A local physician has come up with a sort of Mad magazine for doctors.

AUBURN – Doctors who prescribe a healthy dose of humor for patients seldom get enough of it themselves.

But that’s not the case with the family physician who publishes the Placebo Journal, a bimonthly magazine he hopes will help doctors keep their sense of humor while battling what he calls the “Medical Axis of Evil:” drug companies, HMOs and medical malpractice insurers.

“I’m doing this absolutely out of fun. This is my therapy,” said Dr. Doug Farrago, who launched the magazine in 2001 to point out all that’s wrong with medicine and to have a few laughs along the way.

The publication is a vehicle for foxhole humor aimed at practitioners who are no strangers to tragedy. Farrago, who has 2,500 patients, diagnoses a terminal cancer each month.

“You have to be Robo-Doc to deal with it. You have this emotional shield. The only way to re-humanize yourself is to laugh and vent,” he said.

With a circulation of 5,000, the Placebo Journal is believed to be the nation’s only humor magazine targeted at physicians.

Some describe it as Mad magazine for doctors. But instead of Alfred E. Neuman, the mascot is a skull with Groucho glasses, nose and mustache.

Lighten up, already

Farrago, a native of Long Island, N.Y., believes doctors need to lighten up. It’s not only good for doctors, it’s good for their patients. “A doctor who’s relaxed and has a sense of humor gives better care,” he said.

Playing off a holiday standard, the December edition featured on its cover “It’s a Wonderful Physician’s Life” and offered a different spin on a memorable line: “Every time Daddy’s pager goes off, an angel gets his wings.”

Other features included “Stupid Pharmaceutical Tricks,” the “X-ray Files” featuring unusual X-rays and, of course, “True Stories from Medicine.”

The president of the American Academy of Family Physicians agrees with Farrago on the need for doctors to maintain a sense of humor.

Family physicians have one of the highest burnout rates, and one of the reasons is that they take themselves too seriously, said Dr. Michael O. Fleming, a family physician in Shreveport, La.

“It’s my opinion that having a sense of humor and being able to laugh and smile is absolutely critical – I couldn’t work without it,” he said.

The magazine contains no advertising. It’s funded through subscriptions and with profits from a device he invented called the Knee Saver, which reduces stress on the knees of baseball catchers.

Farrago’s humor goes beyond the written word. It erupts early and often in the Auburn family practice Farrago shares with three other docs, Ray Stone, Carolyn Kase and John Comis.

The four are reminiscent of the “Seinfeld” cast during their daily lunch break at Dunkin’ Donuts. Nothing is off limits and the laughter is infectious as they blow off steam and crack jokes.

On a recent afternoon, Kase offered a commentary on her slender build by suggesting she needed “butt implants.” The others joked about the size of Comis’ head and his failure to pass an Army physical fitness test.

Some of the magazine’s jokes originate here.

Talk of the popular Atkins diet turned into a spoof called the “Fatkins Diet” – all-fat, of course. The four also swapped suggestions for a parody on The Learning Channel’s popular “Trading Spaces,” called “Trading Cases.”

Farrago, who sees himself as the Seinfeld of the group, will decide whether those jokes make it into a future edition.

Clues to Farrago’s wackiness abound in his office.

There is a golden bust of Elvis, a framed picture of Walt Disney, a Three Stooges cookie jar and a crown made from speculums. He has a few Disney character masks that he wears to make children smile, but cautions that he’s no Patch Adams.

Much of the humor in the Placebo Journal is dark, focusing on pharmaceutical companies and their “reps,” the constant threat of lawsuits, narcotics-seeking patients and endless paperwork for insurers.

He strikes back by making fun of it all.

‘You’re not alone’

Dr. Amber Tyler, a resident at the University of Nebraska Medical Center, said the Placebo Journal hits upon the realities of modern day doctoring.

“Burnout does set in early and I was born jaded. I’m six to seven months into my residency and I’m already fried. It’s a great thing to sit down and read and laugh and realize that you’re not alone,” she said.

Another fan is Tess Gerritsen, M.D., the best-selling author of medical thrillers including “Harvest” and “The Surgeon.”

“It’s almost a guilty pleasure reading that thing,” Gerritsen said. “I feel a little bad about it because some of the humor – it’s the kind of humor you don’t want your patients to know you’re reading.”

Few things are sacred but there are some ground rules: Stories must be true, patient confidentiality cannot be violated, and no story can involve harm coming to a patient.

From there, the sky’s the limit.

The material is often crude, but it’s the stuff doctors deal with daily. Also popular are the phony ads like one for “OxyCotton Candy,” which takes a poke at OyxContin, a painkiller that has been abused by patients.

Then there’s “Nordart,” a contraceptive dart doctors can use on patients who have children but shouldn’t; “Cyanara,” a weight-loss drug that’s 80 percent cyanide; and “Indifferex,” a mediocre anti-depressant.

Some doctors have been offended, but others love it.

Farrago, who’s 38, makes no apologies.

“We’ve been called sophomoric,” he said. “I’m proud of being sophomoric.”

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