“I dream of practicing free medicine …being a Doctor, not a Provider, Gatekeeper or Service Technician”


Stewart B Segal MDFree medicine (FM) is a concept I just created in response to a comment from a reader on a recent blog post. My reader is a brilliant doc, educator and writer who serves both as mentor and colleague.

Dr. M’s comment pointed out the fact that primary care docs are already a medical bargain. While the world clamors over the ever rising cost of medical care, Dr. M reminded me that the cost of seeing a primary care doc is minuscule in comparison to the cost of chemotherapy, surgery or going to the emergency room.

FM is an old idea whose time has come. FM means being able to practice medicine as it was meant to be practiced, unencumbered by governmental and insurer rules and regulations. Yes, I dream of being able to provide the individualized care my patients both need and deserve without artificial constraints, prior authorizations, codes, etc.

FM means the ability to shelter my patients’ most private problems from the intrusion of modern day medicine’s fixation on sharing virtually everything with insurers, government workers and statisticians. While their intent may be laudable, the information amassed in the “cloud” may be used to destroy the very health we are pledged to preserve (witness the anxiety and depression of those whose data was recently stolen from a large hospital chain).

FM opens a physician’s mind, allowing him/her to be creative in coming up with difficult to make diagnoses and treatment plans. “Best practices” close the physicians mind, stressing compliance with established protocols. Heed my warning: cookbook medicine, better known as evidenced based medicine, has infested my profession and stolen our freedom to think and act as highly educated professionals.

FM means being a doctor, not a provider, gatekeeper or service technician. FM means working for you, my patient, not corporate America. Yes, I dream of being free…

…Primary care accounts for a small amount of the cost of medicine in this country. If we were free from filing insurance and Medicare claims and free from coding and accumulating meaningless reams of data, we primary care docs could reduce our fees and do what we love best: care for you, the patient, who places your life in our hands”

Over at Medpage’s Kevin MD Dr Stewart Segal MD, a family physician who blogs at Livewellthy.org, calls for Patients to join him in his free medicine movement.

I think a lot of what he’s expressing here is being felt across the world by Doctors who want to get back to working directly with their Patients as a result of the different priorities and tedious administrivia that they’ve adopted in their efforts to serve the complex billing systems of big pharma, governments and corporations.

I think it’s very revealing that within just a few hours a Patient “Suzi Q” has commented on the article: “I need a doctor that has a practice like yours. Problem is, I live in California

I’m hopeful that the adoption of consumer technologies and the modernisation of rules governing consulting across state lines is going to increasingly remove the need for Patients to be geographically close to the most appropriate Doctor and enable Doctors who are disillusioned by their new roles serving others to once again establish trusted relationships directly with their Patients…

Don Jones VP Qualcomm Consulting with 3G Doctor's Dr F Kavanagh MRCGP

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