Wednesday, February 10, 2016

Cultural Development of DPC: Pure, Mixed and Hybrid

Here's the overview of my BTR Show from Tuesday February 9, 2016. I review several definitions of culture and several models about cultural structures and functions from an interesting outline from Texas A & M University.  Here's the link to the DPC Ohio UnSummit Agenda and registration forms --to be held on February 20th: DPC Ohio UnSummit
Direct Primary Care is growing and groaning.  What drives it?  What goes into the development of the DPC culture? Is there a culture of DPC?  "A culture is a way of life of a group of people--the behaviors, beliefs, values, and symbols that they accept, generally without thinking about them, and that are passed along by communication and imitation from one generation to the next." one Internet definition.
Models of DPC include "Pure", Mixed and Hybrid.  I'll define Mixed during the show.  
Who is doing it and how does it come together?
The DPC Summits help to anchor the movement.  July 8-10 in Kansas City is the next national one.
Our Ohio UnSummit seeks to help with the development of the Ohio DPC culture.  I'll discuss the UnSummit (Feb 20th in Dublin, OH) and shamelessly promote it during the show.


Click Here to listen: Cultural Development of DPC: Pure, Mixed and Hybrid

Sunday, February 7, 2016

Payment Reform is Costly and Misguided: Except for Direct Primary Care

Some of my thoughts after reading the Health Affairs Blog about the Conundrum explained in the link below.  We're headed toward a government only health system. Now doctors get incentives to be employed, penalized to remain in a Fee for Service model (which has been twisted to maximize profits for employers of physicians, which only took 9% of GDP with mostly independent physicians while now,  with mostly employed physicians, it's 18% of GDP- read the comments with the article, too, they're very thought provoking and no one starts name calling- they politely give their opinions).   The mandated models aren't proven, cost more in reality, are only successful where prices had been extremely high, drive physicians into becoming shills for industry and are ignoring Patient Autonomy- one of the principles of medical ethics, other than that they feel good to many non-physicians.

This will probably be my last year in any insurance plans.  I have a Direct Primary Care Track (called Direct Family Medicine the way I do it).  That new part of the practice is called Neighborly Family Medicine.  We're open for uninsured families in our Beavercreek office.  Those who can act should act in the next couple years.  None of this is fast, but it's deadly.

Over-testing is almost mandatory as is over-prescribing for so-called quality bonuses.  Physicians of 90 year olds are starting them on statins in spite of no scientific support to do so and knowing that cognitive dysfunction is one of the side effects of statins that every Family Physician has seen.  We're (The Medical- Industrial Complex) in a steady decline for medical quality and shamelessly bankrupting America in the name of "Quality".  I see evidence of this daily.  Daily. Not in a philosophy column by a health planner or government official or a political rant, but in person in my medical office daily.

Health Policy and Payment Reform Conundrum

Sunday, January 31, 2016

Biographic Information on Dr. Synonymous

Dr. Synonymous is written by A. Patrick Jonas, MD ABFM.
Someone asked for some information to introduce me, A. Patrick Jonas, MD, for a presentation.  I started to make a few notes, then noticed that it was a bit long.  So I wrote a shorter version and then an even shorter version.  Here are all three sets of information.  I decided to post it on the blog so those who are interested can read it and most can ignore it.  Believe it or not, I left out a lot.

Brief option for introduction:  Dr. Jonas is a Family Physician with a vast array of experience, including about 190,000 patient encounters.  He's still having fun.

Short option on the introduction:  Local origins to West Point to Vietnam flying helicopters to OSU COM to Penn State for Family Medicine training to practice in Granville adding college health and sports medicine at Denison U before a full time faculty stint at OSU then Kettering Medical Center as Director of Family Medicine Education followed by another private practice in Beavercreek from 1999 to present, with the addition of Open Arms Health Clinic in Bellbrook.  Still having fun as a Family Physician. And a social media geezer.  And picking the banjo and playing the didgeridoo.

My background longer form:
I'm a Holistic Family Physician and Scholar practicing in Beavercreek in Family Health Connections, Inc., a practice that I own, and the Free Clinic in Bellbrook- Open Arms Health Clinic - in which I'm Medical Director and Board President of the all-volunteer 2 year old adventure (now also supported by volunteer members of AED).

I grew up in Liberty, a town of about 80 people, counting dogs and cats, eight miles west of Downtown Dayton, went to Jefferson Township High School, then graduated from West Point in 1968 followed by Army Ranger, Airborne and Rotary Wing Aviator schools and a free trip to Vietnam where I flew helicopters supporting the Army Corps of Engineers (which was my Army Branch).  After two years as an aviator and small unit commander at Ft. Riley, KS, I went to OSU College of Medicine on the three year track in the class of 1976.  Chocolate then called me to do my Family Medicine Residency in Hershey, PA at the M. S. Hershey Med Center of Penn State University.  The Three Mile Island nuclear reactor partial melt-down helped with our decision to come back to Ohio to practice in Granville, home of Denison University, for 11 years.

Private practice, clinical precepting at the OSU Department of Family Medicine weekly, doing college health and sports medicine for Denison- where I was Medical Director of the health center and Head Team Physician for 11 years -  was followed by full time faculty status at OSU in 1990 to restructure the Department of Family Medicine when regimes changed.  We succeeded so well that OSU was named one of the top five primary care med schools in the nation two years in a row by US News.  OSU was so surprised that they dismantled the leadership of the department in 1994 and I came to Kettering Medical Center to develop Family Medicine Training affiliated with Wright State.

When regimes changed there, I started the current practice in Beavercreek and picked up an array of holistic skills which complement traditional Family Medicine, including Reiki, Aromatherapy, Reflexology, Holistic Chair Massage, Non Directive Imagery, Neurolinguistic Programming, Sound Attunement Therapy, and others.

For 35 years, I've been a Family Fanatic, still owning the only practice in Ohio that only takes families.  Yes, the whole household signs up, making the Human Genome a daily activity in my practice - and now we're playing with the Microbiome.  And we have fun. 

Halfway through helicopter training, I was smart enough to marry a mid 1969 UD graduate who I knew since the eighth grade.  We have three sons, two of whom are physicians- a hospitalist at Ohio State and a Medical Faculty at UNC in Chapel Hill, NC who is director of their Center for Evidence Based Practice and member of a pharmacogenomics research team.  The oldest son does billing, coding and business activities in my practice which my wife coordinates.

I pick the banjo, write songs, sing in the church choir and just started to lead the men's group at the Bellbrook United Methodist Church. I was named one of the top 20 Family Physicians on Twitter by Medical Economics Online.  I am a social media geezer with two blogs, a weekly internet radio show, four facebook pages, and a few YouTube videos of some of my songs.

I'm also active in medical leadership having served as the President of the Ohio Academy of Family Physicians and currently as the Greene County Delegate to the Ohio State Medical Association House of Delegates.  I'm rounding out with a state and national leadership role in Direct Primary Care, a business model that eliminates 40% of the cost of overhead for primary care physicians, giving them back the dream of serving patients in a way that both patient and doctor deserve.

I'm still having fun, and you can have fun, too. I care deeply for my patients.  I get to laugh daily and cry weekly.  (How much you care is how much you can hurt).

I love what I get to be and do.

Thursday, January 28, 2016

Direct Primary Care Secrets (Time and Relationships)

My BlogTalk Radio Show January 26, 2016:  DPC Secrets
Dr. Pat Jonas, your host on the Dr Synonymous Show, will discuss Direct Primary Care again focusing on some DPC secrets that make it appealing.  Time, Time, Time.  Expanded Differential Diagnosis.  Depth of personalization.  Even genomics.  Even eating strategies. Time, Time, Time.
Eating for Health.  Learning from Dr.'s Davis and Perlmutter.  Probiotics:  Eating microbes to seed the intestinal flora and Prebiotics:  Fiber that feeds our intestinal flora.  What is it? Why is it important?
Dr Jonas will also comment on the DPC Ohio UnSummit IV to be held in Dublin, OH on February 20 from 8:30 until 4:30.  We'll have some fun learning and sharing about DPC.
Blog and Tweet Review as usual.  Connect in our chat room.

Wednesday, January 27, 2016

The War and The Wall and West Point

Forty-three years ago today, the Vietnam Peace accords were signed and there was a cease fire.
Here's President Nixon announcing the peace:
Nixon Peace with Honor Speech


As a Vietnam Veteran, I reflect on my experience and our nation's experience in Vietnam.  I write about it every year.  I read about it five or six times a year.  I look at two shelves worth of books about Vietnam in my home office every day and think briefly about the war and its meaning.  And the twenty members of the West Point Class of 1968 who died in the war.  Their names are on The Wall.

The War, The Wall and West Point.  The confluence of many lives and deaths.  The sources of deep, intense meaning.  The origins of human connections that last forever.

Who has the answers?  Who has the questions?

It goes on and on.

I pray for peace in the hearts of all involved and affected by the "Conflict" in Vietnam.  Amen