This Sceptred Aisle by Pat Conrad MD

It’s sort of shooting low hanging fruit in a barrel, but is there ever a wrong time to make fun of production-line health care?

The land that brought us Monty Python and is now banning scary-looking knives is also an epoch leader in the “health care is a right” thought disorder, and as ever is short of cash.  The United Kingdom National Health Service has overbooked and overworked their GP’s to the point that they are making plans for group visits, in groups of up to 15, and included in the new 10-year plan.  Patient advocacy groups say that patients would feel “incredibly uncomfortable,” to which I say Thhhhhffffbbbpppptttttt!  The taxpayers have felt incredibly uncomfortable for years funding this expenditure without end.  And what about the GP’s?  How exactly did a shortage occur, if they were trained and paid appropriately?  Patients are getting more of the consequences of the public policy they have chosen since 1945, and they deserve these rewards. 

 “Doctors at the Royal College of GPs’ annual conference yesterday said the groups were a ‘fun and efficient’ way to carry out consultations with patients who shared the same conditions.”  Which is proof that the AAFP has a branch office in London. 

 “Doctors using group consultations said they had proved far more efficient at dealing with a host of heath complaints, including arthritis, diabetes, obesity, and even treatment of erectile dysfunction.”  Oh, I’ll bet!  “Gladys, you’ve stuff down any more boiled kidney pie and you’ll weigh 3 stone more, priming yourself for the arthritis Beatrice keeps complaining about all the while refusing to exercise, and Gertrude here can’t get any wink-wink, nudge-nudge from ol’ Tom, who’s just joining us today because he can’t wake up his old fellow, isn’t that right Tom?” 

“Under the system, patients will spend much of their time with a “facilitator” – a receptionist, clerk or healthcare assistant with a day’s training – who can point them to advice on their health condition, the conference was told.”  That sounds familiar.

 Okay, now everyone take a deep, calming breath before this next, realizing that it isn’t parody:

 “GPs said patients were given forms telling them to respect confidentiality, and told: ‘What’s said in the room stays in the room; don’t go discussing it with the postman and his dog.’”  By now Tom’s troubles have made it around the pub.

 Before we laugh too hard, we should remember U.S. voters watched this mess unfold – and then instituted Medicare.  We saw it get worse in Britain, and we expanded Medicaid.  We have several decades of experience in embracing bad ideas incrementally without arguing against their central flaws.  Which makes us dumber than people who habitually eat kidneys and deliberately watch soccer.

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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] 

  1 comment for “This Sceptred Aisle by Pat Conrad MD

  1. Steve O'
    February 17, 2019 at 10:30 am

    When you see something happen, over and over again, it must be a pattern. (duh).

    Many moderns are mired in dreadful relationships, because of attraction to individuals who are psychologically damaged, often borderlines, narcissists, and antisocials. There is nothing wrong with working with these people, in a professional relationship. It’s when they enter into your personal sphere, things usually turn dreadful. There is a social problem in modern society that veers people seeking relationships towards these sort of individuals, rather than away from them.

    Similarly, there is a social tendency towards affection and trust towards the people offering advice about a certain topic who seem smart, self-assured and fluent. Unfortunately, these are properties often easily attained by hucksters and blowhards.

    When the forum becomes the new British experiment – group visits, in groups of up to 15 – one is guaranteed to tap into the common social dynamic. In the modern American world, the capacity to cite things on the Internet trumps study, education, practice and expertise in the practice of medicine.

    In such a group, the physician – that contemptible slave to the medical establishment – will perhaps be pilloried, and the smart, confident young Internet surfer will parry any medical advice with lightening-fast refutation. Thus will “group visits” decline to the quality of care approved by the least-informed member. The Medical Home demonstrates how treatment by consensus does the same thing.

    As an aside, in researching a veterinary question as a pet owner, I came across a scathing debate over whether hydrocortisone is bad for pets, and Vitamin D is better; or the reverse. It made my head hurt. Smart, confident young Internet surfers expressed shock that one’s veterinarian was so callous and ignorant as to prescribe hydrocortisone to a dog. Everyone knows, of course, that hydrocortisone is bad. Or good. Join the debate.

    Perhaps the admonition “don’t go discussing it with the postman and his dog.” is mistaken. Many postmen, and most dogs, admit that they know less than veterinarians, and do not offer uneducated advice on pet care. If only internet surfers had such insight. But the Internet Academy fellows take firmly-rooted certainty in their own wisdom, that they know the Good from the Maleficent. Dogs often take such a posture towards postal service employees, and that is no doubt the reason that all the mail in our complex is delivered to a free-standing group mailbox in a dog-free zone.

    If only the Doctors at the Royal College of GPs were as smart as the Royal Mail and Post Office Ltd. They certainly should be leashed, and their extruded opinions tastefully picked up and placed in the designated receptacle.

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