Childhood and Adolescent Depression; Tweet Chats #CHSOCM

The Dr Synonymous Show October 30, 2012  Here

 Dr Synonymous aka, A. Patrick Jonas, MD starts with comments about tweets on Twitter, then 

 "Treatment of Childhood and Adolescent Depression" from the American Family Physician, 

Sept 1, 2012 issue by Clark, Jansen and Cloy from the University of Mississippi Medical Center.  

The risk factors and diagnostic criteria are well reviewed along with screening tools.  

Helpful comments about therapies are reviewed.

Tweets followed by Dr Jonas are perused with a focus on a tweet chat by #CHSOCM, including their opening prayer.  

Blog reviews include one by Meredith Gould about book authorship processes and one by Kenny Lin about support for Family Medicine as written by Richard Young, MD.

Last is some expansion by Dr S about his upcoming chat session at the BellHOP Cafe in Bellbrook on Saturday morning November 10 at 9AM.

Dr Synonymous Show 10/23/2012 Humble, Collaborative Docs IBS & Blogs

Starting with information about the issues in the upcoming Presidential election, Dr Synonymous then reviews some information from JAMA about Peripheral Artery Disease (PAD) and correlation with risk factors for CAD. Then comments on a JAMA article reflecting on small studies showing large effects being exagerated due to sample size.  A  study about parachute jumps with and without a parachute that will never be undertaken was used to make a point.  Large studies seldom find large effects.  Docs should be collaborative and humble about uncertainties.

Diagnosis and treatment of Irritable Bowel Syndrome is discussed next from The American Family Physician 9/1/2012.

Introduction of Intellectual Disabilities, At Your Fingertips by Carl Tyler, MD and Steve Baker, MS.  Good looking content and very useful for Family Physicians in the office.  Thanks Carl and Steve!

Blog reviews: Medical Mojave, A Chronic Dose and two books by Laurie Edwards, and Dr Synonymous- announcing his chat at the BellHOP Cafe in Bellbrook, OH November 10 at 9 AM.

Dr Synonymous Show October 23, 2012 on Blog Talk Radio

Dr Synonymous at the BellHOP Cafe November 10th

Dr Synonymous at the BellHOP Cafe November 10, 9-11:30 AM

Chat with Dr Synonymous at the BellHOP Cafe in Bellbrook (OH) on Saturday November 10, 2012 from 9-11:30 AM.  Come early, eat breakfast and enjoy some coffee in a relaxed, informal setting.  Map to BellHOP Cafe

A. Patrick Jonas, MD a Holistic-Minded Family Physician is Dr. Synonymous on BlogTalk Radio (internet radio) and through his Dr Synonymous blog (www.drsynonymous.blogspot.com).

During the first hour of the session at the BellHOP Cafe, Dr Synonymous will review:
                                       
                                           "5-5-5: Strategies for a Healthy Eating Season"
                                         
                                           "Successful Visits to your Doctor"

                                           "Heart Health and Bone Health"

In the second hour, after a short break, Dr Synonymous will answer questions from those present about health, healthcare, illness and dying with dignity.  He will interact with the audience frequently during both hours.  He still has fun practicing medicine and enjoys learning from and about patients, even after 170,000 patient encounters since 1979.

Expect to hear about Family Medicine, healthy habits, vitamins, supplements, respect for self and others, protecting yourself from harm in the medical system, brain health, stress and coping, God, prayer, family, love, relaxation, massage, the five senses, medication, the placebo response, the nocebo response, America, the Medical Industrial Complex, cost, respect, misguided quality initiatives, awesome people, and how doctors think in comments made by Dr Synonymous.

Disclaimer:  Dr Jonas will not be practicing medicine on those in attendance.  They should not expect to solve their personal medical problems in this session.  Nothing in this session is intended to replace the medical care currently being received by those present from their personal physician or other medical specialists.

We'll see you at the BellHOP Cafe November 10th at 9 AM.

Family Medicine: Time to Warrior-Up!

Warrior. 

There, I've written the word.  What images does it generate in your brain?  What thoughts?  What feelings?  What sounds?  Any smells?  Or tastes?

Or FEARS?!  (Yes, many feel afraid when they hear or read the word warrior).

In the Four-Fold Way by Angeles Arrien, she describes the Way of the Warrior:

"The Way of the Warrior or Leader is to show up, or choose to be present.
Being present allows us to access the human resources of power, presence, and communication. We express the way of the Leader through appropriate action, good timing, and clear communication.":

Family Medicine needs more warriors (Uh Oh, warrior in the same sentence with Family Medicine- meek, soft spoken, please everyone, don't make waves, sacrifice for the poor, ignore the rich-Family Medicine)

Family Medicine needs more warriors.  A little bit louder now, and proudly- with enthusiasm:  Family Medicine needs more Warriors!

We are complicit with the misaligned behavior of The Beast- the Medical Industrial Complex- that is shamelessly bankrupting America.  Can we Warrior-Up and re-direct it?  Can we Warrior-Up and protect our patients from its darker side?

Warrior-Up, Family Medicine.  We owe it to ourselves and our patients.

What do you think?

Context and Reflection in the Human Centered Health Home

“The central tasks of a physician’s life are understanding illness and understanding people.  Because one cannot fully understand an illness without also understanding the person who is ill, these two tasks are indivisible.”…McWhinney in Family Medicine

Also, a physician should understand him/her self and their own worldview.  Context is powerful in the patient-physician relationship, including that of the patient, the physician and their relationship.  Yes, the confluence of the worldviews of the patient and the physician is important.

The last post referred to clinical decision making in the Human Centered Health Home (HCHH).  After Respecting, Protecting, Connecting, Detecting, and Correcting, the dyad of patient and physician finish their engagement by Reflecting.  This may include Reflecting on the current engagement, the relationship, the decision making process, the future, etc.

Part of the Reflecting by the physician includes recording the clinical encounter note.  Eventually, this may be partly written by the patient.  Both parties may eventually have a separate note about the engagement that has a merged component and is shared for the Personalized Health Record (PHR) owned by the patient and the Electronic Medical Record (EMR), controlled by the physician.

As the "Socio-Technical Neighborhood" is further developed, audio and video elements of the note will be shared for Reflection in the PHR and the EMR.  Arrangements for confidentiality, HIPAA, and consent to use information by either party will require further clarification.  It will become more and more popular.

What do you think about the context of the patient physician engagement?  How do you like to Reflect on the engagement and the relationship? What aspects of the "Socio-Technical Neighborhood" should be developed?  Will be helpful?