Thursday, July 30, 2015

Direct Primary Care Ohio "Unsummit" III Dayton, Ohio August 22, 2015

A. Patrick Jonas, MD

Philip Whitecar, MD

Will Sawyer, MD

will present at the DPC Ohio Unsummit III in Beavercreek (Dayton Suburb) on August 22, 2015.

These Family Physicians have studied Direct Primary Care and play with it daily.  Dr.'s Jonas and Whitecare have Hybrid (traditional and DPC) practices in Beavercreek.  Dr. Sawyer has a subscription practice in Sharonville.

They will expound on DPC Nuts and Bolts and their personal situations relative to DPC in interactive sessions that allow attendees a personalized opportunity to interact about DPC and get lots of questions answered.  We'll address student and resident issues including curriculum and practical experiences.  Legislation will be an important discussion.

What won't happen: Mention or discussion about prices.  This keeps us on the right side of the FTC.

All primary care physicians, NP's, PA's, Office Administrators, Office Staff are welcome.  Medical Students and residents are welcome.  Other stakeholders such as medical societies, holistic practitioners, general surgeons, imaging centers, laboratories, wellness companies (such as Gemcare Wellness) and special insurances (such as LibertyHealthShare, etc.) may wish to sponsor and attend.

9 AM to 4 PM at 3210 Beaver Vu Drive, Beavercreek OH.  That's the Chamber of Commerce Conference Room.  Just N of Rt 35 East of I675.  Across street from Beaver Vu Bowling Alley (bring your ball and shoes for more fun).

This is a big WiFi type meeting.  DPC is all over the web.

$150 to attend ($125 subsequent person from same practice). Medical Students $25    Residents $50.

Make checks to CIFCH  and send to CIFCH 2633 Commons Blvd Suiite 120, Beavercreek, OH 45431 or pay at the door after registering on Facebook as below.

More information: Pat Jonas, MD or Rebecca at 427-7540 or email

$250 to sponsor with a display table.

We'll see you on August 22 (and later in 2015 for Ohio Unsummit IV).

Registration via message to Center for Innovation in Family and Community Health on Facebook.

Tuesday, July 28, 2015

Vietnam Departure 45 Years Ago: "Lately, I've Got Phu Bai on My Mind"

July 27th 1970, I left my wife of seven months at the Cincinnati Airport (actually in Kentucky) and headed for Vietnam.  It was a long journey which never ends.  A young Engineer officer with new helicopter pilot's wings flew to Travis Air Force Base in CA, then to Alaska, where I learned that my nephew Matthew had just been born (Happy Birthday Matt- and Mike, his brother who was born July 27th two years before).  Then off to Japan for fuel enroute, then to the Saigon area.

I filled out a "dream sheet" of the types of aviation units I might wish to fly with at Army personnel headquarters at Long Binh and waited with other pilots in my rotary wing aviator class for the assignment sheets to be posted on a bulletin board.  We drank beer and chatted.  Then the postings.  I was assigned to the 18th Engineer Brigade.  I would fly for the Engineers.  The orders said to go to Cam Ranh Bay to the unit HQ. I was there for one day, played volleyball with some other pilots and learned the next day that I was being assigned to fly with the 45th Engineer Group HQ in Phu Bai (which means Land of the Dead) in I Corps, the northernmost of the four sections of Vietnam used for military planning.

I flew for a year and returned home, meeting my wife in Cincinnati for a few days before coming home to visit in Liberty and Farmersville where my parents and her parents lived.  Then we toured the western US and set up in Milford Kansas, just outside Ft. Riley where I was to finish my Army career as a pilot and instructor pilot and small unit commander.

45 years after leaving for Vietnam, I'm still learning about the meaning of the whole Vietnam experience.  I read about the background of the war and the decision processes that kept it going and ended it.  Very complex and very human processes that led to a lot of confusion.  Twenty of my West Point classmates died as a result of their service in Vietnam.  I think of them often.  I think of Phu Bai, too.

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.                        

Click here for the video/musical version with banjo

Wednesday, July 22, 2015

Preparing for the West Point Glee Club Alumni Reunion- Nostalgia

Dr Synonymous Show: Nostalgia Via West Point Alumni Glee Club Reunion

Dr Synonymous, aka Pat Jonas, MD- West Point Class of 1968, is travelling to West Point for a Glee Club Alumni Reunion (his third).  "I love these experiences.  The music is great, the people are great, the place is beautiful."
Listen as Dr Jonas reviews the agenda for the weekend and reflects on his days in the West Point Glee Club, life as a cadet and after.  He'll  reflect on a few songs and  even sing a few bars here and there and review a few Glee Club Memories.
The concert will be July 15th 7:30 PM- 9 PM at Trophy Point on the post at  West Point.

Wednesday, July 15, 2015

The Dr Synonymous Show Discusses Direct Primary Care and Ohio "Unsummit" III

Let's talk about Direct Primary Care for a while.  What's going to happen at the Third DPC Ohio "Unsummit"?  DPC is happening slowly but surely. Getting better and  better.  Are you Fed Up with getting the run-around in healthcare?  Do you want a doctor who will listen to you?  Do you want to step away from the annoying, artificial financial pressures of your insurance company?
Maybe you should look into Direct Primary Care.
Physicians: Do you want something different?  Do you miss getting to spend time with patients helping to solve their problems and treat their diseases?  Do you want more independence?
Maybe you should look into Direct Primary Care.
Dr. Jonas discusses  DPC and introduces the DPC Ohio Unsummit III scheduled in Dayton, Ohio on August 22, 2015 on The Dr Synonymous Show:
DPC and Ohio DPC "Unsummit" III .

Here is the information about the "Unsummit":  Facts about the "Unsummit" and Registration
Follow the Facebook page of The Center for Innovation in Family and Community Health for more information as the schedule unfolds.  Mark the date now if you want to get ready to practice in a DPC setting.
My Blogs from July 9 and 11 are reviewed, finishing with a Didgeridoo solo.

Saturday, July 11, 2015

Why Are So Many Physicians Afraid?: The Coward to Warrior Ratio Seems Huge

From coward to warrior, physicians come in all shapes, sizes and attitudes.  Or do we?

It seems that lots of physicians are afraid to be a professional.  They are afraid to disagree with the financial decision makers in their institutions (that employ them or with whom thy're contracted). This is rampant behavior.

We represent an ethical position that our patients and communities expect.  They don't know it's not happening like it used to.  Yes, it used to be common behavior for physicians to vehemently disagree with hospital administrators over a principle involving ethical decision making.

It looks like we were for sale.  We were bought.  We're saluting the hospital flag and altering clinical judgement to the massive expense of our patients and our society.

We sold out to the EHR which was billing software slightly altered for clinical purposes.

We sold out to do massive numbers of CT scans in ER's of questionable utility.

We sold out in rehab facilities to maximize reimbursement.

Were we always for sale?

Were we always cowards?

What are we afraid of?

Do our patients and communities know?

Let's tell them.  That's informed consent.

(Better than what they get in ER's when they aren't informed about the potential benefits and harms of all the CT scans.  Look around your ER for a consent form to do a procedure like CT scans that can cause cancer. You won't find one.  Shouldn't a patient know? )

Thursday, July 9, 2015

Breathing, Snoring and the Didgeridoo

Here's the outline for my presentation at the Institute of Holistic Leadership for July 9, 2015
Yes, I'm teaching the didgeridoo to attendees for fun and that they may have diminished or no snoring.

Breathing, Snoring and the Didgeridoo                                  Pat Jonas, MD
July 9, 2015                       Institute of Holistic Leadership

Breathing                           First exercise                    Three Deep Breaths
Didgeridoo First Demo                                                Dr J
               Baby 44, Adult 14-18 breaths per minute
               Oxygen Dissociation Curve, Sports Medicine
               Usual Breathing
               Diaphragmatic breathing
Breathing Exercise Two                                               The Stimulating Breath (Bellows Breath)
Nasal Breathing                              Heating, Cooling, Nitric Oxide
Breathing Exercise Three              The Balancing Breath                  Dr. Laskow
               Left Brain, Right Brain Issues
Didgeridoo Second Demo
Breathing Exercise Four                               The 4-7-8 (Relaxing) Breath      Dr. Weil
Snoring Study 85% at 5 mos
The Didgeridoo                What it is  rhythm, What it does,  History   
               Grab your Didge:  The raspberry and the sweet spot
               The Drone
               Vowels                A-E-I-O-U
               Consonants        B-C-D-T
               Kazoo Effect
               Circular Breathing
Lip Buzz, Dizzyness        Dying Cow               YouTube Lessons
Didgeribreathing Exercise


Sunday, July 5, 2015

Independence Weekend 2015

Independence Day is actually Independence Weekend most years and 2015 is no exception.  Friday the third of July we had some patients to see and closed at two PM. Before a special weekend like this I ask most patients what they are doing for the holiday. Many of them will have an altered experience due to the affliction that caused them to see a doctor.  Others are "a threat to society" because of the contagious nature of their infection.  Vomiting with abdominal pain is especially important to keep away from other people.  Most will be shedding viruses for a few days after the vomiting stops.  (Don't let them breathe near you).

When people mention their holiday plans, they are often sharing information about their values and dreams.  Who, What, Where, When, Why, Who are often included.  This information helps me to understand them and issues that relate to their health.  It also informs me about what people in general are doing these days.

One of the roles of the Family Physician is to act as a public health agent-- identifying issues that affect the health of the public enables us to contribute to prevention efforts and share trends with other physicians and public health officials.  Our generalist role in health care gives us a perspective about health system trends that may be helpful or harmful to patients.  We have to stay aware of our duty to inform and protect people (you and us - we have a duty to help each other).

Warning to you:  Currently the healthcare system seems out of control and constitutes a threat to the financial survival of individuals, families and communities-  in fact it's a threat to the nation.  More, more, more is what we say about everything.  More tests, more medication, more mandatory prescribing, more "quality" bonuses for health plans and physicians.  There is no realistic plan to do otherwise. There are superficial efforts to reduce certain tests and procedures.  I just saw a letter from one of the area practice networks advising their male patients to have the PSA test, which actually is no longer recognized as a screening test for prostate cancer.  It's only supposed to be used in symptomatic males- which is a diagnostic test--not a screening test (for non-symptomatic persons).  How is a patient to know that?  I was shocked and disappointed.  But I can blog about it and tell the people about it and mention to physicians about how the PSA test is supposed to be used.

I'm looking into programs like Samaritan Ministries and Liberty Healthshare as a consideration for our Direct Family Medicine (Direct Pay)  patients to have hospitalization outside the Affordable Care Act.  They are for Christians, but I assume that each religion has some special waivers relative to the Affordable Care Act, although I haven't researched it.  

Huge changes are coming in the next three years.  Stay tuned.

Independence Day.  I love America.  I love patriotic music.  I love the Boston Pops Independence Day Concert and A Capital Fourth both with the 1812 Overture.  I'm getting ready for the third ever West Point Glee Club Alumni Reunion Concert on July 25th.  I sang in the first two.  I'm looking forward to 3 days of the Hudson River Valley, nostalgia and patriotic music.  God Bless America.