Category Archives: Blog

Fixing Healthcare – Part Three

Physician’s Assistants (PAs) and Advanced Registered Nurse  (ARNPs) are helping lower costs and increase access. While some nurse practitioners, can operate relatively independently; other nurse practitioners and most physicians’ assistants, cannot. Why?

Physicians are adamant that they maintain a high degree of control over these and other healthcare workers. This is a throwback to the nineteenth century—which is kind of interesting in a weird sort of way. The story, and I cannot vouch for its accuracy, although all my research seems to support it, is that the country was besotted with traveling medicine shows hawking patent medicines (You’ve seen it in the movies—“One for a man, two for a horse”). The physician industry supposedly promised to get things under control if they were put in charge of medical practitioners, i.e., physicians and surgeons (MD). It, at best, minimized, if not blackballed, osteopathic physicians (DO), chiropractors (DC) and chiropodists, now known as podiatrists (DPM).

A physician, at the time, could authorize any hireling under his license to perform any duty under the concept that the doctor was “the captain of the ship” and was responsible for everything. Therefore, he had authority to authorize any employee to do anything—hopefully, but not necessarily, after some training.

Today, many non-physician healthcare workers are licensed in their own right; in most states this includes nurses (of all levels), therapists (of all varieties), and technologists (ditto). These people are trained and possess technical skills that physicians do not. Generally speaking, only television doctors leave their practice in order to operating high technology devices. It’s good theater but bad economics.

Many of the other healthcare careers such as nurse practitioners, physicians’ assistants, etc., have made significant advances Unfortunately, old attitudes die hard, and there are too many physicians who try to maintain an inordinate control over everything, including these other professionals. Nurse anesthetists and physicians’ assistance must be “supervised” by a physician, although such supervision does not require actual observation or even the presence of the supervising physician.

Efforts to keep others under control have led to some bizarre arrangements. In radiology, for example I’m told that the technologists are now required to periodically retake the examination that initially proved their competence even though there has been continuing education requirements for 40 years. If true, I believe this is a unique requirement, but a warning to all others. Of all the physicians’ assistants, only those specializing in radiology are not permitted to interpret x-ray or other diagnostic images.


Some blame the American Medical Association, a very powerful organization with effective lobbyists. However, it apparently speaks for a self-selected group of physicians. Out of 923,308 practicing physicians, the most recent numbers available indicates that only 228,000 belonged to the AMA. If you don’t round, that’s just less than 25 percent.

Nobel Laureate Milton Friedman and his wife, who wrote the book Free to Choose, asserted that the AMA functions more like a guild with the goal of increasing physicians’ wages and fees by limiting both the supply of physicians and the competition from non-physician groups.

This is yet another issue that must be addressed if we are truly interested in fixing healthcare.

To Err Is Human—To Really F*** Up, You Really Need a Computer

I admit that life demands a place over blogging. I admit that faith, family, friends, work, and keeping up with laundry, mowing, etc. get in the way, too. However, over the past few weeks, I have actually written a few blogs, but my computer would not let me post them, and then they disappeared.

Eventually, I realized the truth.

Whenever I arrive home—early, late, whatever—Louis (our dog) expects to eat. Whenever Adam, my son is gone, his cat demands attention from me—lots of attention—just so long as I don’t try to actually pick her up and hold her.

OMG*, my computers have developed similar traits. If I don’t pay them adequate attention, they act out—obvious passive aggressive actions.

First, it’s a slowing of all functions followed by lost files. Something like:

Me: “Open blog May 2, 2017”

Computer: “                                                                                        Huh?


Then the computer moves to:

“I can’t locate the file.

What application do you want to use to open the file?

The file is corrupted and cannot be opened.

Ooops! The dog ate my files—I mean file not located.”

I’ve been busy looking at new computers online—using the offending computer—but it has such an inflated opinion of itself, it doesn’t seem to care. It just might be in for a big surprise. Feel free to castigate my offensive hardware.



*Others May Question (my sanity)


Complain, Complain, Complain!

I haven’t written much lately, or at least not much for the blog. (I have been working on a story, though. For some reason, writing fiction has become more satisfying than writing about reality).  I try, when I write, to focus on the silver lining rather than the cloud. Lately, this has become most difficult.

We’ve already discussed how the news media obsesses on all things negative—or meaningless (What’s wrong with Richard Simmons? Will Johnny Depp survive the breakup? Will Caitlin decide to become Bruce once again?). Every trend dies sooner or later, except, apparently for this one. I suppose it’s because they pick the stories that sell the most erectile dysfunction prescriptions, thereby financially benefiting the media, your physician, Big Pharma, venture capitalists, and investment firms.

I propose that we start anew. First, let’s hold a memorial service for journalism. It had a short and tragic life. The first American newspapers were all opinion pieces, but there was one brief shining moment—a century or so—when factual reporting became the gold standard. Many were thrilled at its demise.

My favorite magazines—National Geographic, Wired, and Smithsonian, and National Public Radio have begun to beat me over the head with more doom and gloom. I don’t care who just wrote a book to announce that they’ve come out as gay; I’m sorry that peasants hack down the rain forests because they need to plant food; I regret that there’s a controversy in reintroducing wild wolves into areas where cattle are raised; and I find it unfortunate that while developed countries used coal in the nineteenth century, we balk at twenty-first century countries using such antiquated (but economically viable) methods.  The difference is that rising sea levels today threaten ninety percent of the world’s population because they live near the coast.

In the 1960s we had a saying, “If you’re not part of the solution, you’re part of the problem.” Complaining, even if you’re a well-known television newsperson, accomplishes nothing. How do you plan to solve the problem? Like the ghost of Freddie Prinz the response seems to be, “Not my problem, man!”


Schizophrenia as an Aid to Writing

Writers of fiction need to be a bit schizophrenic; they live partially in this world and partially in the world that doesn’t exist except as printed words. It’s the characters that are to blame. As I’ve mentioned before, when I’m writing, if I know my character—and for clarity’s sake, let’s stick to just a single character—when that character is placed in a certain situation, it’s easy to write, because I know what that character would do. I can even anticipate when that character is going to do the opposite of what would it would normally do.

As a writer I unconsciously develop the character’s back story. In the story I’m working on now, I’ve got a pretty good understanding of what the protagonist’s life has been like up till now. I may not have thought through details, but since I have the overview, the events that led to a particular trait reveal themselves fairly easily when I need them.

I wrote one column for nearly twenty years, and I knew one character intimately. On the other hand, these stories included a narrator—think Dr. Watson to Sherlock Holmes. The difference was that I never really knew who this narrator was. Was it me? Was the narrator male? Female? Caucasian? Ethnic? To this day, almost 33 years after I first began to write that story, I can’t tell you.

Why? I don’t know. Perhaps it encouraged everyone to identify with the narrator. It might have been that as a character, the narrator was merely a mechanism—like the plucky comic relief character in a movie. The narrator might have been the human version of Alfred Hitchcock’s McGuffin. Hitchcock explained that a McGuffin was something like the microfilm that all the characters tried to get; what is on the microfilm is unimportant.

For that matter, the narrator back then might even have been named McGuffin. Who knows?


As promised, in order to be completely politically correct, this blog is devoted to mayonnaise. Perhaps devoted is too strong a word, but it will be about mayonnaise—I don’t want anyone thinking I have some kind of mayonnaise fetish.

Wikipedia says that mayonnaise is, “a thick, creamy dressing often used as a condiment. It is a stable emulsion of oil, egg yolk, and either vinegar or lemon juice, with many options for embellishment with other herbs and spices.”

I say that mayonnaise is politically correct, non-controversial and slightly bland.

Many of us grew up being told that the most dangerous thing at a picnic was not the poison ivy, the fire ants, or even hungry bears. We were warned to avoid any potato salad that had been out of the refrigerator for more than ten seconds because it would spoil, cause food poisoning,  and we’d die a slow, painful death. Some years later I heard on the radio that because mayonnaise contains vinegar and/or lemon juice—both acting as preservatives—this was unlikely. Of course the guy on the radio might have actually intended to be a mass murderer and slaughter thousands of gullible listeners,wielding spoiled potato salad like a deadly weapon.

There’s phony mayo, labeled either “Salad Dressing” or “Phony Mayo.” Considering that a dab gets added to a sandwich filled with several kinds of meat, cheese, lettuce, tomato, pickles, and jalapenos, I’m sure most people couldn’t tell which dab had been added to  the sandwich they were eating.

Spices are often added because mayonnaise is slightly bland. You must be careful, though since adding things to mayonnaise, changes it. Add mustard to mayo and you have remoulade. Add chopped cooked potatoes, eggs and celery and you have deadly potato salad.

I hope you have enjoyed today’s politically correct, non-controversial, and slightly bland blog. Please do not leave this blog outside in the summer sun as it may spoil and kill you.

Choosing a Subject

Today, let’s discuss politics

Some bathrooms are designed

With having my blog, I’ve considered my own server

I like to play music because the relaxation may help me live longer. Look at professional musicians

It’s spring! Let’s enjoy the sunshine, except for the risk of melanoma and climate change

I’ve always enjoyed Pink Floyd, especially their greatest album, The Wall

Has political correctness gone too far?

We just had our local elections


It’s not that I’ve had writer’s block, it’s just that most topics have just gotten, for lack of a better word, too icky. So, I’m working on a serious piece, and still working on that story I mentioned earlier. Today I put together a number documents that might be helpful to the radio operators in the event of a hurricane—after all we’ve had about four years of relative peace and quiet. So, alas, I have not been parked in front of the television being mindlessly entertained.

On the other hand, I read lots of fascinating things: National Geographic’s take on life and death; Popular Science’s interview with President Obama, which I thoroughly enjoyed; Wired’s coverage of computer security—which I would have enjoyed, but they take a fascinating article and print it in weird fonts, low contrast inks and hinky graphics. That takes all the fun out of it.

So I’ll try to come up with something that is intellectually stimulating, but not controversial, that respects diversity, individual preferences, and is, of course, politically correct. Therefore, you can look forward to my exciting coverage on

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Data-ish Stuff

Data (datt’ a) used to be the plural of datum [ˈdādəm, ˈdadəm] NOUN

  1. a piece of information..
    • an assumption or premise from which inferences may be drawn. See sense datum.
  2. a fixed starting point of a scale or operation.


mid 18th cent.: from Latin, literally ‘something given,’ neuter past participle of dare ‘give.’*

Somewhere along the line, data became both singular AND plural, although the singular often was used as an adjective, such as “a data point.” Recently I’ve begun to see data used as the singular and datas as the plural. That’s the problem with a living language—it keeps changing.

On the other hand, Data (day’ ta), the android on Star Trek, the Next Generation, will apparently always remain Data.

Or is that just too many datums for you?

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