Authentic Medicine Gazette

Enjoy our most current issue of the most popular medical e-newsletter on the internet.

Blogs and Thoughts for April 11th to April 17, 2019

Here is what we had this past week:

  1. The Story Behind the King of Medicine Name

  2. Alexa is HIPAA Ready!

  3. Quick, Someone Call the AAP! by Pat Conrad MD

  4. Medicare Fun

  5. The AAFP Loves the ABFM and Sleeps Right Along Side Them

  6. Friday Funny: Penmanship

  7. Quote of the Week: Tony Bennett


1. The Story Behind the King of Medicine Name

April 17, 2019

Sometimes I forget how long I have been doing this blog. I realized that I have been through a few generation of doctors since the King of Medicine nickname began. Some people who see it now think it is pompous or egotistical. I find that funny since it started around the year 2000 as a goof to poke fun at our broken healthcare system. At that time I wrote an editorial to the Boston Globe claiming that the system is so ludicrous that a king should run it and I should be that king. And they printed it! 

When I started my Placebo Journal (2001-2011), I just continued the nickname. It seemed fitting for the only humorous medical journal out there. Yes, before Gomerblog and before ZDoggMD there was the Placebo Journal. Once again, it was all a spoof. The above picture was from an article written about me over a decade ago and the below images are from one issue of the Placebo Journal.

In these times of healthcare insanity, where insurers, hospital administrators and Big Pharma rule the land, isn’t it time we have something or someone so stupid like “King of Medicine” be in charge. 

I thought so.

Now please lighten up and smile. And let me take over from here. 

Get one of our books here.

Leave Your Comment Here

2. Alexa is HIPAA Ready!

April 16, 2019

Remember how scared you were when you heard about HIPAA? Remember how you were going to get sued, fined or lose your license because you may mention a patient by name or talk to them in the supermarket with the possibility of someone listening? Well, in another example of double standards:

Alexa can now transfer sensitive, personal health information using software that meets health-privacy requirements under federal law. Five companies, including insurer Cigna Corp. , diabetes-management company Livongo Health Inc. and major hospital systems, said they developed new Alexa features for consumers using the federal protocol. The features let Alexa perform tasks such as scheduling urgent-care appointments, tracking when drugs are shipped, checking health-insurance benefits or reading blood-sugar results.

No worries, right? We can trust Amazon, Cigna, Livongo, and so on to be private but doctors? No way. Just another example of how big money talks and the power some companies wield. 

Here is the funny part. Not long after the first article there was this one: Inc. employs thousands of people around the world to help improve the Alexa digital assistant powering its line of Echo speakers. The team listens to voice recordings captured in Echo owners’ homes and offices. The recordings are transcribed, annotated and then fed back into the software as part of an effort to eliminate gaps in Alexa’s understanding of human speech and help it better respond to commands.

So… chance of this going bad, huh? I am sure all medical information is safe. 

But let’s hammer the doctors for any mistakes they make. That’s fair. 

Hire Dr. Farrago as a your next keynote speaker. Find our more here.

Please Leave Your Comment Here

3. Quick, Someone Call the AAP! by Pat Conrad MD

April 15, 2019

Anyone with half a brain knows very well that sodas contain a lot of sugar.  And consuming a lot of sugar can cause all sorts of tooth rot and will make you fat, the latter leading to bad joints, diabetes, heart disease, and only a very tiny, miniscule shot as ending up in the latest Sports Illustrated Swimsuit Issue as a “body positive” model.  Of course, excluding those without at least half a brain still sets the bar to high, and invites in the entire nanny do-gooder industry and state to protect you from yourself.

Enter the doctors, spearheading a polyglot of concerned acronyms all focused on forcibly keeping the rest of us healthy because, presumably, we all fall below that half-brain bar. 

“In its scientific statement on the role of added sugars and cardiovascular disease risk in children, the American Heart Association (AHA) concluded that strong evidence supports the association of added sugars with increased cardiovascular disease risk through increased caloric intake, increased adiposity, and dyslipidemia” (somebody call CNN).  In what has to be the strongest argument in favor of geopolitical isolationism yet, “the European Society for Paediatric Gastroenterology, Hepatology and Nutrition called on national authorities to adopt policies aimed at reducing free sugar intake in infants, children, and adolescents.” 

And stateside, our own American Academy of Pediatrics (AAP) advocates warning parents about the demon sugars, advising its members to limit consumption of fruit juices to no more than 4 oz per day in children 1-3, and “recommended that children and adolescents avoid all energy drinks and the routine consumption of carbohydrate-containing sports drinks and instead drink water.”  Which makes one think that the average AAP-sanctioned first-grader’s birthday party of kale chips and water would be not as eagerly attended as once thought.  But hey, pound your drum…

Except now the AAP and AHA are doing what these tiresome groups always do, which is to take their good advice and try to shove them down everyone else’s throats, presumably if they aren’t blocked by a logjam of carrots sticks.  ” On the basis of lessons learned from tobacco-control efforts”, the AAP and AHA want to push for legislation at state and federal levels to implement taxes on sugary beverages to curb consumption.  They cite successes of such initiatives in Chile, Mexico, and Berkley, California, three countries that surely warrant no emulation in a free society.  Many major U.S. cities have soda excise taxes, defended thusly:  “Although people of lower socioeconomic status bear a greater burden from taxation, they also disproportionately benefit from the health and economic benefits from prevention of cardiovascular disease and type 2 diabetes mellitus.”  And with the applause of the white-coated arbiters of taste, these good monies may be doled out for better purposes:  “For example, the Philadelphia tax has been used to fund prekindergarten programs that are of direct benefit to underserved communities.”  These noble doctors also want more federal and state regulation of sugary drink marketing, because I suppose, misery loves company.  They even want hospitals to ” disincentivize” the purchase of sugary drinks.  Would one soda machine over the federally approved allotment be justification to withhold 2% of Medicare / Medicaid reimbursements on the ground of not meeting community health promotion guidelines?

The point is that for all the dumb or apathetic people roaming the streets, we have more than an overabundance of arrogant, insufferably self-important nagging doctors who detract from the seriousness of what should be their profession by forcing themselves into everyone else’s business.  

Get One of Our Books Here

Please Leave A Comment Here. I read them all!

4. Medicare Fun

April 14, 2019

The Medicare Payment Advisory Commission is exploring options for moving further away from fee-for-service reimbursement that include allowing beneficiaries unrestricted choice of health care providers while incorporating bundled and site-neutral payments as well as new quality incentives. Here are the models:

  • Scenario 1: Traditional FFS continues and incorporates reforms such as bundled payments, site-neutral payments and new quality incentives. Beneficiaries continue to receive their choice of “any willing provider.”
  • Scenario 2: Traditional FFS option is removed. Providers must join ACOs to be eligible for FFS payments and Medicare assigns all FFS beneficiaries to ACOs. The Centers for Medicare and Medicaid Services (CMS) pays claims for ACOs using FFS rates. Beneficiaries retain the option to enroll in Medicare Advantage (MA) plans.
  • Scenario 3: Traditional FFS option is removed. MA plans and ACOs pay providers for all services, but CMS continues to release the FFS fee schedule. “ACOs effectively become capitated health plans,” according to MedPAC briefing documents.
  • Scenario 4: Total elimination of FFS program. CMS would not maintain the FFS fee schedule. MA plans and ACOs pay providers for all services.

My thoughts? Thank god for Direct Primary Care. I will never deal with this stuff. Ever. 

Get one of our T-shirts Here

Please Leave A Comment Here. I read them all!

5. The AAFP Loves the ABFM and Sleeps Right Along Side Them

April 13, 2019

Doctors have to get CME each year to keep their state licenses up to date. Unless you have been under a rock, you know that the ABFM has been controlling the board certification process forever. They also invented the MOC (maintenance of certification) in order to capture all that CME money. Wes Fisher MD has been getting traction in suing the ABIM but the force is strong with the ABFM. Their newest trick is to not call it MOC but instead the “Longitudinal Assessment Self-Study Package”. The AAFP, who makes a ton of money off this same process, is in bed with the ABFM. And guess what? They have the “All-in-one FMCLA companion”. FMCLA =Family Medicine Certification Longitudinal Assessment. The cost to you is only $995 ($1195 for non-members). 

Do the members of the AAFP still want the MOC? It has NEVER been proven to do anything other than make them, and the ABFM, money. Do we need live and work by evidence?

Here is my twitter conversation (public) with the current president of the AAFP in January:

Feel free to ask the AAFP why they support the ABFM and the corrupt MOC, or whatever name they want to give it. 

Get our awesome newsletter by signing up here. We don’t give your email out and we don’t spam you.

Please Leave A Comment Here. I read them all!

6. Friday Funny: Penmanship

April 12, 2019

This comic strip is great.

Please Leave A Comment HERE

7. Quote of the Week: Tony Bennett

April 11, 2019

“If my life is just about winning championships—if it’s just about being the best—then I’m running the wrong race,” he said. “That’s empty. But if it’s about trying to be excellent and do things the right way, to honor the university that’s hired you, the athletic director you work for and the young men you’re coaching—always in the process trying to bring glory to God—then that’s the right thing.”

Tony Bennett, UVa Basketball Coach

Congrats to my alma mater!

Please Leave A Comment Here. I read them all!

  86 comments for “Authentic Medicine Gazette

  1. Frank J Rubino MD
    April 17, 2019 at 11:55 pm

    CBS NEWS Reported tonight 4/18/2019:
    ” Dozens of people, including 53 medical professionals, have been charged for their alleged participation in the illegal prescription and distribution of opioids and other narcotics, Justice Department and Department of Health and Human Services officials said Wednesday. Federal law enforcement and health officials held a press conference in Cincinnati where they announced charges resulting from the Appalachian Regional Prescription Opioid Strike Force takedown operation that began only four months ago. ”

    I wonder if these “Doctors” were “Board Certified by ABMS”? Board certification would have prevented all this would in it ???? It has to, doesn’t it? Anyone certified by the American Board of Medical Specialties confers the Goodhousekeeping seal of approval. It is like United Laboratories that approves electrical wiring. It is like Apple Pie and America. A Board Certified
    “doctor” would never prescribe 800 vicodin tablets per month in exchange for money and sexual favors from his patient. Board Certification from ABIM or ABFM prevents all this! Doesn’t it.


    • Doug Farrago
      April 18, 2019 at 6:28 am

      Great point. Can you find out for me?

  2. Wandal
    January 31, 2018 at 10:57 am

    Love the Gazette, Doug. One thing: We see lots of fads in society, including in medicine, and the latest one is “physician burnout”. Seems every medical publication now has to have a feature on that . . . or at least a comment or letter to the editor. I’m sure there is an element of truth in all of that BUT part of me wants to say ‘what a bunch of cry babies’. There are a LOT of people out there that just don’t get it: They see the salaries of physicians consistently near the top (especially specialists!!), look at the income they and their friends/family/neighbors have and get pissed off. Life and work are hard on a lot of people; more so than on physicians. Income disparity is very wide and growing in this country and it is causing a lot of ??? anger, envy, voting for Trump ??? Just saying . . .

    • bobby garrison
      February 7, 2018 at 3:30 pm

      up yours. way to blame the victim. I can’t have a problem ’cause other people have problems too?? I can’t have a problem ’cause other people don’t make as much money as I do?? Are you out of your mind? Please tell me you are not a physician as you seem to have lost all empathy (and possibly sympathy.)

    • Frank J. Rubino MD
      March 8, 2018 at 10:48 pm

      I don’t think “burn out” is the issue. It is anger. Deep seated anger to the nonsense in health care.
      Meaning less metrics , meaningless MOC crap, Quality measures, etc. ANGER.

      • Mary Lang Carney, MD
        March 28, 2018 at 9:38 pm

        Frank: I totally agree with you!! When will the stupidity end?

        • Frank J. Rubino MD
          April 16, 2018 at 7:38 pm

          Hi, good to hear from you.

    • James Tinsley
      January 30, 2019 at 1:28 pm

      I would also like to add a hearty up yours. What do you do for a living? I just finished working 11-12 hours a day for over a year. No lunch and 2 bathroom breaks. My daughter cried to me twice and said I was never home. Once on fathers day. I missed all my son’s track meets and half his boy scout meetings. My boss and a rep from the Chief of staff said it didn’t matter and to take work home with me. I was going to quit my childhood dream of being a family physician until I found DPC. You say this is endemic in society? I say BS. I burned out like many of my associates. Please tell us what your job is. If it’s a doctor tell us what specialty and how many hours a week you are working.

  3. Dennis Kabasan
    April 27, 2017 at 10:23 am

    I ordered the Cryohelmet for my sixteen year old daughter, who sustained a concussion, with brief loc, after being struck in the forehead by a soccer ball, in a school match, two weeks ago. She’s been wearing the helmet, as recommended, one hour at a time, since it arrived three days ago. Her pediatrician is following her. She only tolerates a few classes each day, d/t frontal and temporal headaches and extreme tiredness. Sleep helps her. Is there any benefit to longer wear-time? Thanks.

    • Doug Farrago
      April 27, 2017 at 10:31 am

      See my email to you

  4. April 12, 2017 at 2:52 pm

    For some reason, my version of Authentic Medicine is delivered with comments from 2011 and 2012.

    Any notion of what may be going on?


    • Doug Farrago
      April 12, 2017 at 3:55 pm


  5. John Comis, DO
    May 30, 2012 at 11:34 am

    Please encourage the KOM to join his friends at QC13.

    (…of the lemons)
    PS the healthcare system is so terrible it is beyond any further comment.

    • Doug Farrago
      May 30, 2012 at 12:27 pm

      I will try.

    • au-digit
      January 26, 2017 at 3:33 pm

      The Bush you quote was #41.

  6. Gary Gaddis
    May 20, 2012 at 7:43 pm

    Regarding our Federal government, Centers for Medicare and Medicaid Services (CMS), Secretary of Health and Human Services Kathleen Sebelius, and the growing gap between CMS perceptions and reality, here is my sarcastic “Sound Bite” suitable for the brief attention span of our electronic news media:

    “Since the Department of Justice is headed by an attorney, and the leader of the Federal Reserve is an economist, then how is it logical that the Secretary of Health and Human Services is also headed by an attorney?”

    Does anyone else agree with me?

    • Kristina Berger MD
      May 21, 2012 at 7:31 am

      There are too few physicians in politics. Is it because we dont have the stomach for it, or another reason? I know if there were more of us as policy makers, the healthcare system in this country would improve greatly.

      • Simon Cummings
        May 23, 2012 at 8:59 am

        My vote is for Doug and not the type of physician represented by the Cardiologist who told me that he wasn’t interested in cardiac rehabilitation cos there’s no money in it!

    • Judy
      May 24, 2012 at 8:58 pm

      No, I think that it is correct for a lawyer to head the Department of Health & Human Services. Only a lawyer can read the volumes of crap they put out as regulations and find a loophole way to still make a living; only a lawyer can repeatedly find a way to let someone die and it be due to no fault attachable to him; only a lawyer can write voluminous policies that effectively help only a select few of his supporters and require the rest of the populace to pay for it except himself; and only a lawyer can sit passively by and provide no useful assistance to a group of sick, needy people but still require them to pay for his service. If you will think on these comments for a few minutes, you may change your opinion.

      • Bill
        June 4, 2012 at 9:22 pm

        Hey Doug ! I am a lawyer. never made more than $85K /year and spent my entire career in trenches helping people, most who did not have much money, with problems, many of them caused by their own bad decisions and choices. and I love your journal.
        Given the wide range of attitudes, opinions and incomes among doctors do you really want a politically-connected MD in charge ? maybe an orthopedist ? xoxo

        • Doug Farrago
          June 4, 2012 at 10:43 pm

          The description “politically-connected” should remove that person from contention immediately.

        • Dr Bonz
          June 21, 2017 at 8:29 am

          Dear Bill.

          F*** You.


          An orthopedist.

    • Jeff
      February 22, 2017 at 3:14 pm

      I agree, absolutely, that HHS should be headed by a physician.

      What about having an advanced practice nurse in that role?

      But (God help us) not an attorney, a chiropractor, a homeopath, a naturopath, a shaman, or a faith healer!

      On second thought, a shaman would be better than a lawyer any day.

    • Jeff Palmer
      February 22, 2017 at 3:16 pm

      I agree, absolutely, that HHS should be headed by a physician.

      What about having an advanced practice nurse in that role?

      But (God help us) not an attorney, a chiropractor, a homeopath, a naturopath, a shaman, or a faith healer!

      On second thought, a shaman would be better than a lawyer any day.

    • John A Goldman, mD
      March 4, 2017 at 3:10 pm

      thank goodness in 2017 it is a physician

      • John A Goldman
        July 21, 2018 at 4:23 pm

        But now we are screwed – It is a Pharma CEO who wants more part D (His company drugs are injectables) -what a farce

    • James Tinsley
      February 6, 2019 at 1:52 pm

      Great observation. Shows how little the government really cares about the health of the individual.

  7. Alan Levine
    May 9, 2012 at 9:03 am

    You have bemoaned our lowly position in hospitals, commenting how few recognized our contributions on Physician Recognition DAY. In what I feel is a further diminution of what we do, my hospital is now celebrating Nurse Recognition WEEK!!!! How far we have fallen………….

    • Doug Farrago
      May 9, 2012 at 2:53 pm

      I agree

      • Jack Forbush
        May 23, 2012 at 12:10 pm


    • Common Sense
      May 30, 2012 at 4:54 pm

      So you’re denigrating nurses in an attempt to rally support for your plight? It is just as easy to argue that since nurses spent 7 times more time with patients, theyre deserving of their week.

      Or, you know, we could all just stop getting butthurt over who has the longest display of solely symbolic “appreciation” and get back to working as the team we were intended to be.

      We’re your knights and you’re our Earls. There is nothing to be gained by making besouring diatribe. Be good to your staff and your patients and you’ll have more appreciation and recognition than your little heart can handle.

      • Doug Farrago
        May 30, 2012 at 5:11 pm

        You really need to have read the thread completely before making that comment. Please check out the blogs on how Doctor’s Day has been totally dismissed. Maybe then you will understand how we feel. This is NOT about doctors against nurses. It really is about administrators.

      • Doug Farrago
        May 30, 2012 at 5:12 pm

        You missed the point on this. It is about Doctor’s Day being totally dismissed by administrators. Please read those blogs.

        • Alan Levine
          May 31, 2012 at 8:56 am

          That was exactly my point. In recognition of out efforts several years ago my hospital–a level 3 teaching hospital–gave chocolate bars (small ones) to the docs. Nurses this year received flowers and other shows of appreciation.

          • JoAnne Fox
            June 8, 2012 at 7:23 pm

            Acknowledgement of a job well done would have been nice. I got a scoop of hot cocoa mix, repackaged in a baggie, with a little note attached telling me how wonderful nurses are.

  8. Doug Given
    April 25, 2012 at 5:29 pm

    What a screw job from the lovely IRS on the Mandate.

  9. Judy
    April 18, 2012 at 10:05 am

    think you should run for President, as long as you will continue to keep up this site after you win!

  10. Dave Hoffman
    February 29, 2012 at 11:20 am

    Great thoughts as always, Doug!

    Is there a way to start new comment threads each time you post a new entry?

    • Doug Farrago
      February 29, 2012 at 12:31 pm

      Each entry is a blog and has their own comment section

      • t mcglone
        April 4, 2012 at 8:25 pm

        Having “served” for 15 years, those are finely edited comments fit for civilian consumption .

  11. February 29, 2012 at 8:53 am

    today’s (feb 28, 2012) gazette was one of your best. some might say that your gazette is merely entertainment. i however, enjoy the articles with their kernel of truth/fact at the center and your encouragement for us to critically examine the field of medicine that we are a part of. the top ten signs that a hospital stay isn’t going well is what we see all our careers. uphoric for gout patients who like beer and ujerky for cardiac patients and the statin report were particularly good reading. i don’t know how you find the time or energy to do this. i was usually totally exhausted by the middle to end of my workday. thanks again.

    • Doug Farrago
      February 29, 2012 at 9:06 am

      thanks, dennis! I appreciate the feedback and I am truly flattered.

  12. Angi Wall DO
    February 9, 2012 at 9:18 pm

    I’m with Doug on the dietary/diabetes. It’s not often you catch those guys looking good in a bikini and munching on carrots.

  13. Dr. Veronica Friel
    January 25, 2012 at 4:20 pm

    More! More!! Doug, keep it coming!!!

  14. Robert Bosl, MD
    January 25, 2012 at 1:27 pm

    Regarding relationship of AD & DM, and comment that DM is dietary–too simplistic and likely wrong. We know about dysmetabolic syndrome & PCOS etc. which is genetic, DMS causes weight gain and subsequent DM. Consider whether strong relationship of DM to increased risk of AD is also genetic predisposition to both rather than one causing the other.

    • Doug Farrago
      January 25, 2012 at 2:06 pm

      100% disagree. Predisposition is not a certainty. How can you NOT think DM is dietary related?

      • Robert Bosl, MD
        February 1, 2012 at 4:12 pm

        My earlier comment may have been oversimplified–just tried to point out that some legit. MD’s believe in insulin resistance as a cause of some obesity issues than the result thereof, and it is conceivable that the “insulin resistance gene” may also play a role in development of Alzheimer’s.

    • Bridget Reidy
      March 8, 2012 at 6:49 am

      Ever consider the relationship between Alzheimer’s and diabetes might be iatrogenic brain damage from hypoglycemia? I’m always shocked at how lightly my patients consider the risk of it.

      • March 16, 2012 at 12:13 am

        May I suggest that the dementia with chronic diabetes isn’t Alzheimer’s, it is more likely to be due to the vasculopathy that accompanies non-well controlled diabetes or elderly age + diabetes. So the relationship is between DEMENTIA and diabetes, not Alzheimer’s Disease and diabetes. The fact that most elderly diabetics are vasculopaths, and the recurring theme in medicine that the brain depends on a constant supply of glucose and oxygen to function well, and that vasculopathy impairs oxygen and glucose delivery, is much more plausible than recurrent hypoglycemia.

    • William Braswell MD
      December 13, 2018 at 11:23 pm

      DM2 is the metabolic syndrome caused by simply sugar in the pie-hole that does not belong there. But if we forbid the sugar then the statin industry will bankrupt and crash the stock market. Reboot yourselves by reading HDL in wikipedia. Simple first year pathophys that is brainwashed out by the end of residency. It takes about 6 years of solo practice before the lights start going off and we wake up. If you never solo practice then all your 1/4 milion in loans were a waste of time and you will forever be stuck in an inbreeding circle of backbiting fearmongering arogants sucking your life out. No one is denied pain! My name is Bill and I am arogant and angry! My only hope has been the Serenity Prayer. Beautiful rant, huh!

  15. Scott Miller, MD
    January 25, 2012 at 12:34 pm

    I work in urgent care and when I get home at night I am too tired to exercise. I find that the exercise I get from going back and forth in order to finish the articles in your journal gives me the physical exercise I need to stay healthy and sane. Thanks, Doug! Could you get me a beer when you go to the kitchen?

    • Doug Farrago
      January 25, 2012 at 2:08 pm

      You got it!

  16. Allyagottadois
    January 18, 2012 at 8:55 am

    If I can print it out in its’ entirety, I can leave it casually around the hospital. Mailroom, Medical floors, ICU, ER, surgical suites, administrative offices, JACHO. Because All I’ve got to do is: everything everybody tells me to do.

  17. Dr. Bill Ameen
    January 1, 2012 at 11:31 am

    Hey Dr. Doug,
    To start the new year right, this ticks me off! I was belatedly reading the 11/4/11 issue of THE WEEK, an article about the Top 1% wage-earners. It takes annual earnings of $516,000 to qualify. Guess what? One out of six of the Top 1% is “in medicine”…I suppose some could be CEO’s of Big Pharma, but I suspect a large number are like the pediatric surgeon who heads the AMA and lives overlooking Central Park, and probably every orthopedist. Sorry, but I believe that anybody who makes that kind of dough either 1) inherited it, 2) stole it, or, as with most surgeons, sports figures and actors, 3) was grossly overpaid (as by insurance companies).

    • Doug Farrago
      January 1, 2012 at 12:32 pm


  18. bill lorentz
    December 28, 2011 at 11:25 am

    I am a recent professor emeritus from a well known university medical school. For a number of years I worked with administration as an associate chief of staff. We spent considerable time and effort reviewing patient satisfaction scores using a well known national company and were quite excited that ours were consistently higher than most othere and certainly higher than I thought was reasonable.
    Bottom line-we discovered that the administrator in charge of managing the satisfaction suvery was “doctoring” our results. When we changed over to a more honest effort our scores dropped significantly. However, no one in administration was happy with our new lower scores and the subsequent need to address the outcomes.

  19. David Devonis
    December 16, 2011 at 11:17 am

    Impressed that a lot of teachers are reading this material. Your site is the Writing on the Wall. Keep it coming!

    • Doug Farrago
      December 16, 2011 at 1:35 pm


  20. Dr. Bill Ameen
    December 15, 2011 at 10:46 pm

    Hey Dr. Doug, Heard that due to droughts affecting the peanut crop the price of peanut butter will go up. There’s a worsening shortage of PCP’s, so guess what? They’re paying us less..and less…and less. Also, latest Medical Economics has lead article about MOC. I was gritting my teeth reading remembering when you published the ABIM chief’s salary at $600,000. I’m sure ABFP CEO’s isn’t far behind. Where are the studies showing MOC (or even boards) make any difference in our performance? Finally, get “The Parking Lot Movie” on DVD. It’s a hysterically funny documentary about the parking lot behind The Corner at U.Va that will remind you of your days there!

    • Doug Farrago
      December 16, 2011 at 5:04 am

      Thanks for the great points, Bill! Will need to get that DVD, as well. On one of my first dates with my future wife she remembers me checking all over the ground for parking lot tickets that were cheaper than the one I had in my hand. I was a class act.

    • Dr. Veronica Friel
      January 25, 2012 at 4:16 pm

      Peanut butter prices going up? At COSTCO, the price of the large-size Jiffy Peanut Butter remains the SAME – the large-size is simply 8 oz. smaller.

    • Connie Severin
      February 8, 2012 at 1:06 pm

      Thanks so much for adding that bit about the movie. I just ordered it off Amazon. I worked at UVa Med Cen from 1980-1985 and remember the strip and the parking behind it (apparently pre-Farina days). I remember some sort of parking honor system and some lot Nazis from back then too, but obviously predating when this documentary is set. It was about the only parking within a mile of campus too, so finding any spot at all was a miracle. I’m looking forward to the video. Thanks for the heads up.

  21. Mary K Freel
    December 9, 2011 at 7:08 am

    RE: Grading Dr. on patient performance. Can you grade me if I work in a factory stamping out parts? Absolutely!! If the part doesn’t meet specifications then I’ve failed. Can you grade me on my patient’s health performance? Absolutely not!! I can only control a small part of what goes into a patient’s health and as studies have shown patients often pay for the dr. advice and then do nothing or the opposite. What a wonderful world it would be if when the dr. told his patient to lose weight and quit smoking they went right out and did those things. I was a nurse for 22 years and a teacher for 10 and in both professions I was the one who got blamed for whatever didn’t go right–whether it was poor scores on tests and the patient not getting better faster. Until people take ownership in their own health and realize that they are the number one reason that their health doesn’t improve the overall health of this nation will not improve and so our health care costs will continue to rise.

  22. Bridget Reidy MD
    December 8, 2011 at 10:44 pm

    I agree with the teacher and have always been suspicious of both of our “quality” grading.

    The recent issue of AMA News gave opinions of practicing docs on lots of little issues but NONE on their main article on why small practices (aren’t they usually run by docs?) aren’t getting EMR’s. Gee 15% more pay for 50% more work – why wouldn’t we bite? I wonder if it’s a censored rag. Thank you Doug for validating our voices.

    • JoAnne Fox
      June 8, 2012 at 7:32 pm

      Where do you find doctor owned small practices?? Most everyone around here is owned by one of the two hospital systems, and one has the gall to proclaim itself “not for profit” – I guess if you don’t mention the wholly owned subsidiaries they don’t count.

      • Doug Farrago
        June 8, 2012 at 8:27 pm

        Hopefully you will find them in the future

  23. Pat Nagle
    December 7, 2011 at 11:45 am

    I enjoy your site. I appreciate your heartfelt concern for patients and your irritation at the “solutions” suggested/mandated by outsiders (e.g. politicians). What strikes me most of all are the similarities between the world of medicine and the world of education, in which I spent 40+ years, working from K-graduate schools.

    Although the history, dynamics, and focuses are different,
    healthcare and education get pushed around by folks who don’t know what the hell they’re talking about, from Presidents, Congresspeople, media, on up, and the bottom line is always the bottom line, not the needs of patients and students.

    Your tirades against administrators parallel my feelings about the “consultants” and “foundations” who infest educational policymaking at every level. The last ones consulted are the frontline teachers and docs. And of course, the politicians and business moguls take no responsibility for the culture and economy they’ve helped create which lead to the problems in both areas.

    I don’t always agree with you (I’m adamantly for universal/single payer healthcare), but I appreciate your struggle. Keep up the good work.

    • Doug Farrago
      December 7, 2011 at 12:39 pm

      Thanks for some great feedback! And the similarities are eery.


    • Frank J. Rubino MD
      December 14, 2011 at 6:55 pm

      We do have much in common. “No child left behind” where the teacher is held responsible for the sucess of each and every child no mater how functional or dysfunctional is the child’s family.

      “Pay for performance” reguardless of how cooperative a patient is with diet & exercise and with their medication regimine for hypertension, diabetes etc.

      If one wants to make a lot of money in a short period of time, one should become a “consultant” to to school districts or to health care organizations. Expensive advice with out the responsibility. Charge a lot and then get out of town.

    • pat nagle
      December 21, 2011 at 12:50 pm

      Pardon me for doubledipping, but I forgot to mention that no legislator/congressperson has ever begged to be put on merit pay/pay for performance. Obviously, legislating doesn’t lend itself to factory models of evaluation. So why do medicine and education? The things that count aren’t measurable, and the measurable things don’t count.

      • Judy
        January 4, 2012 at 9:26 am

        hey, Pat, hope you don’t have a patent on your last line! that is about to become my ‘signature statement’ on my sign-offs!

        • Richard W. Mondak
          March 28, 2012 at 1:56 pm

          I think several of us are going to “borrow” that line (of course we’ll give credit to whomever coined that phrase — whoever that is)

  24. John Chase
    December 7, 2011 at 9:11 am

    I would prefer your stories to run in their entirety rather than “read more”. Very irritating to have to go back and forth

    • Doug Farrago
      December 7, 2011 at 10:08 am

      Ok, will work on it.

      • Greg Salard
        December 8, 2011 at 2:35 am

        I have to agree. Not only is it irritating, it can be confusing when you have to …

        Read More >>>

        • Doug Farrago
          December 8, 2011 at 3:31 am

          LOL. Will work on it

          • thea
            December 14, 2011 at 8:00 am

            Would like more written stories/blogs etc, do not have sound card on computer so can’t hear any of these videos..they kinda lose their punch without sound?

          • Doug Farrago
            December 14, 2011 at 8:14 am

            Understandable. I had some videos done already and needed to get out a few extra this week. Won’t always be like that.

          • Chris
            December 15, 2011 at 11:20 am

            Dear Doug,

            Not only do I want full articles on the page and written articles instead of videos, but I also want to have $100 deposited into my bank account each time I click onto your sight. And world peace.

          • Doug Farrago
            December 15, 2011 at 11:25 am

            Done and done.

          • tom walsh
            January 11, 2012 at 7:52 am

            These same people who can’t fathom going “back and forth” to read an article are the same ones who had difficulty with ‘butterfly” ballots in the 2000 elections in Florida.
            I have been enjoying your articles for quite a while and have no problems with the layout. Keep up the great work!! And, thanks.

          • Doug Farrago
            January 11, 2012 at 7:54 am

            Thank you, Tom!

          • Connie Severin
            February 8, 2012 at 1:09 pm

            Thanks for the new format! Jumping between responses and articles was a nuisance. I like being able to read everything in only one, maybe two spots at one read. It also makes it easier to check on new entries to the comments all at once, rather than having to check for each separate article.

        • Richard W. Mondak
          February 22, 2012 at 12:21 pm

          I have a short attention span, so reading part of the article and assuming I know what is being stated is par for the course for me. I often shoot par – 36 on the first 5 or 6 holes – so why play more?

          I don’t mind procrastining to READ MORE>> later

      • Ariel
        December 8, 2011 at 8:58 pm

        Agree with Mr. Chase. Thanks for looking into it!

        • Sharon
          December 28, 2011 at 10:10 am

          I totally agree with Chris!

Leave a Reply

Your email address will not be published. Required fields are marked *

Protected with IP Blacklist CloudIP Blacklist Cloud