You Will Be Analyzed

I am torn. When I first read this this article in the WSJ I was on-board. But then it felt creepy. The title is

Investigators Use New Strategy to Combat Opioid Crisis: Data Analytics 

Justice Department tracks prescription and billing records to find patterns of abuse in opioid epidemic

The article starts out like this and goes:

When federal investigators got a tip in 2015 that a health center in Houston was distributing millions of doses of opioid painkillers, they tried a new approach: look at the numbers.

State and federal prescription and medical billing data showed a pattern of overprescription, giving authorities enough ammunition to send an undercover Drug Enforcement Administration agent. She found a crowded waiting room and armed security guards. After a 91-second appointment with the sole doctor, the agent paid $270 at the cash-only clinic and walked out with 100 10mg pills of the powerful opioid hydrocodone.

Yes, I get it! These pill mills needed to be raided and the doctors jailed. Oh, and the patients should have been jailed, too, as many were just diverters. And, in the case above, the doctor did go to jail.

Then I read this:

The Justice Department effort is led by a data scientist with a Ph.D. and staffed by veteran health-care fraud prosecutors working in both Washington and out in the field. They pull and examine a huge trove of data culled from Medicare, Medicaid, the Centers for Disease Control and Prevention, state pharmacy databases and other sources.

Is anyone else afraid of what the government can do with this unlimited data? Are you overprescribing antibiotics? Do you not include enough Medicaid patients in your panel? I hope you see where I am going with this.

Or am I just being paranoid?

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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 “You Will Be Analyzed

  1. Steve O'
    September 11, 2019 at 2:14 pm

    Frank Herbert’s religious melange offered: Thou shalt not make a machine in the likeness of a human mind.
    Thou shalt not disfigure the soul.
    Data should serve humanity, rather than vice-versa. Medicine is not an algorithm.

  2. Wandal
    September 11, 2019 at 1:20 pm

    You are not paranoid, Doug. In fact, there can be a fine line between paranoid and visionary . What surprises (and frustrates me) is that many of my doc peers are pushing for Single Payor and at the same time ranting about Managed Care. Single Payor a la VA/Medicaid/Medicare is Managed Care on steroids with the feds setting all the rules driven by Big Data, Big Committees, etc. !

    • PW
      September 11, 2019 at 9:11 pm

      Big Brother is here.

  3. Pat
    September 11, 2019 at 10:20 am

    I’m not torn. I am against federal government involvement in the provision of routine, daily health care. As in other debates roiling the nation, the government will harm increasing numbers of innocents, while failing to significantly hamper those doing the greatest harm.

  4. George Voigtlander
    September 11, 2019 at 7:07 am

    Just because you’re paranoid doesn’t mean they’re not out to get you! The government was responsible be the opioid problem with bogus pain is the fourth vital sign and the FDA allowing junk science to sell narcotics.

    • Kurt
      September 12, 2019 at 10:21 am

      BINGO!! Although I was reticent to prescribe Oxy-Contin
      ‘Cause it cost so danged much back in the day. If grandma’s kidneys were toasted and couldn’t take NSAID’s, careful use of narcs is all we have have for pain relief. I find that most oldsters are careful about this and I indoctrinate these folks about it. Last I heard we can’t prescribe heroin (or herion as I saw it spelled on intake applications I saw at a methodone clinic I spent one day a week as a resident in the mid 80’s. The nurses actually ran it well and I was along for the ride. Learned a lot.)
      So docs aren’t accountable for the heroin epidemic. The ivory tower bastids should all be sent to Hades for using “pain” as the extra vital sign. I still see the stupid faced emoticon sheets for pain representation in the clinic and the hospital. For acute post-op pain, fine. I needed 4mg of Morphine IV q2h times 5 doses after a robotic prostatectomy. Hit the call light and said, “Fire in the hole ma’am.” Went home the next day with a foley and the hydrocodone did a fine job with ibuprofen. I didn’t end up cruising the streets for smack. My contention here is there is a genetic predisposition for narc abuse like there is for alcohol and nicotine. Bottom line is if one is one of these persons, they absolutely have to avoid those substances at all costs. Yeah I know it’s hard if an ex-addict has surgery but they have to avoid falling into that trap. Me, it helped my pain when it was intense and after it decreased I didn’t feel the need to continue taking a narc for fun. That’s the key.

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