Tuesday, October 22, 2013

Direct Family Medicine: Beavercreek, OH Update

Family Health Connections, Inc.   Beavercreek  (937) 427-7540
New Patients:  No Insurance Needed

Now offering Direct Family Medicine to New Patients

Neighborly Family Medical Care:  Dr Rebecca Cherry, Dr A. Patrick Jonas
            Respecting our Patients and Protecting them from Avoidable Care
            Acute Problems, Chronic Diseases, Prevention, Physicals
            Traditional After Hours On Call Physician Coverage
Families ONLY (entire households)

Family Fees:
Enrollment                Monthly        Visit
1 Adult           $80                             60                  20      
2 Adults         $150                           120                 20
1 A, 1 Child   $140                           100                 20
1 A, 2 C          $190                          140                 20
2 A, 1 C          $205                          160                 20
2 A, 2 C          $250                          200                 20
2 A, 3 C          $295                          240                 20
2 A, 4 C          $340                          280                 20

Infant (Child less than 2)- add $20 to family w/child enrollment, $10 to monthly

For Example:  2A, 1 Infant equals $215, $130, $20 for enrollment, monthly and visit fees

Labs, X-Rays, Office Surgeries, Immunizations extra

Patients are advised to have catastrophic medical insurance in addition to Direct Primary Care

Thursday, October 17, 2013

Dr Synonymous BTR Show Reflects on the Direct Primary Care National Summit

Here are my reflections about the Direct Primary Care National Summit in St. Louis October 11-12. 2013.  Listen in for my perspectives about the Summit and DPC.

Dr Synonymous Show: Reflections on DPC Summit

I review the entire program, vendors and sponsors.  I also review Tweets from the #DPCSummit Twitter site referring to speakers and other aspects of the meeting.

The energy was impressive.  The ideas were rampant.  DPC is moving right along.  A follow up to the summit will be in April, May or June in Washington, DC.


Tuesday, October 15, 2013

Direct Primary Care National Summit: WOW!

What a great group of people gathered in St Louis for the Direct Primary Care (DPC) National Summit, October 11-12.  A vast array of perspective and experience was represented in an effort to focus some of the energy of this movement and share information.  It felt pretty successful.

While DPC is way more vast than this meeting of 170 people, the energy of DPC seemed present.  The variety of DPC practice models could only be superficially represented in such a meeting, but the attendees got a flavor for many of them.  They also heard about the challenging history of DPC through legal, professional and political battles since 2000.  Many of the "founders" of the DPC movement were present and more were not, but the stories were great from Garrison Bliss, MD, who was founding president of a few organizations that sought to define and protect DPC.

Creativity was overflowing in every session and even during the breaks from those doing or preparing or thinking of doing DPC.  Medical students from PA and NC were present to get in the "DPC" pipeline.  Residents were also in attendance, applauding the program and the movement.  Physician Assistants and Nurse Practitioners added their voice to the meeting with timely comments about teamwork.

Vendors seemed busy talking with all the participants who wanted to do DPC better.

It seemed to answer the needs of attendees as evidenced by their numerous comments during the Town Hall session at the end of the meeting.  They shared gladly, in general, but Dave Chase had to remind a few about how big the market is on the ground floor of DPC where we don't need vigorous competition...yet.
Listen to my review of the entire program as well as listing sponsors and  vendors.

Dr Synonymous Internet Radio Show: DPC Summit Reflections

More later.  Onward with Direct Primary Care.

Tuesday, October 8, 2013

Dr Synonymous Show October 8,2013: Direct Primary Care Transitional Practice Becomes Hybrid

Direct Primary Care:  Transitional Practice Becomes Hybrid
A.Patrick Jonas, MD, ABFM
Beavercreek, OH

Family Health Connections, Inc.
Families Only
1.6 FTE Family Physicians
1-2 half days/week FNP
Next Door New 75 bed gen hosp
Suburban, Mall across street

Suddenly:  A Dynamic Dysequilibrium
EMR, Meaningless use,  Quality initiatives
Financial Losses
Philosophy of Care- Before DPC
Deliver Continuous , Comprehensive Care
To Individuals and Families
From Birth to Death

Philosophy of Care -With DPC
Be a Neighborly Family Practice
In a Human Centered Way

A Human Centered Health Home (HCHH) is Neighborly

Scope of Practice
Families Only
Persons of all ages & stages- includes Hospice
Well, Ill or Injured
Acute, Chronic, Prevention
Integrative Practices aligned w/NCCAM
Ext Relationships w/ Drs, Labs, Imaging, Hosp

Families w/Individuals & Current Patients
Small Businesses via Chamber of Commerce
Physician Offices and PHA
Health Food Stores
Holistic Practitioners

Retain Commercial, Medicare, Medicaid
No new patients in any of them
Retain Hospital relationship w/privileges
Seek vendor relationships for DPC & Network

Challenges of Hybrid Practice
Office Staff Belief/Support
Patient Understanding & Motivation
We seek limited number of patients
Align with philosophy and scope
Avoiding “The Beast”

Direct Primary Care:  Transitional/ Hybrid Practice

Friday, October 4, 2013

Family Medicine Celebration

OK, Family Medicine Nation,  Let's Celebrate...Something of our own choosing... a well child exam... an "old child" visit with a 93 year old in their home.

That's more like it.

Peace to all

Wednesday, October 2, 2013

Affordable Care Act Preliminary Insurance Information for Ohio

This is from  WebMD 9/25/13: Ohio Plans, Benefits, and Costs

Companies can offer four levels of plans: bronze, silver, gold and platinum. These “metal level” plans all cover the same benefits in your state. What differs is how much they pay on average toward the costs of the services the plan covers. Here’s how it works:
  • Bronze Plan: You pay 40% and the plan pays 60%.
  • Silver Plan: You pay 30% and the plan pays 70%.
  • Gold Plan: You pay 20% and the plan pays 80%.
  • Platinum Plan: You pay 10% and the plan pays 90%.
Catastrophic plans may be available, especially for people who are under 30 and healthy. These plans cost less up front, but they don't give you as much coverage. They generally require you to pay more out-of-pocket costs. 
You must have at least a bronze-level plan to meet minimum requirements under the Affordable Care Act and avoid the penalty for not having health insurance.  
Costs: Here are the average monthly premiums across Ohio for all age groups released by the Department of Health and Human Services. Specific premiums will vary from these averages based on the region within the state, the specific insurance plan selected, and age. 
  • Lowest cost bronze: $263
  • Lowest cost silver: $304
Tobacco Surcharge: Ohio allows insurance companies to charge tobacco users 50% more than non-tobacco users. 
Who Is Selling Insurance in the Ohio Marketplace?  Ohio is waiting for insurance companies to submit rates and plans. The state needs to give this information to the federal government by July 31.
What's covered: All approved plans in the state must cover the same package of benefits, called essential health benefits. In Ohio, the benefits include:
  1. Outpatient services, such as doctor visits or tests done outside a hospital
  2. Emergency services
  3. Hospital stays
  4. Pregnancy and baby care
  5. Mental health and substance abuse services, including behavioral health treatment
  6. Prescription drugs, including  generic and certain brand-name drugs
  7. Rehab and habilitative services, those that help people recover from an accident or injury and those that help with developmental issues. In Ohio, this includes physical rehabilitation, speech and language therapy, applied behavioral analysis, and mental health services for children with a diagnosis of autism spectrum disorder.
  8. Lab tests
  9. Preventive and wellness services, along with those that help people manage chronic conditions. This includes biofeedback and chiropractic care.
  10. Children's care including dental and eye care

Tuesday, October 1, 2013

Family Medicine: We Take Care of People

I love doing Family Medicine (FM).  The people are amazing.  Their biologic variation is phenomenal.  The opportunity for helping others to have their life is quite satisfying.  That's what I call quality.  They define it, often with our help, and together, we deliver it.  What a team.  Wow!

Secret:  Later, they all die.  Oops, we do, too.  Even if we don't smoke, or drink or swear.  Even if we had a great set of labs every year.  Even if we had our shingles shot, colonoscopy, flu shot, pneumonia shot and Adacel.  What kind of quality is it if we all die?  Who decides?

The Medical Director of Wholeness may be the one to decide.  If we die whole, that's quality.

I remember an elderly patient I was caring for who arrived at a terminal state while in the hospital with pneumonia.  He improved enough to get comfortable enough to die.  Alone.  His wife said he didn't die alone.  He was with God all along the way, and he didn't need people for his departure.  She declared that he died whole, with God.  She was pleased.

Another opportunity to redefine quality arises with the expansion of Direct Primary Care.  My mode of  practice is a hybrid of "traditional" FM and a version of DPC that I call  Direct Family Medicine (DFM).  In DFM, I have more time to work with patients to define their goals after learning about their values and dreams than many Family Physicians who are getting caught on the "medical hamster wheel".  Dream building helps to define quality goals in a personalized way.  That's the fun of  both traditional FM and DFM.  Personalized care via dreaming.  What is their dream?  How can we use our skills to better align them with it?  How do we celebrate accomplishing the dream?

Once we identify the dream, we assess motivation and belief.  Do they believe they can do it?  Much of Family Medicine is about these steps, especially helping them to know that they matter and we believe in them.  We look out for our people.

As they succeed over time,  we recognize the quality and celebrate with them.  We take care of people.  It's special.  It's Family Medicine.

Let's protect it like we do our people.  Let's adjust our business models so we can still dream for our patients and for ourselves.  Let's respect it, our patients and ourselves.  We all matter.