Whatchya doin' after the Scott Brown victory speech?
Tuesday, January 19, 2010
When Will France Learn to Just Shut Up?
If you understand even the most basic elements of the history of the nation of Haiti, this story is beyond ironic.
Even being French is no excuse for this degree of stupidity. "Pot, I'm not sure if you and Kettle have met..."
Even being French is no excuse for this degree of stupidity. "Pot, I'm not sure if you and Kettle have met..."
Tuesday, January 12, 2010
Deep Thoughts for 2010: No. 2
Thirty-eight percent less zen than Deep Thought No. 1:
The pathetic, whimpering demise of Western civilization can be summarized by this recent web advertisement:
"Buy your Emo mugs, T-shirts, and magnets here!"
Discuss.
The pathetic, whimpering demise of Western civilization can be summarized by this recent web advertisement:
"Buy your Emo mugs, T-shirts, and magnets here!"
Discuss.
Wednesday, December 30, 2009
Friday, November 20, 2009
The Day Science Died
I've always been considerably mistrustful of "evidence based medicine", although I could never quite put my finger on why. As is too often the case, it is only in retrospect - when it appears it may be too late to do anything constructive - that I see the reason.
Benjamin Disraeli, First Earl of Beaconsfield and conservative 19th-century British Prime Minister once famously quipped that "There are three kinds of lies: lies, damned lies, and statistics. As I've become a student of public health statistics, I've found that Disraeli was right on target. Statistics in medicine is, more often than not, the science of deception using what should be the most unassailable of all techniques: mathematics. A skeptic of mathematics is, of course, immediately dismissed as an idiot or a nut or both. Nevertheless, I find myself in that dwindling group of physicians that views "studies", the new intellectual currency of medicine, through doubtful eyes.
This week's shocking reversal of opinion about the importance of screening for breast and cervical cancer by no less an authority than the American College of Obstetricians and Gynecologists (ACOG) indicates that I and my fellow heretics were right to be skeptical. This comes hard on the heels of the head-spinning announcement by the American Cancer Society that, on the basis of "studies", the benefits of routine screening for preventable cancers have likely been overstated, and that treatment of these cancers in the early stages may, in fact, do more harm than good.
Really? Three years ago, the American Cancer Society repudiated a British researcher's "evidence" that there was minimal benefit to screening for breast cancer in women under 50. This study, it should be noted, concluded that the undeniable benefits of early detection in women under 50 were outweighed by...cost (http://www.breastcancer.org/symptoms/testing/new_research/20061208.jsp).
It would not be insane to at least consider the political context in which these recent statements were made. If and when health care becomes a government industry, they have a strong financial interest in cutting costs. What is the real meaning of these recent announcements? They are the first evidence of health care rationing. When cost-containment is a primary concern, there are some patients who are cheaper if they will simply die before they get expensive.
The medical establishment has now completed its transition to government surrogate. Propagating their own brand of dubious evidence and pseudo-scientific "evidence", ACOG leaders can now attend the same lavish Washington cocktail parties attended by the other members of the enlightened collectivist intelligentsia and manmade-global-warming devotees. Real doctors - the men and women who actually treat patients every day - have been betrayed by the societies created to facilitate the effective treatment of disease. We can no longer trust our own societies. And sadly, patients feel they can no longer trust us.
Where do real doctors go from here? It's a pretty bleak picture. Real doctors are few. Having spent centuries mastering the science of medicine, we lost our way somewhere along the road and forgot what science was. Science is observation. Our real-life observations of our patients and their experiences, however, have been denigrated by the medical establishment for decades. "It's only anecdotal," they would say. "Where's your real evidence?" Generations of doctors have emerged from their training as automatons - depending on others to be their eyes and ears. We always assumed that those hired eyes and ears were working for the benefit of patients as we were. Instead, they were being paid to sign their name to ghost-written research. They were on the payroll of for-profit companies. They were on the payroll of a government who now shows its true motive - to become one giant cost-obsessed insurance company. Only now does my gut instinct about "evidence-based medicine" find things placed into focus. I pray it isn't too late for our profession and for our patients.
The first step is to do everything in our power to distance ourselves from the hopelessly corrupted medical establishment - and fast. They had already sold us out for transparent government promises; now our patients are their new targets. They must not be allowed to use our memberships as tacit approval of their actions. Cancel your memberships. They are worthless anyway.
We must, as real doctors with real patients with real concerns, secede from our "profession" and return to what we were entrusted to do. If the government and Big Insurance won't allow the market to work on the large-scale, we must endeavor to do it on the small-scale. I can do examinations for a low price for as many patients as will pay me a fair price for my services. If patients pay for their own mammograms, I'll bet we can find willing radiologists to read those tests for a discount - and end up better off in the end by-passing the endless paperwork and red tape. The increased demand for these procedures would, of course, lead to lower costs per procedure. I would be surprised if some enterprising pathologist wouldn't be willing to do the same regarding Pap smears. Nothing says that we can't do this on our own, if there are simply enough of us left. We don't need permission from the President, the HHS Secretary, or the insurance companies. We only need the approval of our patients. But most of all, we need their trust. If we start now, we can still salvage what is left of it and be real doctors again. If we start now, we may yet rescue our science from death by the strangulation of greed and corruption.
If we start now.
Benjamin Disraeli, First Earl of Beaconsfield and conservative 19th-century British Prime Minister once famously quipped that "There are three kinds of lies: lies, damned lies, and statistics. As I've become a student of public health statistics, I've found that Disraeli was right on target. Statistics in medicine is, more often than not, the science of deception using what should be the most unassailable of all techniques: mathematics. A skeptic of mathematics is, of course, immediately dismissed as an idiot or a nut or both. Nevertheless, I find myself in that dwindling group of physicians that views "studies", the new intellectual currency of medicine, through doubtful eyes.
This week's shocking reversal of opinion about the importance of screening for breast and cervical cancer by no less an authority than the American College of Obstetricians and Gynecologists (ACOG) indicates that I and my fellow heretics were right to be skeptical. This comes hard on the heels of the head-spinning announcement by the American Cancer Society that, on the basis of "studies", the benefits of routine screening for preventable cancers have likely been overstated, and that treatment of these cancers in the early stages may, in fact, do more harm than good.
Really? Three years ago, the American Cancer Society repudiated a British researcher's "evidence" that there was minimal benefit to screening for breast cancer in women under 50. This study, it should be noted, concluded that the undeniable benefits of early detection in women under 50 were outweighed by...cost (http://www.breastcancer.org/symptoms/testing/new_research/20061208.jsp).
It would not be insane to at least consider the political context in which these recent statements were made. If and when health care becomes a government industry, they have a strong financial interest in cutting costs. What is the real meaning of these recent announcements? They are the first evidence of health care rationing. When cost-containment is a primary concern, there are some patients who are cheaper if they will simply die before they get expensive.
The medical establishment has now completed its transition to government surrogate. Propagating their own brand of dubious evidence and pseudo-scientific "evidence", ACOG leaders can now attend the same lavish Washington cocktail parties attended by the other members of the enlightened collectivist intelligentsia and manmade-global-warming devotees. Real doctors - the men and women who actually treat patients every day - have been betrayed by the societies created to facilitate the effective treatment of disease. We can no longer trust our own societies. And sadly, patients feel they can no longer trust us.
Where do real doctors go from here? It's a pretty bleak picture. Real doctors are few. Having spent centuries mastering the science of medicine, we lost our way somewhere along the road and forgot what science was. Science is observation. Our real-life observations of our patients and their experiences, however, have been denigrated by the medical establishment for decades. "It's only anecdotal," they would say. "Where's your real evidence?" Generations of doctors have emerged from their training as automatons - depending on others to be their eyes and ears. We always assumed that those hired eyes and ears were working for the benefit of patients as we were. Instead, they were being paid to sign their name to ghost-written research. They were on the payroll of for-profit companies. They were on the payroll of a government who now shows its true motive - to become one giant cost-obsessed insurance company. Only now does my gut instinct about "evidence-based medicine" find things placed into focus. I pray it isn't too late for our profession and for our patients.
The first step is to do everything in our power to distance ourselves from the hopelessly corrupted medical establishment - and fast. They had already sold us out for transparent government promises; now our patients are their new targets. They must not be allowed to use our memberships as tacit approval of their actions. Cancel your memberships. They are worthless anyway.
We must, as real doctors with real patients with real concerns, secede from our "profession" and return to what we were entrusted to do. If the government and Big Insurance won't allow the market to work on the large-scale, we must endeavor to do it on the small-scale. I can do examinations for a low price for as many patients as will pay me a fair price for my services. If patients pay for their own mammograms, I'll bet we can find willing radiologists to read those tests for a discount - and end up better off in the end by-passing the endless paperwork and red tape. The increased demand for these procedures would, of course, lead to lower costs per procedure. I would be surprised if some enterprising pathologist wouldn't be willing to do the same regarding Pap smears. Nothing says that we can't do this on our own, if there are simply enough of us left. We don't need permission from the President, the HHS Secretary, or the insurance companies. We only need the approval of our patients. But most of all, we need their trust. If we start now, we can still salvage what is left of it and be real doctors again. If we start now, we may yet rescue our science from death by the strangulation of greed and corruption.
If we start now.
Saturday, October 24, 2009
The President Who Cried Wolf...
Disclaimer: My thoughts on this matter do not represent an official medical opinion, and should not be considered as medical advice.
President Obama has declared the outbreak of H1N1 influenza pandemic a "national emergency". This is a very serious claim. For those of us in health care, a mention of an influenza pandemic conjures up memories from countless stories in our training about the 1917-1918 outbreaks that infected an estimated 20 million people in the U.S. and likely killed 850,000.
The current H1N1 influenza outbreak, just to put things in perspective, has killed 100 Americans. There are, to be certain, 100 heartbreaking personal stories to accompany these tragic and untimely ends. We would do well never to forget this. There are real people with real families in real pain behind these nameless, faceless numbers.
But we have a responsibility to weigh this matter with tremendous care. We are being strongly "encouraged" at present to be vaccinated against this strain of influenza, and this latest "emergency" declaration suggests that vaccination may soon be mandatory. The vaccine has been rushed through production - there is no debate about that. There are reports that the vaccine itself may be dangerous. Are we better off taking our chances?
In this time of confusion and fear, we see in sharp focus why it is a problem when people in leadership positions lie. The President and his staff have rendered themselves unworthy of trust. From Rahm Emmanuel's oft-quoted mantra of "never let a crisis go to waste" to the constant din of misrepresentations and obfuscations concerning their health care take-over plans, Administration officials have built a bulwark of lies in their short time in office. Their HHS Secretary, Kathleen Sibelius, made her most powerful contribution to this effort by castigating a reporter who coughed incorrectly, without using his sleeve. The President himself calls physicians greed-obsessed tonsil vultures and serial amputators.
In this climate, when every statement from those in charge is suspect, this latest declaration lacks any convincing quality. Combined with the relatively low mortality numbers and the dubious quality and efficacy of the vaccine, I am left with no choice but to choose to take my chances. This is tragic. After all the advances made in the field of immunology, the work started by Richard Jenner and smallpox now finds its hard-won trustworthiness undone - not by failure, but by the careless abuse of power by a self-obsessed and single-minded fascist.
Once again, the danger of health care dominated by an all-powerful State is clear. There is no longer any objective science. All the researchers are controlled by them. The CDC belongs to them. The media belong to them. Resistance is futile. Maybe the conspiracy theorists are right and the vaccine is some sort of mind-control ploy. Or perhaps they are simply flexing their political muscle. Maybe they are simply using an engineered crisis to overwhelm the system to bring about their further take-over of all facets of American life. More likely they are simply using the crisis to line their pockets in some way.
Or maybe this really is a big deal, and the blood of millions will be on their hands. No shots will have been fired to achieve this genocide. All it will have taken will have been a few lies.
President Obama has declared the outbreak of H1N1 influenza pandemic a "national emergency". This is a very serious claim. For those of us in health care, a mention of an influenza pandemic conjures up memories from countless stories in our training about the 1917-1918 outbreaks that infected an estimated 20 million people in the U.S. and likely killed 850,000.
The current H1N1 influenza outbreak, just to put things in perspective, has killed 100 Americans. There are, to be certain, 100 heartbreaking personal stories to accompany these tragic and untimely ends. We would do well never to forget this. There are real people with real families in real pain behind these nameless, faceless numbers.
But we have a responsibility to weigh this matter with tremendous care. We are being strongly "encouraged" at present to be vaccinated against this strain of influenza, and this latest "emergency" declaration suggests that vaccination may soon be mandatory. The vaccine has been rushed through production - there is no debate about that. There are reports that the vaccine itself may be dangerous. Are we better off taking our chances?
In this time of confusion and fear, we see in sharp focus why it is a problem when people in leadership positions lie. The President and his staff have rendered themselves unworthy of trust. From Rahm Emmanuel's oft-quoted mantra of "never let a crisis go to waste" to the constant din of misrepresentations and obfuscations concerning their health care take-over plans, Administration officials have built a bulwark of lies in their short time in office. Their HHS Secretary, Kathleen Sibelius, made her most powerful contribution to this effort by castigating a reporter who coughed incorrectly, without using his sleeve. The President himself calls physicians greed-obsessed tonsil vultures and serial amputators.
In this climate, when every statement from those in charge is suspect, this latest declaration lacks any convincing quality. Combined with the relatively low mortality numbers and the dubious quality and efficacy of the vaccine, I am left with no choice but to choose to take my chances. This is tragic. After all the advances made in the field of immunology, the work started by Richard Jenner and smallpox now finds its hard-won trustworthiness undone - not by failure, but by the careless abuse of power by a self-obsessed and single-minded fascist.
Once again, the danger of health care dominated by an all-powerful State is clear. There is no longer any objective science. All the researchers are controlled by them. The CDC belongs to them. The media belong to them. Resistance is futile. Maybe the conspiracy theorists are right and the vaccine is some sort of mind-control ploy. Or perhaps they are simply flexing their political muscle. Maybe they are simply using an engineered crisis to overwhelm the system to bring about their further take-over of all facets of American life. More likely they are simply using the crisis to line their pockets in some way.
Or maybe this really is a big deal, and the blood of millions will be on their hands. No shots will have been fired to achieve this genocide. All it will have taken will have been a few lies.
Thursday, October 8, 2009
Demand to Read It.
The cowards who run our legislative branch have refused to make the actual text of their health care bill available to the public before they vote on it. This is simply unacceptable.
This shocking lack of consideration for the rights of their constituents is made even more noxious due to the fact that they are now on the record refusing to promise to read it themselves.
So we are expected to sit back and allow them to commit our tax money for a program with the potential to balloon out of control (as has every socialized health care scheme on earth) with no one minding to spend the time to actually see what is in the bill.
My guess is that they accurately believe that we would be outraged by the stunning lack of honor demonstrated by the text, like...oh, I don't know...Harry Reid's little ploy to save his Senate seat by making Nevada (and only Nevada) exempt from having to participate in the state contribution portion of Medicaid. That means that all the medically-indigent patients in Nevada will be paid for entirely by money from taxpayers from the other 49 states, who also get to pay taxes for their own medically-indigent population, as well as contribute to the state contribution to the program.
This is despicable, but not really surprising. Harry Reid is a sleazy scumbag. None of us needed this to convince us.
The bottom line is this: we must demand, loudly, to be able to read the bill. The stakes are just too high for this catastrophe to occur without anyone knowing what is going on.
This shocking lack of consideration for the rights of their constituents is made even more noxious due to the fact that they are now on the record refusing to promise to read it themselves.
So we are expected to sit back and allow them to commit our tax money for a program with the potential to balloon out of control (as has every socialized health care scheme on earth) with no one minding to spend the time to actually see what is in the bill.
My guess is that they accurately believe that we would be outraged by the stunning lack of honor demonstrated by the text, like...oh, I don't know...Harry Reid's little ploy to save his Senate seat by making Nevada (and only Nevada) exempt from having to participate in the state contribution portion of Medicaid. That means that all the medically-indigent patients in Nevada will be paid for entirely by money from taxpayers from the other 49 states, who also get to pay taxes for their own medically-indigent population, as well as contribute to the state contribution to the program.
This is despicable, but not really surprising. Harry Reid is a sleazy scumbag. None of us needed this to convince us.
The bottom line is this: we must demand, loudly, to be able to read the bill. The stakes are just too high for this catastrophe to occur without anyone knowing what is going on.
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