Re: new article, And The Return of Marus Welby

[Guest guest]

I really like this article... But it just astounds me that nobody gets the fact that the Insurance, squeeze us dry payment system is one of the main reasons there is such a shortage of primary care docs in this country. Med Students and other intelligent graduate level professionals have voted with their market based feet, and have actively Chosen NOT to go into primary care. If there was a well know relatively secure viable non-burnout model that removed the barriers to care, relationships with patients and a reasonable doctors' wages and payment system, this trend would quickly reverse it self with time... Folks of this level of intelligence, passion, skills and humanity would once again not choose law school en-mass and even lesser paying better bennies, less personal life time stressed like

Teaching and other valid career paths...

The Tail is wagging the dog here... It is the broken business and professional model that has ruined this field and its reputation which is why intelligent enough to become a doctor in the first place young adults simply do the math of years spent getting there, debt aquired, hours dedicated to work as well as "The System's BS Paperwork Barriers" and the workload itself and avoid primary care like a plague... which honestly in its present broken model is not a bad analogy for the problems it is spreading across the industry as well as on both the patients and the providers and even their staff... It is no way to run a railroad....

We could easily return to the days of Marcus Welby if we simply took one or two percent from other healthcare dollars spent, proven well in the Perdue Chicken Model (I love that study!!!) by taking good care of docs and their patients by simply getting the heck out of the way and allow those docs to do what the majority would give their right arms for... a good days pay for a good days work of providing relationship centered top quality, integrated care...

HONESTLY, What caring intelligent kid coming out of undergraduate school with at least modest people skills wouldn't want to be a reasonably well compensated local family doctor with a health balanced life and the upper middle class means to persue their other life's interests and live well with their young soon to start family???? It is the obtainable goal, the protected and provided for carrot at the end of the stick that will once again naturally draw the best and the brightest, those who honestly care and desire to be a well respected member of their community with a reasonable lifestyle and with little worses of being financially or Psychologically and Emotionally traumitised and ruined by making this once great choice....

We need to change the system is such a way that it once again naturally attracts such great young people to the field... That is the answer, that is the ticket... Then we can have IMP like, Marcus Welby's in every community in the nation... Plain simple.... But getting their and bringing down the powers that be that stand in the way of honesty and transparency in our system, to allow themselves to be seen as the "Man Behind the Curtain", to stop projecting blame upon the victim who is the provider of the care... That is the problem to achieving this solution....

The Insurance based system and the entire Medical Industralized Complex is basically engaging in a form of projection and abuse known as "Gaslighting" where the abused has their reality denied, the begin to doubt themselves and start to feel a need to defend themselves from the Projection from the Gaslighting Abuser who is in the midst of a manipulative slight of hands to change the point of focus off of themselves where it belongs because they are the sick and or dysfunctional one, the less caring and involved one... The abuser changes the rules of the game in middle of the contest... and accuses the victim of their abuse of the behaviors that they themselves are actually most guilty of.... We the wasteful and greedy Doctors as we have been labeled who block access to care and don't provide care... Since when did an insurance carrier ever provide care???? We are the ones who provide the care and yet they project the blame upon us as not providing

it... They are the really greedy ones keeping up to a third of all healthcare dollars for themselves and their part of the game while the complain mightly about fractions and parts of the lousy five percent that we are presently given as scraps.... This is Gaslighting Projection for sure!!! And that is why most docs and large organizations fall for every next latest greatest sceme to improve care no matter how wacky or illogical, we are in the defensive, thrashing out stage of our trauma response to the abuses and we have sort of bought into the lies formulated by our abusers....

I know that this sounds like a farout theory of a portion of an industry sort of falling into this group mind funk that primary care is in... But in just the last few days I have started to understand the application of this individual person to person theory and to see how it can be a more systemic like theory as well... We have an abuser with enormous powers over us who is attempting to just about squash us like bugs under their thumbs using their economic terrorism and control to force our aquesence, and has created a group think mentality of "Learned Helplessness" upon just about the entire population of care providers... With this much dependence upon our oppressors and abusers, the next leap to the gaslighting part of the mind control game is not that hard to make.... Why else are even we IMP'ers falling all over ourselves to create studies and research full of Metrics to sort of defend and prop up our self image in the face of this

onslaught? Why do we feel so compelled to change the conversation? Because our Abusers have done such a masterful job of gaslighting us that the rest of the country from politicians to patients and even ourselves and fellow healthcare people don't believe our version of reality and instead mirror back the created one for our insanity and mind control so now the majority of doctors don't even realize they have been brain washed, manipulated, wounded and controlled, via this Gaslighting Technique.... We know in our hearts we don't need Care Managment from an insurance carrier or the gov't and yet we are all falling over ourselves to purchase Meaningful EMR's to collect the data and justify our exsistance.... What did all primaries learn in med school??? How to manage the care and the muliple issues and drugs and problems of these real human patients... So why do we fall for and get behind more oversight and more metrics just to defend and prove ourselves

to our oppressors and abusers????

Get rid of the abuse, the gaslighting, the freakin' Cool-Aid and return to a more normal, natural form of work and payment reward and doctors will get well, solve most of their personal and professional problems themselves with time (mostly those brought and forced upon us by this broken abusive system...) and patients will finally get the personal involved care that they need from a doctor they know and trust.... and the first major wound and source of infection will have been removed from our enviornment....

To: Sent: Wed, January 19, 2011 2:46:35 PMSubject: Re: new article

Thanks for pointing out Joe Scherger's article (I hadn't noticed it despite years of receiving Medical Economics in the mail for free, again despite sending cards in multiple times asking to be removed from the mailing list).

It's a good article though. Can cut and paste link:

http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Its-time-to-optimize-primary-care-for-a-healthier-/ArticleStandard/Article/detail/699150

I like the relationship centered model name (that's what I like to call my practice) and the concept of the organized team model as a non-competing but rather complementary way to provide care to larger groups.

Joe lurks on this listserve, I believe. If so, good job!

Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com