Posted in Canadian Health System, Disease Prevention, emotional intelligence, outcomes measurement, Patient Choice, Patient Safety, Policy Issues, Prevention, Protocols, Uncategorized, Unsettled Science

The surgical mask is a bad fit for risk reduction|Shane Neilson, MD | CMAJ.JAMC

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As represented by our cinema and other media, Western society expects too much of masks. In the public’s mind, the still-legitimate use of masks for source control has gone off-label; masks are thought to prevent infection. From here, another problem arises: because surgical masks are thought to protect against infection in the community setting, people wearing masks for legitimate purposes (those who have a cough in a hospital, say) form part of the larger misperception and act to reinforce it. Even this proper use of surgical masks is incorporated into a larger improper use in the era of pandemic fear, especially in Asia, where such fear is high. The widespread misconception about the use of surgical masks — that wearing a mask protects against the transmission of virus — is a problem of the kind theorized by German sociologist Ulrich Beck.

The surgical mask communicates risk. For most, risk is perceived as the potential loss of something of value, but there is another side to risk, memorably formulated by Beck in his Risk Society. Beck states that risk society is “a systematic way of dealing with hazards and insecurities induced and introduced by modernisation itself.” For Beck, risk occurs not only in the form of threat and possible loss, but also in society’s organized management and response to these risks, which create a forwarding of present risk into the future. Furthermore, Beck writes of the “symptoms and symbols of risks” that combine in populations to create a “cosmetics of risk.” He suggests that people living in the present moment conceive of risk in terms of the physical tools used to mitigate risk while still “maintaining the source of the filth.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868614/#:~:text=Wearing%20a%20mask%20reinforces%20fear,%2C%20but%20somehow%20threatening%2C%20future.

 

Posted in Education, Evidence-based Medicine, NIH, outcomes measurement, Quotes from American Presidents, Uncategorized

Check Your Scientism!

qqitfYou might be Scientismist if…

…you source-cite frantically to substantiate your views, even if you haven’t analyzed the data or the methods used or considered the limitations of the findings?

…you automatically believe certain sources and dismiss others without reading the original citations.

…you get your science from Facebook ads

…you believe the use of the phrase “scientific study” imparts devine validation to the conclusions.

…assume peer review is a real thing.

…don’t know the difference between a RCT, case-controlled study, cross-sectional study, cohort study, retrospective or prospective study…and don’t want to because it might call into question validity of your narrative!

…assume strong correlation is same as causation…AND don’t care if you’re wrong as long as it helps make your point!

And the #1 clue that you may be a Scientismist… When your favorite saying is, “the NIH says it, I believe and that settles it!”

Publishing a “study” does not bestow validation and data is mishandled as often as not; which is why much of the medical literature is wrong.

Hyperrational arrogance leads to scientism, which is not the same as good science.

Don’t be a scientismist!

Posted in Access to healthcare, Economic Issues, Government Regulations, Health Insurance, Healthcare financing, Medicaid, Medical Costs, medical inflation, Medicare, out-of-pocket costs, Policy Issues, Uncategorized

The Pernicious Impact of Government Intervention in Healthcare, Captured in a Chart

AdministratorGrowthVS.PhysiciansAs Dan Mitchell mentions in his post, much of the dysfunction we witness in healthcare are simply symptoms of the distortions that arise when we rely on a third-party payer system, with heavy government involvement, and all its perverse incentives which distort decision making for all participants. And so often the proposed “fixes” are aimed at mitigating symptoms caused by the third-party effect, rather than peeling back the layers to get to the root cause. Is it any wonder things aren’t improving despite billions and billions of subsidies, massive intervention, regulations and various forms of scrutiny!

International Liberty

America’s healthcare system is a mess, largely because government intervention (Medicare, Medicaid, Obamacare, and the tax code’s healthcare exclusion) have produced a system where consumers almost never directly pay for their medical services.

This “third-party payer” system basically means market forces are absent. Consumers have very little reason to focus on cost, after all, if taxpayers or insurance companies are picking up the tab for nearly 90 percent of expenses.

As a result, we get ever-higher prices.

But we also get a lot of featherbedding and inefficiency because providers want to take advantage of this system.

Athenahealth offered some sobering analysis on the system last year.

The number of physicians in the United States grew 150 percent between 1975 and 2010, roughly in keeping with population growth, while the number of healthcare administrators increased 3,200 percent for the same time period.

View original post 241 more words

Posted in Access to healthcare, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, government incompetence, Government Regulations, Healthcare financing, Medical Costs, Medical Practice Models, Medicare, News From Washington, Organizational structure, Patient Choice, Patient-centered Care, Policy Issues, primary care, Quality, Reforming Medicare, Third-Party Free Practices, Uncategorized

Is CMS “DPC” model headed wrong direction?

The RFI goes on to explain the CMS vision of, “direct provider contracting (DPC), through which CMS would directly contract with Medicare providers.” Obviously this interpretation of “DPC” turns the true meaning of Direct Patient Care on its head.

https://mailchi.mp/aapsonline/cms-dpc-model?e=7be491a5e2

Posted in Access to healthcare, advance-pricing, Consumer-Driven Health Care, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Health Insurance, Healthcare financing, Independent Physicians, Liberty, Medical Costs, medical inflation, Medical Practice Models, Network Discounts, Organizational structure, out-of-pocket costs, outcomes, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Quality, Self-Insured Plans, Third-Party Free Practices, Uncategorized

A Brief History of the Free Market Healthcare Movement: A discussion with Jay Kempton & Dr. Keith Smith

by Megan Freedman – Editorial Manager, Free Market Healthcare Solutions magazine

These names are, in many ways, synonymous with the current free market movement, and for good reason. These men are the mavericks of healthcare. When Dr. Smith and Mr. Kempton were introduced in 2011 by a mutual friend and client, they had no way of knowing that their partnership would become what it is today and create an entire movement in the healthcare space.

 

Jay.Keith.headlinephotoJay Kempton: When you understand how this business really works, you can see the effect of the dysfunction which I just described; but when you learn more about the cause, you can see that the patients’ actual financial concern is not even on the radar of so many entities that are part of big healthcare.  Hospitals really do not understand that the gouging of pricing that they do trickles down into basically wage stagnation to employees. They say, “We’re raising our prices, but it only hurts the big insurance companies.”  No, that’s never the way it works.  It eventually makes it way as an increased cost to the employer. They can’t afford to just absorb the increase, so how do they offset that?  By lowering or decreasing the increase of wages or they reduce the benefits, or both.

What is the greatest obstacle that this movement and the FMMA faces?

Dr. Keith Smith:    The answer may be counterintuitive.  I think the greatest obstacle the FMMA and this movement faces is ourselves. We are so programmed and conditioned to look to outside leaders or to the government for solutions and answers. They are ultimately responsible for all the problems that have led to our current system.  The answer is looking to ourselves and having the courage to face the possibility that, in innumerable ways, we have been duped. Admitting that is a very personal and difficult experience for many people—to look in the mirror and acknowledge that they’ve been lied to. Even worse, we have believed these lies and have acted accordingly.  People must acknowledge that it is a ground up movement, not one where solutions rain down on us from our rulers or our leaders. They must do their own thinking and not allow those who would like to be protected from innovation to stop us.

Jay Kempton: The obstacle that’s not so benign is how people in the healthcare business get paid.  Brokers, consultants, and agents have tremendous influence over employers and patients, and the way that they see healthcare.  Many people in the employee benefits business get paid when they make money off the problem. In other words, they’re making a percentage of the healthcare spend.  The problem gets bigger, their income goes up. 

If you could tell someone just one thing about the free market in healthcare what would it be?

Dr. Keith Smith: The one thing I would tell them is that the free market is not about sellers having their way with consumers.  The free market is not about brutalizing the poor, or people who are trying to pay for their own care.  
The free market is about an exchange between buyers and sellers that is mutually beneficial, where both parties emerge feeling like it was a good exchange. Any time that the media quotes some corporate healthcare exec or politician bemoaning the tough future that one of the sellers might face given some policy that might be enacted should be discounted or ignored. The focus has to be on the consumer, and on whether a consumer’s decision to buy A or B is a value to that person.  The one message that I would give is to know that this movement is about servicing consumers. Period. Any concerns or desires that sellers have to be protected from the preferences of consumers must be seen as the source of the problem that we all face in health care today.

Jay Kempton: The free market and healthcare is the only true healthcare reform that has a chance of being sustainable. Anything else is just rearranging the deck chairs on the Titanic.  

http://ushealthmedia.com/free-market-mavericks-%E2%80%A2-dr-keith-smith-and-jay-kempton/

Posted in Education, Evidence-based Medicine, outcomes measurement, Patient Safety, Policy Issues, Quality, Uncategorized, Unsettled Science

Irreproducible ‘Scientific’ Results

The reliability of evidence-based medical care depends on validation of original research. Let’s start encouraging and incentivizing investigators to verify (or refute) heretofore non-reproduced studies; while simultaneously discouraging primacy signalling with impact factors such as prestige of the institution.

https://www.medscape.com/viewarticle/893097

Posted in Education, FDA, News From Washington, Patient Safety, Prevention, Uncategorized

Kratom Now an Opioid, FDA Says

FDA scientists analyzed the chemical structures of the 25 most common compounds in kratom and concluded that all of the compounds share structural characteristics with controlled opioid analgesics, such as morphine derivatives. They also found that compounds in kratom bind strongly to mu-opioid receptors, comparable to opioid drugs.

“Based on the data we now have, we feel confident in calling these compounds opioids,” Dr Gottlieb said.

https://www.medscape.com/viewarticle/892375

Posted in Disease Prevention, Education, emotional intelligence, Good Stress, Habits of ultra-likable leaders, Leadership, Sleep, Stress, Uncategorized

Watch “Jordan Peterson – One Of The Most Eye Opening Speeches | Depression & Success” on YouTube

Attacking the Dragon in its Lair Before it Eats You:

A Discussion of meaningful philosophy, psychological health and societal Improvement – by dr. Jordan Peterson