Saturday, August 13, 2016

Physician Burnout: More than Half!?

I'm listening to a presentation about this topic at the Ohio Academy of Family Physicians Annual Members Assembly in a room full of brilliant people- Family Physicians. Are 63% of them burned out, as the Mayo Clinic study indicated in 2015?  If so, how does that impact their ability to help people?  To lead an organization?  To innovate enough to find solutions to health care problems and physician burnout?

Practicing Family Medicine is an incredible privilege.  It's still fun.  Medicare administration and other insurance administrative overload is killing it for more than half of family physicians.

Many physicians are looking for relief.  Mostly in the wrong place, since more are getting burned out (was 51%, now 63%).

Is there hope?

Thursday, August 11, 2016

Thankful and Grateful: Practice Makes Perfect

I thank God frequently.  I'm thankful for the blessings I've received.  I'm grateful for parts of things. I'm grateful for people.
Even this computer--I'm grateful for it.
I practice being thankful and grateful, which may lead to improvement.
I'm even grateful for "Yes, But" .people, as long as they speak in the middle of a meeting and not the end.

And flowers, music and children.
And old people.  And the republicans and the democrats and Hillary and Donald..I'm  thankful.

What about you?

Wednesday, July 27, 2016

Departure for Vietnam 46 Years Ago

It seems like a long time ago, because it was- 46 years ago today, I left for Vietnam.   Forty-five years ago, I came back- changed.  Connected permanently to a phenomena-  Vietnam Veteranhood.

I Am A Vietnam Veteran.

I wear a hat to remind me and you of Vietnam Veteranhood.

Vietnam Veteran 2016

It means a lot to me.  The Wall comes to mind.  The mirror speaks.

It reminds me of Phu Bai, where I was stationed initially in Vietnam.

A poem/song came from it:

Lately I've Got Phu Bai on My Mind

Lately, I've Got Phu Bai on My Mind 
                                                    by CPT Pat Jonas 45th Engr Gp
                                                                    Aviation Section

Lately, I've got Phu Bai on my mind
Thinking now of all we've left behind
Like friendly fire and innocence
And fears that won't unwind

Lately I've got Phu Bai on my mind
Black smoke blowing gently in the wind
Mortars stopped the card game my first week in the war
Winning hand in High Chicago went right out the door

Lately I've got Phu Bai on my mind
Mortars weren't being very kind
Diving in the bunker just outside my hooch
"Our Father Who art in heaven", coming from my lips.

Lately I've got Phu Bai on my mind
All clear sounds, let's get back to my hand
No one cares to sit back down
A buck of my winnings is gone.

Lately I've got  Phu Bai on my mind
Blowing Agent Orange dust into the wind
Flying out to Rakkassan, Tomahawk and Nancy
Visiting our  Engineers, nothing really fancy.

Lately I've got Phu Bai on my mind
Floor show, Cold Duck mixing really fine
Flying to the DMZ to let off Donut Dollies
Rolling on the River mixes well with Buddy Holly

Lately I've got Phu Bai on my mind
Navy tried to make me land downwind
Ducking friendly fire at Khe Sanh and beyond
Bridge Over Troubled Water on AFVN.

Lately I've got Phu Bai on my mind
Cross the river down the coast again
Flying low along the beach- beautiful clear water
Calling into Castle base weather getting hotter.

Lately I've got Phu Bai on my mind.                        

Now back in Ohio.  Being a Vietnam Veteran.




Friday, July 22, 2016

Family Medicine: This is Still Fun! (After 40 Years)

I'm in my office Friday morning.  I get to see these fascinating people and help them and learn from and about them and the contexts for their lives.  It doesn't get any better than this.
A child for Pre -op physical, two patients with rare diseases, evaluation after auto accident, lumbar disc disease with back pain, insulin dependent diabetes for more than 50 years, poison ivy, allergies, sinusitis, chronic low back pain, plus four more acutely ill people who will call in this afternoon.

Storm just started.  Heat index over 100 tomorrow, breathing problems expected.

Still having fun after 190,000 patient encounters and 40 years.

(I just have to re-align the dominant business model that we use and relate to.  Insurance is something to think about eliminating in favor of Direct Family Medicine.  We are meeting with other physicians to discuss the Direct Family Medicine model further for Greene County.)

Saturday, July 9, 2016

Now the Morphine


Mom is getting a bit “gaspy” with her breathing.  Occasionally, she coughs.  She frequently breathes fast, but claims to have no breathing problems.  The Hospice nurse gave her another dose of morphine today to help her get through all the movement associated with her bathing and changing from the Aid who came a bit later.  Mom was very relaxed five hours later and breathing more comfortably.
The morphine will help her to relax and breathe easier more and more often over the next few days as it becomes harder to breathe and harder to relax due to the congestive heart failure and recurrent micro-aspiration of food and liquids into her right lung.  She has no complaints, though.
We the living or We the survivors have more problems than she does.  She has no worries or stressors anymore.  Her mind seems to be dissociating from her weakening body, not noticing its maladies.  Heading toward the end.  Still on course, on glidepath toward her heavenly future.