Dr. Farrago, author of several popular books in Direct Primary Care, talks about the forces driving employed physicians into the DPC model today. Watch the full presentation here: http://video.hint.com/dr-doug-farrago-my-journey-into-dpc

1. DPC: The Hero’s Journey
Douglas Farrago MD

3. Once upon a time
…..a likeable but
flawed character
has her goal
threatened.

4. The Lay of the Land
• 54% characterized their morale as
somewhat or very negative.
• 63% said they have negative feelings
about the future of the medical
profession
• 49% said they often or always
experience feelings of burnout
• 49% of respondents would not
recommend a career in medicine to
their children.
The Physicians Foundation's Survey of America's Physicians
2016

9. Premature Physician Progeria

11. Then

12. Now = RoboDoc

13. ROS Phenomenon
-10
-5
0
5
10
15
20
one two three four five
Years in Practice
ROS

14. Suicide
• Medical profession consistently
hovers as one of the highest risk
of death by suicide.
• A doctor kills himself or herself,
on average, each day in this
country

15. Hero encounters
hurdle after
hurdle and
decides enough
is enough.

17. The hero first
tries to work
from within the
system…

18. AAFP and Burnout
 AAFP Joins National Collaborative to Promote
Clinician Well-being
 AAFP Joins House Members to Spark Burnout
 Speakers Chart Paths from Physician Burnout to
Well-being
 I Bounced back from Burnout by Setting
Boundaries, Priorities
 I Filled My Prescription Against Burnout at the
Gym
 Try PROBE Tool to Help Stave Off Burnout
 Can Mindfulness Meditation Deliver Us From
Burnout?
 Physician Burnout: The AAFP is Winning Battles
For You.

20. “The most unsettling thing for a physician
is when the patient doesn't trust you or
believe you.”
Obstetrician-gynecologist, New York City

21. “I know that Reader’s Digest recommends
bringing in a complete list of all your
symptoms, but every time you do, it only
reinforces my desire to quit this
profession.”
Douglas Farrago, MD

22. 10 Question Burnout Test
1. Do certain patients on your schedule actually
make you violently shake or cry?
2. Do you secretly envy the job of old
friends….every time you see them pumping your
gas?
3. Are you slowly digging a hole through one of
your office walls to escape like the main
character in Shawshank Redemption?
4. Do you find yourself wanting to tell a patient,
“Shhh…you had me at hello?” in order to get rid
of them?
5. Are you secretly planning to get on disability by
contracting a “disease” that is seronegative?

23. 6. Have you already gotten (and passed) a
stress test due to chest pain and/or
palpitations?
7. Have you already bumped your PPI to
BID?
8. Are your kids asking you how long it will
be until you retire? And they are less then
10 years of age.
9. Do you sarcastically answer patients in
your head and become uncomfortable
when they ask why you are smiling?
10.Are you actually considering becoming a
medical administrator?

24. Results
 0 – you are lying or are on some type
of psychoactive substance
 1 to 3 – you are fresh out of residency
or are retiring in the next year
 4 to 6 – Most doctors are here. Time
to start thinking about a career change
 7 to 10 – You are toast. DPC is your
last chance

34. Administrators
 Want
◦ Control
◦ Productivity
◦ Money
◦ Awards
◦ Prestige
 Don’t Want
◦ Controversy
◦ Being Questioned
◦ Friction
◦ Resistance
◦ Disruption

38. With her goal
threatened, our
hero finds the
forces of evil too
strong….

39. “Physician happiness is
inversely proportional to the
amount of bureaucratic drag
on their lives”
Doug Farrago MD

40. Executive Leadership and Physician Well-being
Tait D. Shanafelt, MD, John H. Noseworthy, MD, CEO
Mayo Clinic Proceedings
Volume 92, Issue 1, Pages 129-146 (January 2017)
DOI: 10.1016/j.mayocp.2016.10.004

41. The Unsolvable Healthcare
Equation?

42. Kobayishi Maru

43. The hero finds
the magic
formula in the
magic land to
break the
system…

45. The hero, once
headed to burnout,
emerges
transformed and
rewarded but…

46. …now others
attack, ridicule,
ignore or mock
her!

47. “I am not lucky. You know what I
am? I am smart, I am talented, I
take advantage of the
opportunities that come my way
and I work really, really hard.
Don’t call me lucky. Call me a
badass.”
Shonda Rhimes

48. Death Row Syndrome

50. “They tried to bury us. They
didn’t know we were seeds”
Mexican Proverb

51. “The reasonable man adapts himself
to the world. The unreasonable one
persists in trying to adapt the world
to himself. Therefore, all progress
depends on the unreasonable man.”
 George Bernard Shaw

52. “Stop being a prisoner of
your past. Become the
architect of your future.”
Robin Sharma

53. You are the
heroes of this
story!

56. The heroes heed
the warnings and
shares them with
others..

62. Heroes motivate
others to act…

63. What you can do:
 Fulfill your dream
 Encourage
 Evangelize
 Don’t sell out
 Be patient
 Don’t compare

64. Most importantly:
Spread the DPC
Virus!

65. Remember…

66. Heroes continue
to break the
rules, disrupt the
system and
change the
world.

68. Lee S. Gross

69. Only $20 Each
Shameless Self Promotion:
For Sale After the Talk!

70. Don’t Let This Be You

71. Find Your Balls

72. And live your life
happily ever
after.
The End