Category Archives: Business

The Brain? Abby Normal

foot

Aaron Hernandez (the late football star) is in the news because he committed suicide while in prison after he was sentenced for murder. His dead body provided shocking information that medical science was not able to discern; his autopsy showed chronic traumatic encephalopathy.

Now, let me get this straight—it’s the twenty-first century, and instead of having flying cars (dammit!) we are just beginning to realize that if you hit someone in the head, over and over, it affects them. It impairs their judgement, causes mood swings, and inappropriate behavior.

Well, we’d better stop that—unless getting hit in the head is part of a professional sport that generates millions of dollars in revenue.

Sounds curiously like the justification for the gladiators fighting to the death in the Roman Coliseum. That, of course, pleased the crowds, but was barbaric.

We’d never stoop so low today, but, if it has major network coverage, instant replays with everything coordinated to accommodate commercial breaks, and attractive cheerleaders, it’s okay. Hell, we’ll have a dedicated section of the newspaper every day!

Hmm.

Being surprised that repeated head trauma causes problems is kind of like the medical logic that “if you shove an ice-pick up somebody’s nose far enough so that it reaches the brain and you wiggle it back and forth, they act differently afterward.”

Is it just me, or are we missing the blazingly obvious?

Maybe I should just shut up and bang my head against the wall repeatedly, until it makes sense.

From Whence Comes the Disaster?

So, with Hurricane Irma headed my way, I drove my Wells Fargo financed car to the airport, and with my Wells Fargo credit card, I bought a ticket on United Airlines.

Anyone want to guess where things went awry?

(Hint: My car was repossessed, my credit score demolished, I got dragged from the airplane, and never got to my destination. Those are only hints.)

Labor Day

According to the US Department of Labor, Labor Day was first celebrated in New York City in 1882, although there is some disagreement as to whether the machinists’ union or the carpenters’ union can claim credit. It was a municipal holiday, and other cities were invited to follow suit. After 23 states recognized it in 1894, the US Congress passed legislation making it a national holiday.

As one trained in management, it was repeatedly pointed out to us in college that the real job of management is to remove the roadblocks that prevent workers from being productive. Except in very small businesses, managers and owners produce no products nor do they provide services to the customer. Everybody’s paycheck comes from the efforts of the workers.

In many ways, we seem to have forgotten that and tend to believe that the people in the big offices and the expensive suits are the producers. Meetings don’t generate revenue. PowerPoint slides, slickly bound and printed reports, consume a lot of resources, but belong solely to the Expense side of the ledger.

Even as automation takes over many jobs, reports are that the demand for workers is increasing. The workers may perform different functions, but they are still critical to the process, no matter how much the elites may wish to believe otherwise.

Today there are many industries that produce nothing. Instead they move money around, mix it up, and in so doing make a profit. Some of this “profit” is virtual—it exists on paper, but may never translate into cash. Other profits occur when money is moved from one owner to another; this is a transfer—profit means that there is more, not that we’ve moved it around.

We are becoming a banking and finance nation, which is one of the places where a nation moves when it ceases to be great. The great nations of only a few centuries ago—The Netherlands, Spain, Portugal, France, Great Britain, etc. are only a shadow of their former selves.

So, to those of you who build, grow, design, or otherwise create, thank you. It’s your day—enjoy.

Football In the Future

Football Hall of Fame Re-opens

Newly remodeled Football Hall of Remembrance opens to celebrate Traumatic Brain Injury.

SATIRE AFFILIATED PRESS
CANTON, OHIO 11 September 2035

Although American style football has been banned, the Football Hall of Remembrance—formerly the Football Hall of Fame—is still a popular tourist attraction. It’s remodeling was recently completed and the familiar football roof is now surmounted by an artist’s conception of traumatic brain injury. Over the front door, the entryway features a bronze relief of a player being carted off the field after, as they used to say, “Having his bell rung.”

While the exhibits still include trophies, helmets, jerseys, and other game paraphernalia, it’s the preserved brain tissue and MRI scans that are today’s favorite. Visitors can view the pathology, then try to guess to which famous player the brain once belonged. Pressing a touch screen, the player’s name, teams, scores, and number of concussions is displayed. Original plans included videos of interviews with former players, but many could no longer communicate, being content to babble incoherently, or stop mid-sentence with, “What did you just ask me?”

Taking a page from big tobacco’s playbook, the industry insisted for years that football was not dangerous; eventually there were too many injuries at the high school, university, and professional levels to ignore. Professional teams found that medical insurance costs exceeded revenues—even if the revenue from sale of team products like hats and jerseys are included. With the profits gone, most owners took their investments elsewhere. Unfortunately, this left many cities with substantial debt for stadiums they built. Many are crumbling and have been condemned because of the degree of deterioration; there’s reason to repair them and no money to tear them down. Universities initially expected a huge financial crisis, but found that the sport had actually not been a money maker, in terms of real cash, but a huge annual loss. Without football many universities were able to improve facilities and pay teachers better.

Football, is gone, but not forgotten—except by those who played the game and had their bells rung too many times.

It’s Good to Be the Tsar!

putin

Vladimir Putin, according to reports, is wealthier than the next two richest people combined with a net worth of $200 billion. Pretty good for someone who grew up as Communist with enough commitment to work for the KGB.

His career with the KGB was unremarkable (his highest rank was lieutenant colonel), but once he got into politics, he found his niche. Trained as a lawyer, he adopted the Don Corleone business model (“One lawyer with a briefcase can steal more money than 100 men with guns.”–The Godfather). When the Soviet Union fell, various Russians began to acquire wealth. Putin apparently made many of them an offer they couldn’t refuse.

It might be good to keep that in mind before considering doing business with Putin.

Goodbye to an Old Friend

Long before my time, Theodore and Milton Deutschmann started a business to cater to the new field of wireless—specifically, amateur radio. They called their business Radio Shack.

rs

Why? Ships were among the first to adopt wireless communications, and since early transmitters created a signal by generating a huge spark, there was the risk of starting a fire. To minimize risk, the radio equipment was placed on the main deck, in a separate small building, which came to be called the radio shack.

Ham radio operators (no one knows for sure why they’re called “hams”) tended to call the place where their radio station was located as the radio shack, or ham shack. Amateur radio was shut down during both world wars, but hams returned to the air as soon as it was legal to do so. The end of the Second World War provided an added advantage with huge selection of inexpensively priced military surplus radio equipment.

When I was a youngster, there were a few radio stores around town where you could buy components or tools. However, periodically the mailman would deliver a catalog from Lafayette, Allied, or Olsen Electronics. The Sears Christmas toy catalog couldn’t compete with these for the pure lust they generated. I remember building a set of Knight Kit walkie talkies, purchased from Allied.

In the late 1960s, Allied began opening stores in malls, outcompeting most the other companies, which gradually faded away. Allied purchased Radio Shack, but the combined Allied-Radio Shack was determined to be too monopolistic, and the two companies were split up. Allied became the industrial supplier while Radio Shack stayed as the retailer in the malls. Radio Shack sold things that you couldn’t find elsewhere. The TRS-80 computer was one of the first personal computers. They introduced a pocket-sized computer and one of the first laptops. Radio Shack had a niche market—the nerds—but nerds were paying $2,500 for a radio shack computer before the general population knew personal computers existed.

You could find all the parts to build a stereo from tuner to speaker wire. How about a multimeter and a soldering iron? They sold CB radios, of course, but also some ham radio transceivers. Most everything was manufactured by someone else, but carried one of Radio Shack’s brand names.

If you were working on a project and need a 47 ohm resistor (usual price, 10 cents—Radio Shack price, two dollars) you could drive to the mall on a Sunday and finish your project before dinner, even on a Sunday afternoon. Yeah, their components were overpriced, but the convenience made it worth it.

Then, one fateful day, the brainless
pencilnecks management of Radio Shack decided to sell the same products (e.g., cell phones) that you could buy for less money at Best Buy, WalMart, RiteAid, etc.

I’ve been told by Radio Shack managers that the really profitable part of the store was the parts section with those overpriced resistors, capacitors, and semiconductors. You know, the ones you could buy whenever you needed them? The parts selection went from a large section of wall to a metal cabinet with multiple drawers. I think the cabinet got smaller, but in any case, there were fewer and fewer parts available. Cell phones—no problem. Parts? Sorry.

I hear that Radio Shack is still sort of, kind of, in business, but you couldn’t prove it by me. The last local store is now empty. Like Bigfoot or the Loch Ness Monster, you only hear about someone who knows someone whose brother-in-law saw one. It’s too bad—they could have coasted a few more years just on what I spent there.

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.

Why?

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.