“Total Patient Autonomy” concept clinics supported by GOP frontrunners Christie and Paul


Chris Christie and Rand Paul, two frontrunners for the Republican nomination for president in 2016, have combined recently to spearhead a new campaign for freedom of choice in medical care. Expanding on their recent views about freedom of choice in vaccines and incorporating their libertarian rhetoric, they have championed their own medical care concept where the patient, not the advanced medical practitioner, gets to decide literally every aspect of their care.

The initial iteration of this “Total Patient Autonomy,” aka TPA, initiative has applied only to urgent care/ED environments, but they hope to expand into primary care at a later date.

The process works like this. Patients enter the clinic and mention their chief complaint to the triage nurse. They are then handed a sheet with checkboxes for labs, radiology studies, and medications typically recommended for their chief complaint. The patient then checks off what they want to order. Once the testing is done, patients get the results and decide what to do with the information. For a $300 fee, they could consult a physician or PA/NP who will be sitting nearby as to their recommendations, and decide how to proceed. If admission is desired by the patient, this could be facilitated.

Louis Dublokeney, 67, of St. Cloud, MN recently visited a pilot version of this clinic concept and came away impressed. “I came in with this awful chest pain. I checked off the list they gave me which included something called a ‘troponin’. I didn’t do no EKayGee [sic] because I heard on Dr Oz that electricity causes cancer. Anyway, the troponin was like 80 or something. I googled that it was a heart enzyme or something so I figured if it was that high my heart must be doin’ real good! I left happy that my heart was in good shape and I didn’t need to pay no doctor!”

Cletus Moss, 43, of San Bernadino, CA recently visited a site and was equally impressed. “I had this back pain for, like, 2 years. I don’t see no doctor because they don’t understand my body like I do and I needs my Dilaudid. Anyway, I came in and they handed me a sheet for back pain and I checked the box for a Dilaudid PCA. Since I recently lost my disability check and got kicked out of my apartment, I figured I’d stay in the hospital until my pain was better and I could find another place to stay. I’ve been pushing that button every few minutes for, like, 3 days. I feel a lot better. I think I’ll find a hotel in a few weeks when I get around to looking. Meanwhile, I feel great and my satisfaction couldn’t be higher”!

Finally, Jane Poppycock, 33, of Farmington Hills, MI shared her story, “I had this cough and stuffy nose for the last day or so. I walked in, checked off the ‘Levaquin’ box (since Z-paks are never ‘strong enough’ for my stuffy nose), got my prescription, and I was out in 2 minutes! This place rocks”!

Mr. Christie commented for this story, “We need to allow people to exercise their basic freedoms without being constrained by medical bureaucrats and their elite, liberal, ‘formal training’ agendas. These clinics are the start of a revolution in healthcare that will replace the socialist Obamacare with an improved ‘patient-centered’ system.”

Dr. Paul was not available for comment. His chief of staff relayed to us that he had contracted measles and was at home recuperating.


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