Thursday, January 21, 2016

Family Medicine: A Quiet Revolution

The midnight special January 21 Dr Synonymous Show on blogtalk Radio is a call for realigning with the essence of Family Medicine which I review on the show, sometimes passionately ranting about "meaningless use", bonus based medicine and evidence based medicine.

"The Secret of Quality is Love" click to listen to the show.

Dr Jonas, your host, holds a late night session about morbid measurement and murderous metrics which are killing healthcare.  The NYT article "How Measurement Fails Doctors and Teachers" by Robert Wachter in the Sunday Review is a timely message of importance to the nation.  We will discuss it.
How does this relate to Family Medicine?  Many ways.  We have abandoned our essence as if it is unmeasurable fluff.  We have agreed to be measured by wigeteers and come up short for our patients.  Patient autonomy be damned and meaningful use be honored seemed to be our motto.  We failed to exert the leadership that would protect our patients from massive amounts of bonus based healthcare.  The EMR outranked medical ethics.  Is there hope for Family Medicine and our patients?

Yes, if we become Quiet Revolutionaries.

Yes, if we reaffirm our essence as Family Physicians.
Yes, if we stimulate a dynamic dysequilibrium in healthcare that allows patient autonomy to be honored again.
Yes, if we move away from "meaningless use" of patients and resources.
Yes, if we seize, retain and exploit the initiative of the Direct Primary Movement.
Yes, if we stop selling out to hospitals, insurance companies and Big Pharma.
Yes, if we celebrate the fun of neighborly clinical decision making, by integrating patient values into decision processes.
Yes, if we honor each other as scarce, valuable resources.
Yes, if we stop using so called evidence based medicine as a weapon.
Yes, if we nurture the pipeline that feeds our specialty and the nation with Family Physicians.
Yes, if we love what we do and how we do it.  Quietly.

We are the Quiet Revolutionaries.

What do you think?


  1. I listened to your podcast and agree with your points there and in the writing above. To be honest, I don't hold out too much hope however for the success of this quiet revolution. I think at best it will remain a smoldering fringe insurgency with small "under-the-radar" pockets of medicine being practiced the way it should be with a "love-based" doctor-patient relationship at its core.

    There are just too many vested interests in maintaining the current slow motion train wreck that our healthcare system has become, and a public that is too mind-numb to notice or care as long as they can grasp at the next shiny object promised to them by their "betters" in D.C. and Academia.

  2. Thanks for your comments, drsam. You are right-on based on the evidence. The Medical-Industrial Complex and the Payment Centered Medical Home (PCMH) carry a lot of weight. We have to hold the course of the quiet revolution and see what happens. 4-8% chance of success is a start and may grow (or not). Peace. apj