interest. I hope he is satisfied with what he got.

    What were the little private “not-for-profit” doctors’ hospitals and surgeries? They represented a doctor’s, or a few doctors’, property. In spite of our modern prejudice that quality only occurs at the muzzle of a gun, these centers lived and died by the opinion of the hospitals’ users and colleague physicians who referred patients to them for care. When medicine was a collaborative profession, a bad outcome or legitimate patient complaint was amplified through the community.

    What do we have now? Giant nationwide entities own dozens or hundreds of centers that can vastly differ in quality of services. The people at the top don’t know what’s going on at the facilities, so they require metrics; and they require metric generators called quality analysts to tell them whether the facilities are performing, or underperforming.

    In the community a physician might have a $1 million dollar stake in the hospital; but the farmer has a $1 million dollar stake in the farm, and either one of them could go broke if they aren’t watchful. Today, an assistant vice president has zero stake in the surgical center, but $500,000 a year income. After two or three years, all that stake is tucked away in untouchable investments, not in a fragile and vulnerable place like a hospital.

    Pete Stark has left us with a merry-go-round of irresponsibility, cost shaving and worsening care. I’m sure that he had no intention of doing that, of course. But he didn’t do it on a whim; he spent years installing the cabling and plumbing for the skyscraper Big Medicine, all the while claiming that little medicine needed someone to watch over it. Guess what, Pete? Now it does.

  3. September 24, 2018 at 10:05 am

    Your post should generate a lot of discussion. First. Kaiser Health News. Their pro-hospital bias and anti physician owned facility bias is completely off the charts. One recent hit piece by them against physician owned facilities can only be described as a swing and a miss, the bias was so gross. Second. The absence of market forces in the industry is what allows waiting rooms to be full at facilities that are “in network,” whether they are any good or not. Restaurants go out of business when they are awful. Hospitals and other facilities can continue to thrive, as patients continue to patronize facilities recommended by a larger number of hospital employed primary care docs, under the gun to make these referrals, as you know. Government, having assumed the primary “inspection” role of facilities, crowded out the market’s chance to do so effectively. This is like saying the free market has a lot of work to do delivering first class mail. The real purpose of this article might be to deflect attention away from sporadic and shoddy quality in the inpatient space. I believe an Underwriters Laboratory type of approval stamp is in our future for the medical industry, but the government must get out of the way, first. Many of the boxes that are checked during inspections are driven by approval required by Uncle Sam to take his loot. Just my initial thoughts. Thanks for all that you do.

  4. Sir Lance-a-lot
    September 24, 2018 at 7:47 am

    You mean like JACHO?

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