Sunday, June 17, 2018

Direct Family Medicine: More Thinking and More Fun

What do doctors do when they no longer have contracts with any insurance companies?  They spend more time with patients, they think more and they have more fun being a physician.

We terminated all our commercial insurance contracts December 31,2017 and all remaining Medicare contracts on March 31, 2018.

Our patients could opt for our Direct Family Medicine subscription option or pay cash for their visits.  All new patients are only offered the subscription practice option.

We now have openings for 300 new patients who are interested in having a physician who will listen to their story and work with them to maintain or regain their health.

We get to think clinically with more of our time now and pay less attention to insurance or government initiated administrivia.  Medical Practice is more fun with this model.

Many physicians are getting burned out and frustrated.  They aren't having fun.

We're Neighborly Family Medicine now and we're still having fun- only more.
More later.

Wednesday, June 13, 2018

Decision Making in Medical Care: Interview of Dan Jonas, MD, MPH

How are decisions made in medical care?
Dr. Synonymous (A. Patrick Jonas, MD) will interview Associate Professor Dan Jonas, MD, MPH about this subject on the Dr. Synonymous show June 14, 2018.

Dan teaches courses at the University of North Carolina to medical students, physicians and public health graduate students about analyzing the medical and other scientific literature.

Full disclosure:  He is my middle son.  I'm very pleased with how he has used his gifts and talents.

Dan will review his background.

What are the courses he teaches?  What excites the students?  What surprises them?  What is changing with time and technology?

We'll talk about studies- how big do they have to be to count?

Evidence:  What is it?  What is "Evidence based" and what isn't?

Patients role in medical decision making:  What is it?  What could it be?

Basic Science versus Clinical Science:  How do medical learners process information early and later in their careers?

I'm a (holistic) family physician and Dan is a Med-Peds and public health trained academic physician, so we'll focus on primary care types of examples during the interview.

Chronic disease care (management) versus acute illness care:  What are similarities and differences?

Public Health versus Personal Health:  What are some differences and similarities?

Quality:  What is it and who decides?  How is it measured and reported?  What is patient role in defining quality?  Wheat Belly and Grain Brain.  The microbiome-Quality vs novelty.

Electronic Medical Records:  Benefits and Harms (Remember principles of medical ethics and physician burnout)?

Common versus rare diseases:  How are they found, followed and treated?  (We'll comment about Ehlers Danlos Syndrome among others)

Time management in clinical care versus clinical decision support (tools, etc.)?  Front lines versus ivory tower.

Direct Primary Care versus Usual Primary Care and other models:  How do we change?

How many studies are what level of quality?

Genomics:  Quality studies?  Consumer driven  genomic information as a source of quality and/or physician annoyance?

Click Here for the Interview