Mon. Sep 27th, 2021

In one of the most non-stories we have ever published, it was discovered that:

Primary care practices with zero burnout are more often solo practices owned by physicians and practices not involved in transformation initiatives, such as accountable care organizations (ACOs), according to an analysis published today in Health Affairs.

This study did not say if DPC practices were surveyed but most likely not because their definition of workload included such as seeing a large amount of patients and dealing with insurance companies.

It was also surprising, Edwards said, that practices with some of the heaviest workloads ― solo practitioners juggling large numbers of patients, insurance plans, and regulatory requirements ― were much more likely than larger practices to report zero burnout.

Imagine if they did study DPC? The study author may have had a heart attack because he seems so excited with the results he got already.

Here are some take home points from the Medscape article:

  • He says in small offices, there may be a stronger sense of agency, a sense that everyone is on the same team, and there may be stronger relationships with patients.
  • Organizations that participated in ACOs and other external primary care transformation projects were more likely to have high burnout rates.
  • By contrast, burnout may be higher in health system–owned practices because clinicians may feel they have less control over their work environment and feel a loss of autonomy, according to Goldberg.
  • At the same time, “Having agency at the practice level about how things work is really important in reducing burnout. So in a large system, finding ways to promote agency at the most local level possible can really help with burnout,” he said.

You are going to see that word agency a lot. It means ownership and skin in the game. It means not working for the man. It means a feeling of control over your destiny.

I would expect the big hospital employers, the large medical corporations that keep proliferating, and all medical administrators associated with these groups to try to and hijack that word. Don’t let them.


20230cookie-checkIt Turns Out That Many Solo, Physician-Owned Practices Have Zero-Burnout. Who Would Have Thunk It?

By Doug Farrago

Douglas Farrago MD 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. 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. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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