Apple Failed at Health Care, Doctors Didn’t with Dr. Doug Farrago

There has been no shortage of people or schemes to fix the US health care industry. US medicine consistently fails to deliver quality care at affordable prices and manages to irritate both doctors and patients alike. Politicians and think tanks come up with grandiose plans every day to treat what plagues the system. Likewise, big tech companies like Apple are now entering the fray and bringing their technology as solutions.

Unfortunately for Apple (and its tech cousins like Amazon), the health space is extremely complicated and can't be solved simply using technology. Its attempt to "make it" flopped just as other ventures by tech companies have in the past. The common thread in all of those is the belief that they could replace doctors.

Doctors Make it Work, Not Expensive

A common misconception found at tech companies like Apple is that people are easy to replace with algorithms and gadgets. But humans aren't machines so you can't always predict how they will behave. Even with sophisticated devices monitoring heart rate, blood pressure, etc. that information is not useful in isolation. You must have someone who can figure out if any of the data is important based on examination, intuition, and experience that can't be found in any algorithm.

Also, the companies believe that by removing the physician, they will find the cost savings they need to cut costs and deliver an equivalent service. But anyone who has been paying attention (or looked at expenses in medicine) will find that doctors are one of the smallest parts of the cost equation. They are easily surpassed by imaging, laboratories, pharmaceuticals and the biggest and baddest of them all - administrative. Middle men and the third party payor system in general are what are driving the majority of price inflation in health care.

How to Really Solve the Shortage on Care - Hint: It's not getting rid of doctors

My guest today is Dr. Doug Farrago, founding member of the DPC Alliance, newly retired direct primary care doctor, author of books on how to start your own DPC practice, and inventor of the knee saver for catchers and the cryo helmet for sufferers of migraines and concussions. Dr. Farrago points out the most obvious flaw in the plan from these tech companies - data is only as useful as the one applying it. Just as it wouldn't be recommended to get random batteries of tests to arrive at diagnoses, accumulating massive amounts of vital signs or rhythm data  is just as useless without the context provided.

A good example is familiar to any doctor who has ever ordered a chest x-ray. When you get the reading from the radiologist, their diagnosis of the problem is dependent on the history of the patient. Maybe that fluffy infiltrate is extra fluid, or pneumonia, or blood. You need to correlate what is going on to get the most out of that film. Without a correlation, it is just a random test that may or may not be significant.

The Solution? Direct Primary Care

So what is the solution to the cost and quality problem facing primary care in medicine? Dr. Farrago (and many others whom I've spoken with here, here, here, and here) is direct primary care. The personal membership based relationship between a doctor and patient without insurance or any of the middle men allows for the best care. It is affordable and allows the doctor to use his or her intuition and clinical judgment based on their prior relationship with that patient and their previous  health history. That's why Dr. Farrago thinks DPC is the clearest solution to what is plaguing us - not some new piece of tech. Tech are just tools that the clinician can use - they can't replace a human touch, physical exam, and experience.