"So when you give to the needy, do not announce it with trumpets, as the hypocrites do in the synagogues and on the streets, to be honored by men. I tell you the truth, they have received their reward in full."
Obese and overweight adults in England could be paid to lose weight under plans being considered by the Government. The new strategy to tackle poor eating habits and sedentary lifestyles includes the suggestion that people should receive financial rewards or shopping vouchers for achieving and maintaining a healthy weight.
The report points to evidence from the US that showed that small financial payments, as part of a broader programme, were effective in encouraging individuals to achieve and maintain weight loss.
I failed to find that study or report from the United States. If there is evidence incentives work, then that is really sad. In fact, depending on what that study from the US (or other evidence) says, it makes me appalled that tax dollars fund care for any health conditions even remotely linked to obesity.
Getting Your Jeans On Not Incentive Enough
There is a huge marketing campaign towards losing weight and fitness. Everyone knows the health risks of being obese. And if providing incentives for people to lose weight is independently more efficacious than virtually any other public health measure then that is terribly sad. Everyone Britain who only loses weight to get the carrot at the end of the stick should be ashamed of themselves.
Oh well, if it’s going to happen at least I’ll hope the British program works.
Also, the people who are so adamantly against throwing a couple bucks of their tax money into the pot to help out their fellow countrymen are really sad excuses for human beings. Really. Subhuman at best.
Certainly, but it ignores the entire point - being an asshole with one’s ‘property’ is a right while no such ‘right’ to health care can be defended with any sincerity.
I don’t agree with the choice not to aid your fellow human being, and it isn’t the choice I have/will make with my life, but it should remains that. A choice.
This is alarming. Everyone should be an organ donor, but to force such is shameful. And the ability to opt out is an inadequate solution to protect people’s right to themselves which I would argue extends past their death.
Gordon Brown has thrown his weight behind a move to allow hospitals to take organs from dead patients without explicit consent.
The proposals would mean consent for organ donation after death would be automatically presumed, unless individuals had opted out of the national register or family members objected.
While polls show 90 per cent of Britons are in favour of organ donation, 40 per cent of relatives refuse consent for the organs of their relatives to be donated, a figure which rises to 75 per cent among black and ethnic minorities. To solve this, the organ taskforce plans measures to boost donation, including putting pressure on doctors to identify patients as potential donors before they have died.
I’m surprised about all the hardcore numbers that fly around concerning hours worked. For some people there’s a lot of pride in being hardcore and claiming a lot of hours on the clock in sheet. This is, of course, especially true on surgical rotations.
But how accurate are some of these figures you see?
Now granted, I’m on the ’slow’ general surgery service but there are friends on the other county hospital team who are claiming 100+ hours/week for consecutive weeks. I’m sure it’s possible but…damn, I just don’t know what they’re doing.
I wanted to see if I could “stretch” my numbers. I haven’t taken any days off in the rotation so far and I’m using a liberal interpretation (e.g. on Wednesday I had some ‘free’ time between didactic sessions, which since I was using it to study up at the hospital I’ll count):
Sunday: 6am - 12am (Total Hours for Week: 18) Monday: 12am - 10am (Total Hours for Week: 28) Tuesday: 6am - 7pm (Total Hours for Week: 41) Wednesday: 5am - 6pm (Total Hours for Week: 54) Thursday: 5am - 4pm (Total Hours for Week: 65) Friday: 5am - 12am (Total Hours for Week: 84) Saturday: 12am - 8am (Total Hours for Week: 92)
Okay, that is as far as I can actually stretch it. I guess I am legitimately, conservatively above 80 hours but I also had some time off Friday afternoon but then had trauma call o/n.
Is this just a chump rotation I’m on? This week I didn’t stay past 7pm when I wasn’t on call, I had that ‘free’ time in the afternoon on Wednesday and Friday, and I got out by ~10am both my post call days.
All that said, I still can’t reconcile how my friends at other schools, and my own school, are putting in so many more hours consistently. Is that legitimate?
I’m a huge Civil War buff. In high school, offered the option of traveling anywhere in the continental United States, I made my family spend spring break taking a driving tour of the eastern theater.
So just because: here in four minutes is the history of the Civil War (h/t The Irish Trojan).
Yeah, every year the government wants to slash reimbursement, the disparity between primary care and the specialists is appalling, medical students (*ahem*) are coming out on average with six figures in debt. But I hope it doesn’t take a not exactly prestigious ’study’ on AskMen.com to remind us how lucky the physician community is.
Even by the hour and more importantly even beyond the earning potential.
Bureaucracy and the increasing intrusion of non-medical men into the decision making process are further challenges but practicing medicine is incredible work. Without hyperbole: a gift. What we are able to do for patients is sometimes as remarkable a thing as anyone will ever see.
I hope I don’t lose sight of all of it when I’m out there.
“There’s a chance he could actually walk again, thanks to an innovative treatment,” Katie Couric said on CBS News. Sports Illustrated put the case on its cover, and newspapers carried headlines like “Big Chill May Save Football Player From Paralysis.”
Some doctors, including Everett’s supervising physician, say such accounts misrepresent the role of hypothermia in a way that could be dangerous to future patients.
Here’s the best potential consequence - when lawyers start crying it as the ’standard,’
Lawyers have already cited Everett’s treatment as relevant to other people’s potential litigation. A blog entry published in September by Allen, Flatt, Ballidis & Leslie, a law firm in Newport Beach, Calif., put it this way: “The immediate choices that these doctors make can determine whether a patient dies, lives or ever walks again. Clients with spinal injuries look to their attorneys to stay on top of the latest and best innovation for recovery.”
Dr. Benzel, of the Cleveland Clinic, bristles at such assertions.
“It now appears criminal to not employ, urgently, hypothermia for the care of spinal-cord injuries,” he said. “But in reality, it is not substantiated by truth. We should demand, and the public should demand we demand, research that substantiates safe and effective treatment before we embark on it.”
I’m a week into my surgery rotation and I want to be a surgeon.
My Fashion Statement On My First Day
I’m on a pretty tame service but it isn’t a walk in the park. I worked 78 hours my first week and loved every minute of it (well almost).
I’ve looked stupid, impressed, been chided, been shouted at, even been complimented. Haven’t had anything thrown at me yet.
I’ve been pimped much less than I thought I would, I’ve done a terrible job trying to laprascopically ‘retract’ a liver, I’ve made remarkable progress with my ‘one handed’ ties, I’ve gotten pretty good anticipating with the camera, and I’ve slowly figured out that my chief doesn’t really want to hear anything but objective info that would change his plan on a patient and my assessment. Our rounding is more than I ever could’ve expected from the myth of surgical rounds:
“She’s passing gas. She looks great.”
“Okay, advance her diet.”
And away we go.
I’ve seen my handful of lap choles, I’ve seen a thoracotomy in the resuscitation bay, I’ve seen a lap Nissen, I’ve seen my share of total and subtotal colectomies, I’ve seen a decompressive craniectomy and a ventriculostomy (while on trauma call), I’ve seen an ileostomy takedown which made my patient happier than I’ve ever seen a patient.
1. Surgeons always tuck in their scrubs.
2. Surgeons must never have their stethoscope around their neck, it must be in their pocket (their least valuable tool - haha).
3. Carrying anything other than a stethoscope, some gauze and supplies, and a pen light will lead to ferocious mockery. Pity the fool who would dare to bring a reflex hammer onto the surgical wards.
4. Surgery is almost always about the “most likely” or “most common”. They don’t spend a lot of time worrying about about diagnosing things to death, and the consequences are often too severe for delaying interventions.
[…]
6. It’s amazing watching some of these open procedures than anyone can survive such rough treatment of their insides. Seeing the force put on things like retractors, you wonder how people ever recover.
And I want to do surgery or a surgical subspecialty. That isn’t really a surprise seeing as I thought I wanted to do surgery coming into school. But once here, so much was interesting. So consider this a reaffirmation. I may not know specifically what I’ll try to match into yet, but it will be something surgical.
Ron Paul may be a racist (or more likely he’s not and Orac is just ‘ill informed’ or worse) but Dr. Paul is certainly right about the financial future of this country. Indeed, the only candidate who is right about the single largest challenge to this nation; a challenge larger than the war on terror, than the war in Iraq.
I always say that the plural of anecdote is not data but of the hundreds of Iowans I talked to last week not a single one told me health care was the issue driving their Caucus vote. So despite all the coverage it is difficult for me to imagine healthcare playing a major role come Tuesday and the New Hampshire primary.
[I]n New Hampshire, the first primary state, there’s a sharp partisan split over government’s role in making healthcare available. As a likely battleground, the Granite State could be a bellwether on the issue in next November’s election.
The stark difference between the parties is reflected in the findings of a Boston Globe poll of likely voters in the Jan. 8 New Hampshire presidential primary - 80 percent of Democrats polled say providing health coverage is government’s responsibility; only 30 percent of Republicans agree. Moreover, it explains the dramatically divergent healthcare proposals of the candidates - Democrats would move toward universal coverage and a larger government role; Republicans generally favor tax incentives to expand private insurance and restrain costs through market forces.
One of the contrasts is the support (or lack thereof) for individual mandates. And according to Pollster it may explain Clinton’s reluctance to raise the health care issue into the limelight.
Opposition to the notion of an individual health insurance mandate — “should individuals be required to buy health insurance” — is greatest among the less well-educated and downscale voters that are the core of Clinton’s base in New Hampshire and elsewhere:
Panda Bear and Graham have conflicting posts on the merits of ‘Social Justice’ and just what Social Justice entails.
Social Justice is certainly an amorphous term which in part makes the debate difficult to keep within a set of boundaries but essentially Social Justice is the idea that to each, as he deserves, goes the benefits of society. Those benefits paid for in the form of wealth redistribution.
The debate is a continuum from whether Social Justice should even be an ideal, all the way to exactly how one judges what individuals “deserve.” I think, despite some confusion, that Graham and Panda Bear are talking about the same thing.
Panda Bear worries about the free loader who exploits societal handouts by pretending to be a victim.
Social justice, as I understand, it about equality. Distributing shared, scarce public resources as equitably as possible. Nothing in it speaks of victimhood.
But the two positions on how Social Justice is defined aren’t mutually exclusive. The reality is that, at least subconsciously, victimhood has become the standard by which we evaluate what an individual “deserves.” And determining what of societal benefits an individual deserves is the whole practice of Social Justice.
[T]he mob, once it discovers it can vote itself access to other people’s wallets, is difficult to keep in check and the usual dependency triumvirate of ghetto, trailer park, and academia are perpetually braying for somebody else’s money. The extent to which this money can be secured depends on how many productive citizens can be lured onto the dependency plantation, usually by the proganda of fear and class envy. The problem with creating a welfare state is that it tends to fulfill the dire prophecies of its creators. The more productive citizens are taxed the more economic activity is stifled leading to stagnant economies where there are, in fact, no jobs for many people who would be employed if growth and economic opportunity were encouraged at the expense of stealing from one set of citizens to give to another.
I’ve often criticized the “right to health care” by asking who defines that right in a society with limited resources. ‘Oh you get this yearly mammogram but not that colonoscopy.’ Any line drawn is nearly entirely subjective and indefensible compared to an expanded or contracted definition. Such applies to all welfare, all wealth redistribution, all Social Justice.
Yeah, Society Took The Corn From The Indians And Gave It To The Pilgrims
Graham speaks of ‘equality,’ but it appears to me that if Social Justice is something real then it calls for an equality of position. Here’s what I mean:
First, equality can be defined as an equality of opportunity, in the sense of nothing but natural impediments (your ability, circumstance, etc) to your progress up the social and economic ladder. In such a case Social Justice either doesn’t exist or is satisfied by you merely being alive and not being interfered with by other members of society.
Second, we can talk about an equality of position such that everyone has the same. In such a case Social Justice is paramount, but such calls for the complete redistribution of wealth.
No society, no individual can philosophically defend the determination that “Well you’re entitled to this much in food stamps but no more!” or “$400 in a housing stipend but nothing else!”
You either satisfy ‘equality’ by redistributing all wealth equally or you don’t redistribute wealth at all.
The Noble laureate Friedrich Hayek came to slightly similiar conclusions, in the sense that the problems of trying to determine what individuals ‘deserve,’ in order to satisfy Social Justice destroy the principle itself.
Social justice requires not merely that individuals receive what is rightly theirs in general terms, but that individuals and groups also receive some stipulated distributional share of the society’s total output or wealth. However, Hayek showed that in the market economy, distributions of income are not based on some standard of “deservedness,” but rather on the degree to which the individual has directly or indirectly satisfied consumer demand within the general rules of individual rights and property.
To attempt to distribute income shares by “deservedness” would require the government to establish some overarching standard for disbursing “social justice,” and would necessitate an economic system in which that government had the authority and the power to investigate, measure, and judge each person’s “right” to a share of the society’s wealth. Hayek suggested that such a system would involve a return to the mentality and the rules of a tribal society: government would reimpose a single hierarchy of ends and would decide what each member should have and what should be expected from him in return. It would mean the end of the free and open society.
I’ll keep my arguments philosophical and stay away from the pragmatic consequences of trying to implement Social Justice. Needless to say I agree with much of what Panda Bear concludes.
I’ll hide my insecurity and not even try to argue concerning my typos,
Please be more precise in your practice of medicine than you are in your blogging! First off, I (Mark Lanier) was not the “defense attorney.” I was the “Plaintiffs’ attorney.”
Or apparent lack of empathy,
The guy who wrote this original article is an idiot. He is young, doesn’t care about other people…
You can certainly get a chuckle out of the flamboyant messages and the commenters’ complete lack of understanding of statistics by reading the comments as linked to above.
I will try to shed some light on whether Mark Lanier is wasting his time lurking on obscure medical blogs (From Medskool gets ~100 unique visitors a day and hosts a far from thriving debate on Vioxx litigation). The poster does use Mr. Lanier’s readily available public email address but the IP address logged takes us out to Avon, Colorado. Not New York or Los Angeles or Houston.
That doesn’t preclude it from actually being Mark Lanier, maybe he owns a ski cabin up there or something of the sort.
If it actually is him and Mr. Lanier visits the site again I welcome him to continue to comment.
In anycase, if you’re interested in reading some actual refutation of the claims made by Mark then (as always) head on over to Overlawyered’s post.
I’m a big Ron Paul fan if you don’t know. Doctor Paul is an Ob/Gyn and a ten-term Republican congressman whose about as libertarian as anyone ever elected to federal office. I’m such a fan that right now I’m somewhere between Davenport, IA and Texas, having spent more than a week in Iowa volunteering on his campaign.
Now, despite some of the, uh, optimisim I ran into amongst volunteers and staff in Iowa concerning Dr. Paul’s chances, most know that Ron Paul is not going to be the Republican nominee for President. To the chagrin of some choice dickheads. (I love that Ken Layne couldn’t make it into Palmer College, much less Duke Medical School and yet somehow Wonkette keeps publishing Paul critiques like there’s some value to the lives of it’s editors*).
But whatever Paul’s chances at victory, fifth place is disgusting. Ron Paul lost to Fred Thompson, a man whose idea of campaigning is when someone notices him while he’s trying on slacks at the mall.
It wasn’t the media, it wasn’t the message, it wasn’t the “scandals,” it wasn’t that Iowans are stupid (although after speaking to hundreds of them I can testify to that).
Proof of a Mass Media Conspiracy!
It’s the campaign.
The final polls before the Caucus gave some reasonable hope to the Paul campaign. A finish of third would’ve been remarkable and not totally unreasonable. A finish of fourth more expected. A finish of fifth disappointing. But, even before the Caucusing began there was considerable doubt from anyone on the ground in Iowa, with any sense, who had spent any time with the Ron Paul campaign.
This is the most disorganized political campaign I can imagine. My credentials aren’t terribly impressive - I have some campaign education and I’ve worked on a Congressional campaign - but you don’t need a PhD in political science; one look at the Paul campaign and you know that this isn’t how you run a political campaign.
From near sexual harassment of volunteers to strategic moves like still cold calling people off the voter registration list a day before the Caucus and not even having campaign phone lines to use three days before the Caucus, the centralized Iowa effort for Ron Paul might as well have been non-existent.
While the entire time I was in Iowa was a near disaster in terms of organization, the GOTV effort may have been the most disgusting.
The database of known Paul supporters was, uh…shameful. To top it off, it was corrupted the night before the Caucus and the campaign had no back up of it. It was nearly six o’clock on Caucus night before some volunteers got their lists of supporters to call and remind of the Caucus and most of Iowa lacked Ron Paul volunteers in place to drive people to the Caucus if necessary, despite having the man power in the state.
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
Nothing on this website is to be taken as medical advice. I am not a physician. Please consult a physician concerning any health related questions.
This blog is entirely self funded. It accepts no advertising or other supporting revenue. The author has no relevant financial relationships to disclose.
Unless otherwise noted the media on this blog is under the copyright of the blog author, used under a Creative Common or free use license with appropriate accreditation or is in the public domain. If you believe images or video posted on this blog are copyrighted works used inappropriately please contact me.
Endorsements
"Please be more precise in your practice of medicine than you are in your blogging!"
- Mark Lanier
