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Dr. Young Goes to Washington

January 21, 2012

I recently had the honor and privilege of being chosen by the Center for Medicare and Medicaid services (CMS, don’t ask my why there aren’t two Ms in the acronym. I don’t know.) as a member of their first class of Innovation Advisors. I leave tomorrow to meet the CMS people and the 72 other advisors.

I got the position by applying in mid-November. My proposal was to blow up the current CMS documentation/coding/billing rules and start all over with a system that actually pays family physicians for the work we do. My project will be founded on two studies I conducted with my colleagues in the Residency Research Network of Texas. The first asked family physicians across Texas what patient care approaches they take that explains why areas with more family physicians have better health and lower costs than areas with high numbers of ologists. The second asked family physicians what they would change if they were allowed to throw away the current CMS rules and start all over. We’re still conducting interviews for this study, but I have a pretty good handle on what the major issues are.

I’m excited and nervous about this opportunity. I’ve bitched about the CMS rules for years, but now I’m thinking, “Oh crap. Now I’ve got to produce.”

The program involves some combination of CMS teaching my fellow advisors some things, us teaching CMS some things, and all of us learning from each other. I’ll make 3 or 4 trips this year and bring home lots of homework. Wish me luck!

The other exciting news is my book, American Health$care, is almost ready for distribution. It will be available in high-quality paperback and e-versions, probably in a few weeks. Here is what it will look like.




Please buy a copy and tell all your friends about how much you learned reading it!

And by the way, if the website looks funny for awhile, it just means I’m fumbling around trying to put links to my book on the site. It never works right the first time.

8 Responses to Dr. Young Goes to Washington

  1. Rebecca Coelius on January 21, 2012 at 2:24 pm

    Congrats on the Innovation Advisors Program! Can you provide a link or citation for the studies you mention re what Fam Med heavy areas are doing that make healthcare less expensive? I’m a future Family Doc with both a personal interest, and would also like to write about it on a blog.

    • Richard Young MD on January 21, 2012 at 6:11 pm


      Thanks for the kind thoughts. The literature is huge, so to get you started here is a link to the Robert Graham Center website on studies supporting the value of primary care http://www.graham-center.org/online/graham/home/publications.theme.1.html. The single best summary is the classic review article by Barbara Starfield, et al Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502.

      That should keep you busy for awhile.

    • Richard Young MD on January 21, 2012 at 6:15 pm


      I thought I recognized your name. Congratulations on being named as one of the Pisacano scholars.

      If I can put you on the spot, why didn’t you interview at America’s greatest family medicine residency, the John Peter Smith FMRP in Fort Worth, TX?

  2. Christopher Gregory on January 21, 2012 at 4:01 pm

    Congratulations Dr Young. I can say something without reservation. The healthcare thinkers in Washington should be congratulated – and perhaps warned – that a tenacious, disruptive and innovative Texas doc is coming to town.

    After a long time, I can finally think that some intelligence is arriving in Washington.

  3. Vern Denney on January 21, 2012 at 6:16 pm

    Congrats Richard. We are proud to have been a small part of your life. I know your family, especially, your parents are most proud of you. We send our best thoughts and prayers with you as you go to Washington, Dr. Young.

  4. Joshua Freeman on January 22, 2012 at 11:07 am

    Congratulations, Richard! Knock ’em dead!
    Seriously, we all look forward to seeing what the outcome will be, and what latitude they allow you.
    And I am looking forward to reading the book.
    PS Rebecca, you should also have looked at KU!
    PPS Why there are not 2 “M’s” in CMS I don’t know; it would have been more intuitive, and easier to remember the acronym, had they named it the “Medicare And Medicaid Administration”!

  5. Jake Marg, Jr. on January 25, 2012 at 1:04 pm

    Knock ’em dead! At least the family docs of Texas will have a voice at the table. Too bad you keep your thoughts to yourself. I just wish you were a little more outspoken. Maybe you can take them all copies of your book & let them know your thoughts that way. 🙂

    Give ’em hell!


  6. Robert Watkins on January 27, 2012 at 10:42 am

    Look forward to hearing about your experience. The reports on “The Health Care Blog” are very depressing.

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Important News!

American Health$care is HERE!!! Order today at amazon.com