The history of American medicine in 2 minutes. What happens at 1:31 will make you sick.

Once upon a time you could see your trusted family doc right in the neighborhood with house calls and all the attention you needed. Then big-box clinics bought up all these cute clinics and moved these sweet doctors to assembly-line clinics. Now doctors are like factory workers and patients are just widgets.

Great news! Solo docs are coming back to a neighborhood near you. . .

If you’re a doctor who wants to leave assembly-line medicine and bring ideal care to your neighborhood, here’s a free guide to launching your dream-come-true clinic. Questions? Please contact me. I promise I’ll call you back. I’m so excited to see all these cute clinics again! 🙂 Yay for all of us.

Pamela Wible

Pamela Wible, M.D., is a family physician and founder of the Ideal Medical Care Movement. She loves helping docs get back to being healers, not factory workers. If you need more help, come to our physician retreat.

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24 comments on “The history of American medicine in 2 minutes. What happens at 1:31 will make you sick.
  1. shanhong Lu says:

    I found a few physicians are willing to stick around. One cardiologist got hired by VA and was singing the praises.

    • Pamela Wible MD says:

      Goal is for doctors not to stop being victims. Some employers are better than others. Physicians should certainly be exposed to all models of care (not just production-driven, high-overhead, high-volume offices)

      • Latanza says:

        Yes, I believe in a lot of cases with doctors they’re are victims to being bullied by others. And I also know some doctors live by a code to protect one and another know Matter what right or wrong. I recently just watch the unbelievable happen right before my eyes. Saying it’s know way the doctors I’ve been counting on all my life has been protecting wrong it was like naw let me look and see who is real and who ain’t. My situation with having murcery inside my mouth from a kid and being 37 years old going in the dentist office un aware that I will be walking out with damage nerves I was not aware of the situation and to become so ill and not know what is going on with you and to find out a main nerve has been damaged and to see how many folks slammed there door was a nightmare on elm street. I could not believe I had all these tests ran an people lying saying this test is missing out of slobber when I made sure I sent this in. The right way I’ve been lied to and I know it is something wrong and it’s like who can you really trust in this day of time it’s hard when you find out the world you live in is a big lie.

        • Pamela Wible MD says:

          I am so sorry Latanza. Looks like we have all been lied to. Time for patients and healers (docs, nurses, all in health care) to unite and take back this beautiful profession so nobody else is injured by this uncontrolled greed and fear-driven “health” system. This is not what medical students signed up for when they paid 300K tuition to be a doctor. Such a tragedy.

  2. Greta Shames-Dawson says:

    Dear Pamela,

    While not a physician myself, I am privy to that which you address not only in this video, but your overall perception of the state of our medical system, its deleterious effects on both the practitioners and their patients and your perception of the change(s) needed. I laud you for what you have done and are doing to confront and righten these horrific wrongs. I think of your father and of how proud he would be/is of you.

    With gratitude and respect,

  3. lale says:

    My mother’s geriatric pcp had grown weary of seeing her growing number of non-ambulatory patients struggling to make arrangements to get to her office for their appointments and even more weary of watching how difficult it is for them to move about. So she made the most loving decision about 1.5 years ago to leave her flourishing practice to become a home visiting pcp for her non-ambulatory patients. My mother, who thankfully is ambulatory,begged her doctor to keep her as a patient because she couldn’t imagine trusting anyone else with her healthcare. Needless to say, my mother sees her doctor and/or her pcp’s P.A. God bless my mom’s pcp for going old school style. She’s more satisfied with her healthcare practice now than she was before.

  4. Karen says:

    Thank you, Pamela. You brought memories of our family doctor in a small town in the midwest. Of course, we were friends. Mary, the Doc Fleener’s wife, was a character. She would come out in her fabulous dresses, red lipstick like you…..w/ a Kleenex stuck between her boobs. I would be mesmerized and impressed. One never knew what she would say. I couldn’t wait.

    Now that you have gotten me to think about it, she was a true healer. She’d make me laugh. I remember one day, my older sister said, “Mary, you look lovely, have you lost some weight?”
    Mary being Mary, turned and looked behind her on both sides, saying appallingly, “Why, no…I certainly hope not.” I knew at that moment that healing had to address body, mind and spirit.

    Thanks for your little assignments. I’ve been so out of touch w/ allopathic medicine, I didn’t *see* what was happening. My neighbors tell me they use what they called “doc in the box” clinics. I didn’t know what they were talking about until it was explained.

    You’re right….it’s tragic. My hometown in the Midwest still has a holistic clinic and the PA will visit my 93 year old mum. I’m so appreciative.Maybe we need to brainstorm more “distribution” streams for your work but I’m wondering then, when would you sleep? 😉

    Phil Knight from Nike just gave Stanford U millions of $$$. Maybe they’d like to buy new curriculum for their med school. Wouldn’t that be nice?

    • Pamela Wible MD says:

      Yes! That change in medical education curriculum is coming! Mark my words.

      Current health care delivery model is a failure. From chapter 31 in my my Pet Goats & Pap Smears

      Chapter 31

      Factory-Farmed Physicians

      I was once a factory-farmed physician. Then I escaped and invited patients to design an ideal clinic. Now physicians nationwide are doing the same, leaving their jobs to create more ideal, patient-centered practices.

      Maybe the term factory-farmed is too strong. Then from what precisely did we escape? To find out, I invited hundreds of free-range physicians to participate in an “antonym contest.” What’s the reverse of patient-centered care? What’s the opposite of an ideal clinic? Here’s what docs who got away report they’ll never try again:

      Assembly-Line Medicine
      Production-Driven Health Care
      Meat-Market Medicine
      Drive-By Office Visits
      Take a Number
      Cattle-Car Clinic
      Revolving Door Practice
      Freeze-Dried Med
      One Size Fits None
      Here’s-Some-Meds-Now-Get-Out Medicine
      Premature Consultation
      Treadmill Medicine
      Rat-Race Medicine
      Boot-Camp Medicine
      Primarily-Don’t-Care Provider
      The Doctor-Patient Unrelationship
      Please-Stand-Behind-Our-Bottom-Line Clinic
      Shrink-Wrapped Care
      What Drive$ Our Care?
      We Provide: You Survive
      Hamster-Wheel Medicine

      And the winner? Fifty bucks goes to a physician in Florida for “Treadmill Medicine.” A big thank you to all docs who are demonstrating how to get off the treadmill and care for our patients—and ourselves.

  5. Julie Greene says:

    I was laughing, for two reasons. Number one, I couldn’t agree more. Last I remember of Boston, the clinic where I’d seen my doc ten years was suddenly asking for photo ID’s of all patients. I recall seeing docs who spent 99% of their time staring at computer screens and tapping. Months later, at my very last medical appointment in Boston, I recall zero percent touching, and zero eye contact. After I left the “doctor’s” office, I realized that prior to my entering his office, the secretary had undoubtedly handed him the incorrect patient record and he’d based his entire “commentary/lecture” to me on someone else’s blood levels. What did it matter if I’m only a number?

    Pamela, what you are doing is vital, so keep it up. In my opinion, we all need to speak up. We can no longer sit back while humans are morphed into numbers, as history tells us that doing so invariably leads to genocide.

    Yes, we can stop it, mostly on a personal level by working in our personal lives as you are doing from the ground level. We can be the example ofs of treating people as people. Showing the world that We Can Do This, we don’t want to be classified and numbered any longer.

  6. LN says:

    What about us specialists that are in fields where we are beholden to the hospitals due to the cost of our equipment? And have no primary care training. e.g. Interventional radiologists, radiation oncologists, nuclear medicine. We are often abused and misused by “the system” and feel extraordinarily trapped as we have nothing to fall back on and nowhere to go.

  7. Gayle Esposito says:

    It seems doctors are seen as profit centers and patients are seen as revenue streams.

    • Pamela Wible MD says:

      The predictable result of uncontrolled capitalism on our humanity and the “industrialization of the healing arts.” (that last phrase doesn’t even sound right though that is exactly what has happened here).

  8. Jed Diamond says:

    Pam, Thanks for leading the way back to real healing for real people by real doctors who care working in old fashioned way (and when we do, we won’t need many spoonfuls of sugar for this kind of medicine).

  9. Nancy Morgan says:

    My husband and I returned from an extended mid-career sabbatical in 1994 to find that the decision-making process had been transferred from doctors to third-party payers in our absence. After several faltering attempts to regain control of our ability to help patients, we bailed from our last university-controlled practice and established a private practice in a bedroom community of Seattle, sans ANY contracts with private insurance, Medicare, or Medicaid. Instead, we established a direct patient care practice (better known as a “concierge practice”, although our original prices topped out at $90 a month, hardly for the rich and famous!) That was in 2001, and although the coincidental occurrence of the 9-11 disaster seemed to inhibit people from deciding to “think outside the box” so that our growth seemed inhibited, we are still doing it and would not go back to insurance-based practice for anything. We will never get rich at this, but that was never really the goal. We wake up ready to put all out energy and passion into helping one patient at a time, and we go home at a rational hour, knowing that we gave every patient exactly what they needed that day, and had time to hug them on their way out.

    Don’t waste any more time being held back by fear. Find what it takes to reclaim your passion for medicine. Leave the rat-race without leaving medicine!

  10. Nancy Morgan says:

    As regards the recent question about what to do when an application for privileges or licensing specifically asks if you have ever had “mental illness”, why not just leave that question blank? If the agency responsible questions why you did that, just remind them that the question is not legal. If all doctors, regardless of their own mental health history consistently refused to answer this inappropriate question, these agencies may get the message and change their application, or at least mark that question “optional.” Most of us have forgotten the effectiveness of good passive-aggressiveness.

  11. Charley Johnson says:

    Cute and sad at the same time. How in the world did it come to this. Like a fantastic doctor friend of mine once told me: “some patients need 15 minutes and some patients need an hour and if you’re not giving them that time you’re doing a great disservice”. He gave each patient his very best and undivided attention. We ( the staff and I) would get upset when things were backing up but he always worked at his own pace and his patients and all of us just loved him. Definitely old school and absolutely one of the most compassionate and very best doctors I ever worked with. This is for you Dr. “B.” Charley
    P.S. I’m almost finished with your book, Pamela, but had to stop for a few days after Kaitlyn’s chapter.

  12. James M. Kenyon says:

    This is the way it is at this time, and its a shame too, for we are on the verge of having a great medical system, filled with Dr. who are willing and able to do some good! I support Dr. Wible`s idea of a person centered medical clinic. Thank you Dr. Wible for all your doing for humanity!

  13. Angela Golden says:

    Many nurse practitioners have been doing this for many years, quietly serving their communities with small “ideal” health care :). Not just our physician colleagues understand that our neighbors need the care that we can all deliver. It will take us all to bring healthcare back to America I believe. Thanks for bringing this information forward.

  14. rhahma yulia says:

    I want to ask, what is the ideal medical care movements?

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