Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

Say no to bureaucrats and yes to direct care

Josh Umbehr, MD
Physician
May 17, 2014
Share
Tweet
Share

shutterstock_95318875

Yes, it really is time to revoke the health care mandates issued by bureaucrats who are not in the profession of actual healing.

Daniel F. Craviotto Jr. writes in the Wall Street Journal, “In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship.”

Craviotto, Jr. is a doctor who embodies the fight of direct care. How we interact and treat our patients truly is the practice of medicine. There’s a problem with the rising cost of health care. (For starters, Oregon spent over $1,000 per subscriber on just a website to sign up for coverage that might not even provide a doctor.)

And there’s a larger problem when the individual physician in the trenches doesn’t have a voice in the debate. Bureaucrats are telling doctors what they can and can’t do.

And that needs to stop.

As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. Does anyone endure the gauntlet that is a residency program — 10+ years of training — to do anything except their best work?

Yes, the demands on physicians are great, and many of our families pay a huge price for our unwavering commitment. But shouldn’t our nation take great shame in knowing fee-for-service docs tack on 2+ hours of transcription every working day just to get paid, maybe, for the work they’ve already done?

How can bureaucracy, split between so many non-practitioners, own up to the cleavage of time that it brings upon the very people working to keep our nation healthy?

When do we say damn the mandates and requirements from bureaucrats who are not in the healing profession?

How do we stand up and say we aren’t going to take it any more?

For starters, we say yes to direct care.

We say, stop, every time a doctor joins the movement, every time a doctor pledges to make that transition (and makes a plan to help their patients through it).

We say it every time a patient says, “Give me affordable primary care.”

We say, stop, when we cut the red tape: Offer affordable services for cash, make insurance something that’s only used in real emergencies, and render EMR regulation and meaningful use incentives null and void.

The Centers for Medicare & Medicaid Services do say that fee-for-service docs have to use an EMR or they’ll be penalized with lower reimbursements in the future. Some meaningful use criteria from Medicare tell physicians what they need to include in the electronic health record or they won’t be subsidized the cost of converting to the electronic system and we will be penalized with lower reimbursements.

Meanwhile, keep in mind: EMR vendors are raking in the dough and saving us nothing.

Meanwhile, across the country, fee-for-service doctors waste precious time filling in unnecessary electronic record fields just to satisfy a regulatory measure.

Is that the best use of time for a highly-trained individual?

Physicians are tired — tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way they practice medicine.

And as we know, physicians top the list of professions with the highest suicide rates.

Yes, we’re irrational humans. But we’re doctors, too. So let’s be scientific — saying that EMR machines are literally making doctors kill themselves is a stretch. But, if we have the data that says, “We work in a profession where suicide is common, and we promulgate activities that are totally meaningless, i.e. hours of transcription that could be spent with loved ones,” how is this ethical?

No other profession would put up with this kind of scrutiny and coercion from outside forces.

The legal profession wouldn’t.

Labor unions wouldn’t.

So why should we?

Josh Umbehr is founder, Atlas.md.

Image credit: Shutterstock.com

Prev

Before treating physical pain, address the emotional one

May 17, 2014 Kevin 0
…
Next

Medical students: Hold each other accountable for your relationships

May 17, 2014 Kevin 1
…

Tagged as: Primary Care

< Previous Post
Before treating physical pain, address the emotional one
Next Post >
Medical students: Hold each other accountable for your relationships

ADVERTISEMENT

More by Josh Umbehr, MD

  • Gain time by slowing down with your patients

    Josh Umbehr, MD
  • Direct primary care: Being different is the biggest asset of all

    Josh Umbehr, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Obesity is a disease: Does that change the way doctors practice?

    Josh Umbehr, MD

More in Physician

  • The ticking clock: How time constraints in medicine hurt patient care

    Timothy Lesaca, MD
  • “The only thing that will change will be our name”: a private equity cautionary tale

    Anonymous
  • Leadership in action: How a broken pager fixed a hospital

    Ronald L. Lindsay, MD
  • Profits before patients: the hidden cost of U.S. health care

    Dr. Shantanu Rai
  • Why maintenance of certification varies widely: a system in crisis

    Brian Hudes, MD
  • AI governance in health care: Why physicians must lead the design

    Tod Stillson, MD
  • Most Popular

  • Past Week

    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Learning from patients: How a physician gained strength and resilience

      Samantha Fernandes, MD | Physician
    • Early screening saves limbs from silent vascular disease [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
  • Recent Posts

    • Informed consent for premeds: Is a medical career worth it?

      Michael Minh Le, MD | Education
    • The ticking clock: How time constraints in medicine hurt patient care

      Timothy Lesaca, MD | Physician
    • Insulin resistance is not a disease: a metabolic reframe

      Kevin Whitt | Conditions
    • Understanding Moore’s Law and the exponential growth of technology

      Richard A. Lawhern, PhD | Conditions
    • From glucose to vascular health: the future of diabetes care

      Palma Shaw, MD | Conditions
    • “The only thing that will change will be our name”: a private equity cautionary tale

      Anonymous | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 211 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Learning from patients: How a physician gained strength and resilience

      Samantha Fernandes, MD | Physician
    • Early screening saves limbs from silent vascular disease [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
  • Recent Posts

    • Informed consent for premeds: Is a medical career worth it?

      Michael Minh Le, MD | Education
    • The ticking clock: How time constraints in medicine hurt patient care

      Timothy Lesaca, MD | Physician
    • Insulin resistance is not a disease: a metabolic reframe

      Kevin Whitt | Conditions
    • Understanding Moore’s Law and the exponential growth of technology

      Richard A. Lawhern, PhD | Conditions
    • From glucose to vascular health: the future of diabetes care

      Palma Shaw, MD | Conditions
    • “The only thing that will change will be our name”: a private equity cautionary tale

      Anonymous | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Say no to bureaucrats and yes to direct care
211 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...