Why I Won’t Be Speaking this November at the DPC Nuts and Bolts Conference by the D4PC

I have been asked a few times about my new book coming out on “patient churn” and whether I will have it with me in November at the DPC Nuts and Bolts Conference. The truth is that I am not being invited back to speak. First, some history. I have spoken at every DPC conference that they have had (this is their fourth year). I have heavily promoted this conference on this website. I was even their keynote speaker two years ago and was honored by the standing ovation I received.

Last year I wanted just to be an audience member and was not going to speak but was asked late by Dr. Allison Edwards to do a marketing talk with her. Because she is a friend, I agreed. We were initially rejected in our proposal but later asked to do it (a couple months out).

The lecture went fine because I think we really worked hard on our presentation. Prior to the talk, however, I was asked to pull a slide. It was confusing. The CME auditor thought there was some conflict of interest. The slide was the “Consumer Guide to Primary Care” which is just a free marketing tool for patients to understand why DPC is go great.

This guide took me countless hours to create and then I had it professionally made into a quality PDF that anyone can get when they go on my clinic’s website. As I said, it is a marketing tool. And the subject of our talk was MARKETING. In fact, to this day, I still get people who were at that talk asking for this PDF so they can use it for their practice. And I let these people do that for free.

After trying to persuade the moronic CME auditor that this slide was innocuous they pushed back and said they wouldn’t give CME for my lecture if I didn’t take it down. I relented. But then they changed their mind. The lecture went on as planned and was a great success. End of story. Or was it?

For the past six months or more I have been writing my next (probably last) book on DPC called Slowing the Churn in Direct Primary Care While Also Keeping Your Sanity. Patient turnover is a soul killer in this business. No one wants to talk about it, write about it, or speak about it. My hope was to do a lecture on the subject and show people some of the techniques other industries are using to fix this. I have been working on this lecture over the past month and offered my submission. Then these email interactions happened on July 4th:

Lee Gross: I understand that you don’t speak for AAFP.  Yes there is a chance you won’t be asked to speak.  The board is still upset that you were willing to disqualify our CME last year by not modifying the slides as required by the independent CME auditor.  They haven’t forgotten and brought it up with your recent submission.   

Me: Huh.  I don’t remember it like that.   Here is the conversation via email:

Lee S. Gross Thu, Nov 1, 2018, 2:15 PM
to me, 

If we push this, we will have to give up CME credit on your talk.  They are pushing back hard this year.  This isn’t personal or logical. It just is.  

Sent from my iPhone

Douglas Farrago Thu, Nov 1, 2018, 2:17 PM
to Lee, Allison

I know it is not personal. It’s just stupid.  Before rejecting slides they just may want to ask what they were in reference too.  So, now that they have the explanation, why is there still an issue?

Lee S. Gross Thu, Nov 1, 2018, 2:34 PM
to me, Allison

I’m just letting you know that if they don’t agree with your explanation, and if we push it, they will just pull the CME certification for your talk. Will see what they say.  And yes, it’s stupid. 

Sent from my iPhone

Douglas Farrago Thu, Nov 1, 2018, 2:39 PM
to Lee

 Let’s see what they say. We pull it we pull it but it would always be nice to have a conversation about something before they make demands

Lee S. GrossThu, Nov 1, 2018, 2:45 PM
to me

We have to pull the slides. They said no and I don’t want to lose the CME.  Sorry.  

Sent from my iPhone

Douglas Farrago Thu, Nov 1, 2018, 2:55 PM
to Lee


Lee S. Gross Thu, Nov 1, 2018, 3:29 PM
to me

Apparently they had a change of heart. Go figure.  

Sent from my iPhone

Douglas FarragoThu, Nov 1, 2018, 3:37 PM
to Lee

Yup guess so

Douglas Farrago Thu, Nov 1, 2018, 4:15 PM
to Lee

Appreciate your trying to help. I get all pissy when people accuse me of anything. I do enough bad things without being accused

Douglas FarragoJul 4, 2019, 7:30 PM (5 days ago)
to Lee

Am I missing something there?  
And I think this ALL was about the free guide I give away to patients that I was showing the audience.  Nothing I was selling.. No conflict of interest.  I will attach it.  And I have had so many in attendance that down ask for it and  modify that “Consumer Guide to Primary Care” and allowed them to put their own name on it.  The CME people had no idea what they were talking about. 

Lee S. GrossJul 4, 2019, 7:40 PM (5 days ago)
to me

Not going to debate you about who “won” the argument. Just being honest that they felt that you put the program at risk and voiced concern to do it again.

Douglas Farrago Jul 4, 2019, 8:04 PM (5 days ago)
to Lee

What debate are you even talking about?  Did I say I “won” something?  I’m giving you the email chain so you can share it with the board. It is always your choice but somehow you think I put your program at risk which is not true. I am offended at that accusation.  If you, Lee Gross, don’t want me to talk then just say it. Don’t hide behind the board. 

Lee S. GrossJul 4, 2019, 9:40 PM (5 days ago)
to me

That email chain that you archived supports the timeline that you were appealing the decisions of the independent CME certifier 2 1/2 hours before the certification deadline.  It doesn’t reflect the flurry of emails and phone calls that I was getting at the same time, threatening our CME certification.  I will not be supporting your submission for speaking at this event.  

Okay, so couple of clarifications. The email chain is time-stamped on Nov 1st, which was a Thursday, the day before the conference started. No concerns were sent to me prior to that date. Second, Lee mentions losing CME on my talk ONLY (twice) in that email chain. Third, that chain proves I was willing to give this slide up. And there was no more to this conversation until a few days ago. Everybody ended last year’s conference with smiles and hugs.

So, as you can see, there is more to this story than me not willing to give up a slide. There is something personal here, obviously, that I don’t know about. But does it really matter? I enjoyed giving these talks and meeting you all down there. I am human and it sure pumps the ego, which I need from doing the tough job of primary care for 30 years. I am very sad that I will not get to see any of you but I didn’t want any misconceptions that this was about me getting my ego hurt for not being allowed to speak.

Also, I am not going as an audience member because I can no longer support Lee Gross or the D4PC due to the dishonesty of the conversation and explanation above.

Thank you for letting me clarify things.

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] 

  10 comments for “Why I Won’t Be Speaking this November at the DPC Nuts and Bolts Conference by the D4PC

  1. July 13, 2019 at 2:44 pm

    Fuck them very much.

  2. Natalie Newman, MD
    July 11, 2019 at 4:43 am

    This is nonsense. Feels juvenile. If the guy had an issue he needed to say what the real issue was. Apparently, it bothered him that you archived the conversation. Nothing like having facts thrown in one’s face.

    What irks me the most is their inability to get over personal issues for the greater good of the DPC movement and members who wanted to hear you speak. Obstructive jerks.

  3. bb
    July 10, 2019 at 7:04 am


  4. Peter Millard, MD, PhD
    July 9, 2019 at 7:38 pm

    You clearly demonstrated what dicks they are, Doug. They don’t deserve you.

    • Douglas Farrago MD
      July 9, 2019 at 9:19 pm

      Hey, man, how ya been?

      • Peter Millard
        July 10, 2019 at 3:01 pm

        Excellent, Doug. Emily and I were in Mozambique 2008-13 and have been in Belfast since returning, working with Loxterkamp and Kramer, who have both now retired and I’m med dir of Seaport Community Health Ctr, which is now a branch of Penobscot Comm HC in Bangor. I’m quite involved in Unicirc, a minimally invasive circumcision technique to prevent HIV transmission at https://www.youtube.com/watch?v=RqX_2GNzxqg
        It was my idea to combine a “disposable gomco” with EMLA cream and Dermabond, so no injections or sutures, and heals by primary intention. We’ve applied for 10 grants and gotten 0, so it’s an uphill battle, but we’ll eventually succeed. 3 grandsons now, and one here in the area. How long have you been down in VA?

        • Peter Millard
          July 10, 2019 at 3:04 pm

          email me sometime

        • Ray Stone, DO
          July 12, 2019 at 10:32 pm

          Wow! Hello to Peter and Doug. Hope all is well. Peter, we have talked about you but thought you ended up following the Grateful Dead in concert. Hats off to Peter for your efforts. A disposable gomco is genius! No injections or sutures is fantastic! A disposable penis would be better! Hope you are well. Doug and I are close since residency. He’s a beast! He is not only a great friend but he truly gives a shit about primary care. . He’s is leading a primary care movement called direct primary care that is truly revolutionary. I am so proud of him. I hope you are happy and healthy. Doug and I are getting together this summer. I get up to Belfast occasionally, let me know if your available. Peace brother. Ray Stone.

          • Peter Millard
            July 13, 2019 at 12:38 pm

            Ray! Great to hear from you! Maine Doctor of the Year! Glad that you and Comis are still in Maine, even if Doug bailed! We’d love to see you in Belfast anytime –plan to spend the night. I’m working in Portland starting on Monday (every Monday, my day off) caring for the Angolan refugees. Falo portugues!

  5. Dick Carlson
    July 9, 2019 at 10:15 am

    I used to do keynotes and workshops for years, helping to support conferences I believed in. The level of petty bickering and silly rules got to a level that I just couldn’t enjoy it, any longer.

    Amazing how people feel they can intuit your intent. Just ask — I’ll let you know exactly what’s happening.

Comments are closed.