On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:

>On 3/30/2022 6:01 PM, John B. wrote:
>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>> <ritzannaseaton@gmail.com> wrote:
>>>>
>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>
>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>>>>>>>>>
>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>>>>>>>>>
>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>>>>>>>>>
>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>>>>>>>>
>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>>>>>>>
>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>> 3. Cardiologist for heart attack.
>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>> 5. Podiatrist for foot problems.
>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>> 8. Hematologist for blood clots.
>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>>>>>>>
>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>> --
>>>>>> Cheers,
>>>>>>
>>>>>> John B.
>>>>>
>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>>>>
>>>> But what is good, or what is better? If, for example. you have high
>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>> also strongly recommend that you change your diet, lose weight and
>>>> start to exercise.
>>>>
>>>> Which is the better doctor?
>>>>
>>>> And which is the doctor that most will recommend to their friends?
>>>>
>>>
>>> That's a complex question. The brother of a good friend is
>>> a suburban GP who says that mothers bring children in with
>>> viruses and demand antibiotics. His choice is either to do
>>> the right thing and say no, resulting in a reputation as a
>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>> with the understanding that most childhood viruses will
>>> clear them selves in a few days with rest.
>>>
>>> And you can double that problem for doctors asked to
>>> prescribe morphine and similar. The patient knows that
>>> someone else (insurance company or welfare) will pick up
>>> most of the office visit and prescription charges, leaving
>>> the patient with a saleable item.
>>>
>>> Add in that few MDs are independent professionals now.
>>> They're employees of large entities and capitated, which
>>> means time spent with a patient is strongly discouraged.
>>>
>>> How to approach that problem? Systematize pill pushing!
>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>
>>> Define 'good doctor' any way you like but the degradation of
>>> the medical industry (from the patient's view, not the
>>> revenue side of the industry) continues.
>>
>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>> heart beating regularly. Not that many years ago there weren't any
>> such devices and I'd likely be dead today.
>>
>> Hardly degradation (:-)
>>
>
>I wrote 'degradation' not 'disappearance'.
>
>Pacemakers have been around for some 70 years or so (with
>regular improvement I might add) which makes them hardly an
>exemplar of the current problems.

62 years actually. the first pacemaker was implanted in a human, in
1960, in a 77-year-old man, who lived for 10 months after the surgery.

But, I'm still not sure about "degradation" as that implies that
medical care is less, or less well done, today then it was in the
past, while I'm seeing things done today that would have been
considered impossible a generation ago.
https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
--
Cheers,

John B.

On Wednesday, March 30, 2022 at 8:46:22 PM UTC-5, John B. wrote:
> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <a...@yellowjersey.org> wrote:
>
> >On 3/30/2022 6:01 PM, John B. wrote:
> >> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >>
> >>> On 3/30/2022 3:05 AM, John B. wrote:
> >>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russell...@yahoo.com"
> >>>> <ritzann...@gmail.com> wrote:
> >>>>
> >>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
> >>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
> >>>>>> <ritzann...@gmail.com> wrote:
> >>>>>>
> >>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
> >>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
> >>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
> >>>>>>>>>
> >>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
> >>>>>>>>>
> >>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out..
> >>>>>>>>>
> >>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
> >>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
> >>>>>>>>
> >>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
> >>>>>>>
> >>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
> >>>>>>> 1. Orthopedist for osteoporosis.
> >>>>>>> 2. Rheumatologist for arthritis.
> >>>>>>> 3. Cardiologist for heart attack.
> >>>>>>> 4. Proctologist for hemorrhoids.
> >>>>>>> 5. Podiatrist for foot problems.
> >>>>>>> 6. Ophthalmologist for eye problems.
> >>>>>>> 7. Nephrologist for your kidney disease.
> >>>>>>> 8. Hematologist for blood clots.
> >>>>>>> 9. Otolaryngologist for hearing loss.
> >>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
> >>>>>>>
> >>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
> >>>>>> But, how does one select a "good" doctor? Do doctors publish their
> >>>>>> grades in Medical school? Do doctors publish win/loss scores for
> >>>>>> patients cured/died? How does one pick a "good" doctor?
> >>>>>> --
> >>>>>> Cheers,
> >>>>>>
> >>>>>> John B.
> >>>>>
> >>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
> >>>>
> >>>> But what is good, or what is better? If, for example. you have high
> >>>> cholesterol, one doctor might recommend that you take LIVALO for your
> >>>> problem, but another doctor might recommend lower doses of LIVALO but
> >>>> also strongly recommend that you change your diet, lose weight and
> >>>> start to exercise.
> >>>>
> >>>> Which is the better doctor?
> >>>>
> >>>> And which is the doctor that most will recommend to their friends?
> >>>>
> >>>
> >>> That's a complex question. The brother of a good friend is
> >>> a suburban GP who says that mothers bring children in with
> >>> viruses and demand antibiotics. His choice is either to do
> >>> the right thing and say no, resulting in a reputation as a
> >>> 'bad doctor' or to prescribe a very low dose of antibiotics
> >>> with the understanding that most childhood viruses will
> >>> clear them selves in a few days with rest.
> >>>
> >>> And you can double that problem for doctors asked to
> >>> prescribe morphine and similar. The patient knows that
> >>> someone else (insurance company or welfare) will pick up
> >>> most of the office visit and prescription charges, leaving
> >>> the patient with a saleable item.
> >>>
> >>> Add in that few MDs are independent professionals now.
> >>> They're employees of large entities and capitated, which
> >>> means time spent with a patient is strongly discouraged.
> >>>
> >>> How to approach that problem? Systematize pill pushing!
> >>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
> >>>
> >>> Define 'good doctor' any way you like but the degradation of
> >>> the medical industry (from the patient's view, not the
> >>> revenue side of the industry) continues.
> >>
> >> I'm not sure that I agree with you. I have a pacemaker, which keeps my
> >> heart beating regularly. Not that many years ago there weren't any
> >> such devices and I'd likely be dead today.
> >>
> >> Hardly degradation (:-)
> >>
> >
> >I wrote 'degradation' not 'disappearance'.
> >
> >Pacemakers have been around for some 70 years or so (with
> >regular improvement I might add) which makes them hardly an
> >exemplar of the current problems.
> 62 years actually. the first pacemaker was implanted in a human, in
> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>
> But, I'm still not sure about "degradation" as that implies that
> medical care is less, or less well done, today then it was in the
> past, while I'm seeing things done today that would have been
> considered impossible a generation ago.
> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
> --
> Cheers,
>
> John B.

When I was a young kid, 40+ years ago, I saw a man with a pacemaker. It was big, about half the size of a baseball, underneath the skin on his chest. Are modern pacemakers still like that? Huge bubbles sticking out on the chest? Or have they gotten a whole lot smaller now?

On Thu, 31 Mar 2022 00:57:42 -0700 (PDT), "russellseaton1@yahoo.com"
<ritzannaseaton@gmail.com> wrote:

>On Wednesday, March 30, 2022 at 8:46:22 PM UTC-5, John B. wrote:
>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <a...@yellowjersey.org> wrote:
>>
>> >On 3/30/2022 6:01 PM, John B. wrote:
>> >> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <a...@yellowjersey.org> wrote:
>> >>
>> >>> On 3/30/2022 3:05 AM, John B. wrote:
>> >>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russell...@yahoo.com"
>> >>>> <ritzann...@gmail.com> wrote:
>> >>>>
>> >>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>> >>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>> >>>>>> <ritzann...@gmail.com> wrote:
>> >>>>>>
>> >>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>> >>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>> >>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>> >>>>>>>>>
>> >>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>> >>>>>>>>>
>> >>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>> >>>>>>>>>
>> >>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>> >>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>> >>>>>>>>
>> >>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>> >>>>>>>
>> >>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>> >>>>>>> 1. Orthopedist for osteoporosis.
>> >>>>>>> 2. Rheumatologist for arthritis.
>> >>>>>>> 3. Cardiologist for heart attack.
>> >>>>>>> 4. Proctologist for hemorrhoids.
>> >>>>>>> 5. Podiatrist for foot problems.
>> >>>>>>> 6. Ophthalmologist for eye problems.
>> >>>>>>> 7. Nephrologist for your kidney disease.
>> >>>>>>> 8. Hematologist for blood clots.
>> >>>>>>> 9. Otolaryngologist for hearing loss.
>> >>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>> >>>>>>>
>> >>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>> >>>>>> But, how does one select a "good" doctor? Do doctors publish their
>> >>>>>> grades in Medical school? Do doctors publish win/loss scores for
>> >>>>>> patients cured/died? How does one pick a "good" doctor?
>> >>>>>> --
>> >>>>>> Cheers,
>> >>>>>>
>> >>>>>> John B.
>> >>>>>
>> >>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>> >>>>
>> >>>> But what is good, or what is better? If, for example. you have high
>> >>>> cholesterol, one doctor might recommend that you take LIVALO for your
>> >>>> problem, but another doctor might recommend lower doses of LIVALO but
>> >>>> also strongly recommend that you change your diet, lose weight and
>> >>>> start to exercise.
>> >>>>
>> >>>> Which is the better doctor?
>> >>>>
>> >>>> And which is the doctor that most will recommend to their friends?
>> >>>>
>> >>>
>> >>> That's a complex question. The brother of a good friend is
>> >>> a suburban GP who says that mothers bring children in with
>> >>> viruses and demand antibiotics. His choice is either to do
>> >>> the right thing and say no, resulting in a reputation as a
>> >>> 'bad doctor' or to prescribe a very low dose of antibiotics
>> >>> with the understanding that most childhood viruses will
>> >>> clear them selves in a few days with rest.
>> >>>
>> >>> And you can double that problem for doctors asked to
>> >>> prescribe morphine and similar. The patient knows that
>> >>> someone else (insurance company or welfare) will pick up
>> >>> most of the office visit and prescription charges, leaving
>> >>> the patient with a saleable item.
>> >>>
>> >>> Add in that few MDs are independent professionals now.
>> >>> They're employees of large entities and capitated, which
>> >>> means time spent with a patient is strongly discouraged.
>> >>>
>> >>> How to approach that problem? Systematize pill pushing!
>> >>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>> >>>
>> >>> Define 'good doctor' any way you like but the degradation of
>> >>> the medical industry (from the patient's view, not the
>> >>> revenue side of the industry) continues.
>> >>
>> >> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>> >> heart beating regularly. Not that many years ago there weren't any
>> >> such devices and I'd likely be dead today.
>> >>
>> >> Hardly degradation (:-)
>> >>
>> >
>> >I wrote 'degradation' not 'disappearance'.
>> >
>> >Pacemakers have been around for some 70 years or so (with
>> >regular improvement I might add) which makes them hardly an
>> >exemplar of the current problems.
>> 62 years actually. the first pacemaker was implanted in a human, in
>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>
>> But, I'm still not sure about "degradation" as that implies that
>> medical care is less, or less well done, today then it was in the
>> past, while I'm seeing things done today that would have been
>> considered impossible a generation ago.
>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>> --
>> Cheers,
>>
>> John B.
>
>When I was a young kid, 40+ years ago, I saw a man with a pacemaker. It was big, about half the size of a baseball, underneath the skin on his chest. Are modern pacemakers still like that? Huge bubbles sticking out on the chest? Or have they gotten a whole lot smaller now?

On 3/30/2022 8:46 PM, John B. wrote:
> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>
>> On 3/30/2022 6:01 PM, John B. wrote:
>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>
>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>
>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>>>>>>>>>>
>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>>>>>>>>>>
>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>>>>>>>>>>
>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>>>>>>>>>
>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>>>>>>>>
>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>>>>>>>>
>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>> --
>>>>>>> Cheers,
>>>>>>>
>>>>>>> John B.
>>>>>>
>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>>>>>
>>>>> But what is good, or what is better? If, for example. you have high
>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>> also strongly recommend that you change your diet, lose weight and
>>>>> start to exercise.
>>>>>
>>>>> Which is the better doctor?
>>>>>
>>>>> And which is the doctor that most will recommend to their friends?
>>>>>
>>>>
>>>> That's a complex question. The brother of a good friend is
>>>> a suburban GP who says that mothers bring children in with
>>>> viruses and demand antibiotics. His choice is either to do
>>>> the right thing and say no, resulting in a reputation as a
>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>> with the understanding that most childhood viruses will
>>>> clear them selves in a few days with rest.
>>>>
>>>> And you can double that problem for doctors asked to
>>>> prescribe morphine and similar. The patient knows that
>>>> someone else (insurance company or welfare) will pick up
>>>> most of the office visit and prescription charges, leaving
>>>> the patient with a saleable item.
>>>>
>>>> Add in that few MDs are independent professionals now.
>>>> They're employees of large entities and capitated, which
>>>> means time spent with a patient is strongly discouraged.
>>>>
>>>> How to approach that problem? Systematize pill pushing!
>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>
>>>> Define 'good doctor' any way you like but the degradation of
>>>> the medical industry (from the patient's view, not the
>>>> revenue side of the industry) continues.
>>>
>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>> heart beating regularly. Not that many years ago there weren't any
>>> such devices and I'd likely be dead today.
>>>
>>> Hardly degradation (:-)
>>>
>>
>> I wrote 'degradation' not 'disappearance'.
>>
>> Pacemakers have been around for some 70 years or so (with
>> regular improvement I might add) which makes them hardly an
>> exemplar of the current problems.
>
> 62 years actually. the first pacemaker was implanted in a human, in
> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>
> But, I'm still not sure about "degradation" as that implies that
> medical care is less, or less well done, today then it was in the
> past, while I'm seeing things done today that would have been
> considered impossible a generation ago.
> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>

My first comments on this subject above were, "It's complex".

Yes, innovation continues apace, as you note. Which is good.

Systemic difficulties continue as well:
https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/

I touched on a few other negative trends earlier. A mixed
bag at best, at great cost both in suffering and in dollars.

--
Andrew Muzi
<www.yellowjersey.org/>
Open every day since 1 April, 1971

On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
> >
> Moral Hazard is a well-known factor in the insurance industry.
>
> https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
> "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
>

Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
Or are kids that age not really capable of making that kind of association anyway?

On Thursday, March 31, 2022 at 8:42:51 AM UTC-7, timoth...@gmail.com wrote:
> On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
> > >
> > Moral Hazard is a well-known factor in the insurance industry.
> >
> > https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
> > "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
> >
> Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
> Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
> Or are kids that age not really capable of making that kind of association anyway?

I believe that when you teach children that they are superior to other people as long as they follow certain rules, that they tend to turn out to consider themselves as privileged and more valuable to the world than others. This leads to the idea that others are less valuable to the world and that is followed with criminal acts against others.

You saw the start of this when Obama became President and emphasized that to be anyone you had to have a college education when most of the jobs in this world do not require such and that college for most people is a waste of time and money. I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills. This is NOT a criticism of Frank but rather an attention to reality.

On 3/31/2022 11:15 AM, AMuzi wrote:
> On 3/30/2022 8:46 PM, John B. wrote:
>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>
>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>
>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5,
>>>>>>>>> cycl...@gmail.com wrote:
>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7,
>>>>>>>>>> timoth...@gmail.com wrote:
>>>>>>>>>>> This is one of those rare occasions where I have to partially
>>>>>>>>>>> side with Tom.
>>>>>>>>>>>
>>>>>>>>>>> When you need a neurologist you need a good one, and my
>>>>>>>>>>> experiences had me shopping a bit to find one that was a good
>>>>>>>>>>> fit. The first one was totally useless - perhaps he would
>>>>>>>>>>> have been good if my symptoms had been different but for me
>>>>>>>>>>> he was the wrong one.
>>>>>>>>>>>
>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to
>>>>>>>>>>> work. You don't know what your problem is going to be, and as
>>>>>>>>>>> has been pointed out bicycle injuries are not the majority of
>>>>>>>>>>> reasons to see one; add to that by the time you need one the
>>>>>>>>>>> local guy will have retired or been bought out.
>>>>>>>>>>>
>>>>>>>>>>> The strategy I recommend is first trust your primary care to
>>>>>>>>>>> recommend someone, then if you have the slightest doubt
>>>>>>>>>>> demand a second opinion. That's what I did and it worked out
>>>>>>>>>>> well.
>>>>>>>>>> Well you're correct that some neurologists are not good. They
>>>>>>>>>> mostly treat various forms of dementia and entirely forget
>>>>>>>>>> treating concussion. But knowing where a couple of
>>>>>>>>>> neurologists are is important if you need a good one. I was
>>>>>>>>>> initially sent to a very bad one by my MD and he didn't know
>>>>>>>>>> anything. And then my MD refused to look any further. Thanks
>>>>>>>>>> to my friend he got me to a good one at Stanford (I suppose
>>>>>>>>>> having football team members there doesn't hurt).
>>>>>>>>>>
>>>>>>>>>> I showed how many head injuries there are each year and while
>>>>>>>>>> fewer of those are concussions than football causes that is
>>>>>>>>>> STILL a considerable number of serious concussions. Apparently
>>>>>>>>>> the "group of 5" don't believe in being prepared.
>>>>>>>>>
>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor
>>>>>>>>> for the following much more likely physical problems:
>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>> 10. And last but certainly not least, actually this is the most
>>>>>>>>> important doctor of all for you Tommy to research and find a
>>>>>>>>> really good one, a PSYCHIATRIST for all of Tommy boy's mental
>>>>>>>>> irregularities. And Tommy, add in a Psychologist too. They are
>>>>>>>>> not medical doctors, but your problems are far more mental than
>>>>>>>>> physical, so a Psychologist will be able to help you a lot.
>>>>>>>>>
>>>>>>>>> Tommy, if you have not researched and found a good doctor for
>>>>>>>>> all of these likely issues, then you are just lying and yipping
>>>>>>>>> and yapping about your neurologist. These are more likely to
>>>>>>>>> occur and much higher up on the list of doctors for you to
>>>>>>>>> research. Get to it Tommy boy. Report back when you have every
>>>>>>>>> one of these doctors on your speed dial.
>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>> --
>>>>>>>> Cheers,
>>>>>>>>
>>>>>>>> John B.
>>>>>>>
>>>>>>> To be honest, I don't think you know they are "good" until after
>>>>>>> you see them for awhile. And I suppose you judge how "good" they
>>>>>>> were by whether you got better.  In my lifetime of doctor seeing,
>>>>>>> I have been fortunate enough to have had some really "good"
>>>>>>> doctors.  And would recommend them to others if I was asked.  But
>>>>>>> it took a number of years for me to decide they were "good".
>>>>>>
>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>> start to exercise.
>>>>>>
>>>>>> Which is the better doctor?
>>>>>>
>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>
>>>>>
>>>>> That's a complex question.  The brother of a good friend is
>>>>> a suburban GP who says that mothers bring children in with
>>>>> viruses and demand antibiotics. His choice is either to do
>>>>> the right thing and say no, resulting in a reputation as a
>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>> with the understanding that most childhood viruses will
>>>>> clear them selves in a few days with rest.
>>>>>
>>>>> And you can double that problem for doctors asked to
>>>>> prescribe morphine and similar. The patient knows that
>>>>> someone else (insurance company or welfare) will pick up
>>>>> most of the office visit and prescription charges, leaving
>>>>> the patient with a saleable item.
>>>>>
>>>>> Add in that few MDs are independent professionals now.
>>>>> They're employees of large entities and capitated, which
>>>>> means time spent with a patient is strongly discouraged.
>>>>>
>>>>> How to approach that problem? Systematize pill pushing!
>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>
>>>>>
>>>>> Define 'good doctor' any way you like but the degradation of
>>>>> the medical industry (from the patient's view, not the
>>>>> revenue side of the industry) continues.
>>>>
>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>>> heart beating regularly. Not that many years ago there weren't any
>>>> such devices and I'd likely be dead today.
>>>>
>>>> Hardly degradation (:-)
>>>>
>>>
>>> I wrote 'degradation' not 'disappearance'.
>>>
>>> Pacemakers have been around for some 70 years or so (with
>>> regular improvement I might add) which makes them hardly an
>>> exemplar of the current problems.
>>
>> 62 years actually. the first pacemaker was implanted in a human, in
>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>
>> But, I'm still not sure about "degradation" as that implies that
>> medical care is less, or less well done, today then it was in the
>> past, while I'm seeing things done today that would have been
>> considered impossible a generation ago.
>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>
>>
>
> My first comments on this subject above were, "It's complex".
>
> Yes, innovation continues apace, as you note. Which is good.
>
> Systemic difficulties continue as well:
> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>
>
> I touched on a few other negative trends earlier.  A mixed bag at best,
> at great cost both in suffering and in dollars.

On 3/31/2022 12:36 PM, Tom Kunich wrote:
> I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills.

You would then be _very_ surprised, Tom. I run into graduates of my
program pretty frequently. Your numbers are pretty much backwards.

Not that you would ever admit you were wrong, of course.

--
- Frank Krygowski

On Thursday, March 31, 2022 at 9:59:54 AM UTC-7, Frank Krygowski wrote:
> On 3/31/2022 12:36 PM, Tom Kunich wrote:
> > I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills.
> You would then be _very_ surprised, Tom. I run into graduates of my
> program pretty frequently. Your numbers are pretty much backwards.
>
> Not that you would ever admit you were wrong, of course.

Frank, for some reason I have started getting your postings to my Yahoo account. I will soon correct that but this posting was simply too juicy to pass up. The TOTAL growth is engineering jobs expected in the next TEN years is 21,000 jobs. The number of mechanical engineering graduates which is rapidly growing but with present graduation numbers is about 150,000 or to be blunt - there are only 14% that could be employed and they will NOT come from the University of nowhere. They will virtually all come from big name universities which will more than likely employ at least 12% of the mechanical engineering. That means like your stupid ignorance about the numbers of head injuries for cyclists, you haven't even a close understanding about what in the hell you're talking about. I think the most kind term we could give you is that you're a weenie.

On Thursday, March 31, 2022 at 11:42:51 AM UTC-4, timoth...@gmail.com wrote:
> On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
> > >
> > Moral Hazard is a well-known factor in the insurance industry.
> >
> > https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
> > "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
> >
> Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
> Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
> Or are kids that age not really capable of making that kind of association anyway?
I don't believe children take such risks with the understanding they will be taken care of, but as they grow older and see a lack of a downside towards their actions they are likely to take more risks. A friend of mine has a son who started get into downhill racing when he was a teen. His parents indulged only on the condition that he wouldn't try riding extreme terrain without them around. The predictable happened, he went out to the local abandoned quarry after school with his friends in his new full body armor. Fortunately the result was only a broken collarbone and a few cracked ribs. He admitted he took a risk on a big drop because he thought the suit would protect him.

On Thursday, March 31, 2022 at 2:11:36 PM UTC-4, cycl...@yahoo.com wrote:
> The TOTAL growth is engineering jobs expected in the next TEN years is 21,000 jobs.

gawd....where the fuck does he come up with this bullshit....

On Thursday, March 31, 2022 at 1:11:36 PM UTC-5, cycl...@yahoo.com wrote:
> On Thursday, March 31, 2022 at 9:59:54 AM UTC-7, Frank Krygowski wrote:
> > On 3/31/2022 12:36 PM, Tom Kunich wrote:
> > > I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills.
> > You would then be _very_ surprised, Tom. I run into graduates of my
> > program pretty frequently. Your numbers are pretty much backwards.
> >
> > Not that you would ever admit you were wrong, of course.
> Frank, for some reason I have started getting your postings to my Yahoo account. I will soon correct that but this posting was simply too juicy to pass up. The TOTAL growth is engineering jobs expected in the next TEN years is 21,000 jobs. The number of mechanical engineering graduates which is rapidly growing but with present graduation numbers is about 150,000 or to be blunt - there are only 14% that could be employed and they will NOT come from the University of nowhere. They will virtually all come from big name universities which will more than likely employ at least 12% of the mechanical engineering. That means like your stupid ignorance about the numbers of head injuries for cyclists, you haven't even a close understanding about what in the hell you're talking about. I think the most kind term we could give you is that you're a weenie.

How is it possible for Tommy boy to be so wrong so often?

https://www.bls.gov/opub/ted/2016/employment-outlook-for-engineering-occupations-to-2024.htm#:~:text=Bureau%20of%20Labor%20Statistics,-The%20Economics%20Daily&text=Employment%20of%20engineers%20is%20projected,adding%20about%2065%2C000%20new%20jobs.
"Employment outlook for engineering occupations to 2024
OCTOBER 06, 2016
Employment of engineers is projected to grow 4.0 percent from 2014 to 2024, adding about 65,000 new jobs. Among engineering specialties, several are projected to grow even faster than the 4-percent growth for engineers or the 6.5-percent growth for all occupations: biomedical engineers (23.1 percent), environmental engineers (12.4 percent), and civil engineers (8.4 percent)."

https://www.bls.gov/careeroutlook/2018/article/engineers.htm?view_full
"Engineers: Employment, pay, and outlook
Elka Torpey | February 2018
Did you use roads, electronics, or appliances today? Thank an engineer.
Engineers have a role in creating a variety of structures and products, from airports to zippers. If that sounds intriguing, consider a career in engineering. The U.S. Bureau of Labor Statistics (BLS) projects employment growth for these workers, with nearly 140,000 new jobs expected for engineers over the 2016–26 decade. And in 2016, engineers had a median annual wage of $91,010—more than twice the median wage for all workers."

https://ira.asee.org/u-s-engineering-jobs-projected-growth-through-2026/
"U.S. ENGINEERING JOBS PROJECTED GROWTH THROUGH 2026
June 12, 2019 Institutional Research and Analytics ASEE Off Connections Databytes
The U.S. Bureau of Labor Statistics projects that engineering fields will add over a 135,000 more jobs from the current 1.6 million jobs through 2026. The percentage of growth for each engineering occupation is displayed in Figure 1. Engineering fields are projected to have 122,000 total openings each year through 2026. The projected annual average job openings (in thousands) for each engineering occupation is displayed in Figure 2."

https://swe.org/research/2021/job-outlook/

On Thu, 31 Mar 2022 12:59:50 -0400, Frank Krygowski
<frkrygow@sbcglobal.net> wrote:

>On 3/31/2022 12:36 PM, Tom Kunich wrote:
>> I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills.
>
>You would then be _very_ surprised, Tom. I run into graduates of my
>program pretty frequently. Your numbers are pretty much backwards.
>
>Not that you would ever admit you were wrong, of course.

Tommy Wrong? Surely you jest sir!

--
Cheers,

John B.

On Thu, 31 Mar 2022 08:42:50 -0700 (PDT), Tim R
<timothy42bach@gmail.com> wrote:

>On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
>> >
>> Moral Hazard is a well-known factor in the insurance industry.
>>
>> https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
>> "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
>>
>
>Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
>Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
>Or are kids that age not really capable of making that kind of association anyway?

I though that the major game playing in the industrialized countries
was "computer gamers" ):-(
--
Cheers,

John B.

On Thu, 31 Mar 2022 11:11:35 -0700 (PDT), Tom Kunich
<cyclintom@yahoo.com> wrote:

>On Thursday, March 31, 2022 at 9:59:54 AM UTC-7, Frank Krygowski wrote:
>> On 3/31/2022 12:36 PM, Tom Kunich wrote:
>> > I would be surprised if 2% of the children in Frank's engineering classes actually became engineers and probably at least 5% are driving trucks trying to pay off their college bills.
>> You would then be _very_ surprised, Tom. I run into graduates of my
>> program pretty frequently. Your numbers are pretty much backwards.
>>
>> Not that you would ever admit you were wrong, of course.
>
>Frank, for some reason I have started getting your postings to my Yahoo account. I will
soon correct that but this posting was simply too juicy to pass up.
The TOTAL growth is engineering jobs expected in the next TEN years is
21,000 jobs. The number of mechanical engineering graduates which is
rapidly growing but with present graduation numbers is about 150,000
or to be blunt - there are only 14% that could be employed and they
will NOT come from the University of nowhere. They will virtually all
come from big name universities which will more than likely employ at
least 12% of the mechanical engineering. That means like your stupid
ignorance about the numbers of head injuries for cyclists, you haven't
even a close understanding about what in the hell you're talking
about. I think the most kind term we could give you is that you're a
weenie.

Well, good old dependable Tommy demonstrates once again how wrong he
can be
https://www.bls.gov/careeroutlook/2018/article/engineers.htm?view_full

"The U.S. Bureau of Labor Statistics (BLS) projects employment growth
for these workers, with nearly 140,000 new jobs expected for engineers
over the 2016–26 decade."

Gee Tommy, you only missed the target by, (lets see) 140,000/21.000 =
6.6, that's, (goodness) 666%

Yes Sir! We can certainly depend on Good Old Tommy for our morning
laugh.
--
Cheers,

John B.

On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <am@yellowjersey.org> wrote:

>On 3/30/2022 8:46 PM, John B. wrote:
>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>
>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>
>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>>>>>>>>>>>
>>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>>>>>>>>>>>
>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>>>>>>>>>>>
>>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>>>>>>>>>>
>>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>>>>>>>>>
>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>>>>>>>>>
>>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>> --
>>>>>>>> Cheers,
>>>>>>>>
>>>>>>>> John B.
>>>>>>>
>>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>>>>>>
>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>> start to exercise.
>>>>>>
>>>>>> Which is the better doctor?
>>>>>>
>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>
>>>>>
>>>>> That's a complex question. The brother of a good friend is
>>>>> a suburban GP who says that mothers bring children in with
>>>>> viruses and demand antibiotics. His choice is either to do
>>>>> the right thing and say no, resulting in a reputation as a
>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>> with the understanding that most childhood viruses will
>>>>> clear them selves in a few days with rest.
>>>>>
>>>>> And you can double that problem for doctors asked to
>>>>> prescribe morphine and similar. The patient knows that
>>>>> someone else (insurance company or welfare) will pick up
>>>>> most of the office visit and prescription charges, leaving
>>>>> the patient with a saleable item.
>>>>>
>>>>> Add in that few MDs are independent professionals now.
>>>>> They're employees of large entities and capitated, which
>>>>> means time spent with a patient is strongly discouraged.
>>>>>
>>>>> How to approach that problem? Systematize pill pushing!
>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>
>>>>> Define 'good doctor' any way you like but the degradation of
>>>>> the medical industry (from the patient's view, not the
>>>>> revenue side of the industry) continues.
>>>>
>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>>> heart beating regularly. Not that many years ago there weren't any
>>>> such devices and I'd likely be dead today.
>>>>
>>>> Hardly degradation (:-)
>>>>
>>>
>>> I wrote 'degradation' not 'disappearance'.
>>>
>>> Pacemakers have been around for some 70 years or so (with
>>> regular improvement I might add) which makes them hardly an
>>> exemplar of the current problems.
>>
>> 62 years actually. the first pacemaker was implanted in a human, in
>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>
>> But, I'm still not sure about "degradation" as that implies that
>> medical care is less, or less well done, today then it was in the
>> past, while I'm seeing things done today that would have been
>> considered impossible a generation ago.
>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>
>
>My first comments on this subject above were, "It's complex".
>
>Yes, innovation continues apace, as you note. Which is good.
>
>Systemic difficulties continue as well:
>https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>
>I touched on a few other negative trends earlier. A mixed
>bag at best, at great cost both in suffering and in dollars.

On 3/31/2022 2:30 PM, funkma...@hotmail.com wrote:
> On Thursday, March 31, 2022 at 11:42:51 AM UTC-4, timoth...@gmail.com wrote:
>> On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
>>>>
>>> Moral Hazard is a well-known factor in the insurance industry.
>>>
>>> https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
>>> "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
>>>
>> Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
>> Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
>> Or are kids that age not really capable of making that kind of association anyway?
>
> I don't believe children take such risks with the understanding they will be taken care of, but as they grow older and see a lack of a downside towards their actions they are likely to take more risks. A friend of mine has a son who started get into downhill racing when he was a teen. His parents indulged only on the condition that he wouldn't try riding extreme terrain without them around. The predictable happened, he went out to the local abandoned quarry after school with his friends in his new full body armor. Fortunately the result was only a broken collarbone and a few cracked ribs. He admitted he took a risk on a big drop because he thought the suit would protect him.

A detail: As I understand it, "moral hazard" differs a bit from "risk
compensation" (or "risk homeostasis") in that in a "moral hazard"
situation, the risk is borne by another - say, the insurance company. In
"risk compensation" the risk is borne by the participant.

So I'd say Funk's example is risk compensation. Which, I'll add, is not
always unreasonable. If the increase in risk the person assumes is
comesurate with the increase in protection provided by the new
protection measure, it can be a wash. And example might be adding a
handrail to a staircase, then descending a bit more rapidly with hands
on the rails.

The problem arises when someone has been convinced that the protection
makes them bulletproof, then takes risks that exceed the protective
capacity. Like downhiller body armor. Or like bike helmets.

--
- Frank Krygowski

On Thu, 31 Mar 2022 12:36:50 -0400, Frank Krygowski
<frkrygow@sbcglobal.net> wrote:

>On 3/31/2022 11:15 AM, AMuzi wrote:
>> On 3/30/2022 8:46 PM, John B. wrote:
>>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>>
>>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>>
>>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>>
>>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5,
>>>>>>>>>> cycl...@gmail.com wrote:
>>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7,
>>>>>>>>>>> timoth...@gmail.com wrote:
>>>>>>>>>>>> This is one of those rare occasions where I have to partially
>>>>>>>>>>>> side with Tom.
>>>>>>>>>>>>
>>>>>>>>>>>> When you need a neurologist you need a good one, and my
>>>>>>>>>>>> experiences had me shopping a bit to find one that was a good
>>>>>>>>>>>> fit. The first one was totally useless - perhaps he would
>>>>>>>>>>>> have been good if my symptoms had been different but for me
>>>>>>>>>>>> he was the wrong one.
>>>>>>>>>>>>
>>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to
>>>>>>>>>>>> work. You don't know what your problem is going to be, and as
>>>>>>>>>>>> has been pointed out bicycle injuries are not the majority of
>>>>>>>>>>>> reasons to see one; add to that by the time you need one the
>>>>>>>>>>>> local guy will have retired or been bought out.
>>>>>>>>>>>>
>>>>>>>>>>>> The strategy I recommend is first trust your primary care to
>>>>>>>>>>>> recommend someone, then if you have the slightest doubt
>>>>>>>>>>>> demand a second opinion. That's what I did and it worked out
>>>>>>>>>>>> well.
>>>>>>>>>>> Well you're correct that some neurologists are not good. They
>>>>>>>>>>> mostly treat various forms of dementia and entirely forget
>>>>>>>>>>> treating concussion. But knowing where a couple of
>>>>>>>>>>> neurologists are is important if you need a good one. I was
>>>>>>>>>>> initially sent to a very bad one by my MD and he didn't know
>>>>>>>>>>> anything. And then my MD refused to look any further. Thanks
>>>>>>>>>>> to my friend he got me to a good one at Stanford (I suppose
>>>>>>>>>>> having football team members there doesn't hurt).
>>>>>>>>>>>
>>>>>>>>>>> I showed how many head injuries there are each year and while
>>>>>>>>>>> fewer of those are concussions than football causes that is
>>>>>>>>>>> STILL a considerable number of serious concussions. Apparently
>>>>>>>>>>> the "group of 5" don't believe in being prepared.
>>>>>>>>>>
>>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor
>>>>>>>>>> for the following much more likely physical problems:
>>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>>> 10. And last but certainly not least, actually this is the most
>>>>>>>>>> important doctor of all for you Tommy to research and find a
>>>>>>>>>> really good one, a PSYCHIATRIST for all of Tommy boy's mental
>>>>>>>>>> irregularities. And Tommy, add in a Psychologist too. They are
>>>>>>>>>> not medical doctors, but your problems are far more mental than
>>>>>>>>>> physical, so a Psychologist will be able to help you a lot.
>>>>>>>>>>
>>>>>>>>>> Tommy, if you have not researched and found a good doctor for
>>>>>>>>>> all of these likely issues, then you are just lying and yipping
>>>>>>>>>> and yapping about your neurologist. These are more likely to
>>>>>>>>>> occur and much higher up on the list of doctors for you to
>>>>>>>>>> research. Get to it Tommy boy. Report back when you have every
>>>>>>>>>> one of these doctors on your speed dial.
>>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>>> --
>>>>>>>>> Cheers,
>>>>>>>>>
>>>>>>>>> John B.
>>>>>>>>
>>>>>>>> To be honest, I don't think you know they are "good" until after
>>>>>>>> you see them for awhile. And I suppose you judge how "good" they
>>>>>>>> were by whether you got better.  In my lifetime of doctor seeing,
>>>>>>>> I have been fortunate enough to have had some really "good"
>>>>>>>> doctors.  And would recommend them to others if I was asked.  But
>>>>>>>> it took a number of years for me to decide they were "good".
>>>>>>>
>>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>>> start to exercise.
>>>>>>>
>>>>>>> Which is the better doctor?
>>>>>>>
>>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>>
>>>>>>
>>>>>> That's a complex question.  The brother of a good friend is
>>>>>> a suburban GP who says that mothers bring children in with
>>>>>> viruses and demand antibiotics. His choice is either to do
>>>>>> the right thing and say no, resulting in a reputation as a
>>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>>> with the understanding that most childhood viruses will
>>>>>> clear them selves in a few days with rest.
>>>>>>
>>>>>> And you can double that problem for doctors asked to
>>>>>> prescribe morphine and similar. The patient knows that
>>>>>> someone else (insurance company or welfare) will pick up
>>>>>> most of the office visit and prescription charges, leaving
>>>>>> the patient with a saleable item.
>>>>>>
>>>>>> Add in that few MDs are independent professionals now.
>>>>>> They're employees of large entities and capitated, which
>>>>>> means time spent with a patient is strongly discouraged.
>>>>>>
>>>>>> How to approach that problem? Systematize pill pushing!
>>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>>
>>>>>>
>>>>>> Define 'good doctor' any way you like but the degradation of
>>>>>> the medical industry (from the patient's view, not the
>>>>>> revenue side of the industry) continues.
>>>>>
>>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>>>> heart beating regularly. Not that many years ago there weren't any
>>>>> such devices and I'd likely be dead today.
>>>>>
>>>>> Hardly degradation (:-)
>>>>>
>>>>
>>>> I wrote 'degradation' not 'disappearance'.
>>>>
>>>> Pacemakers have been around for some 70 years or so (with
>>>> regular improvement I might add) which makes them hardly an
>>>> exemplar of the current problems.
>>>
>>> 62 years actually. the first pacemaker was implanted in a human, in
>>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>>
>>> But, I'm still not sure about "degradation" as that implies that
>>> medical care is less, or less well done, today then it was in the
>>> past, while I'm seeing things done today that would have been
>>> considered impossible a generation ago.
>>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>>
>>>
>>
>> My first comments on this subject above were, "It's complex".
>>
>> Yes, innovation continues apace, as you note. Which is good.
>>
>> Systemic difficulties continue as well:
>> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>>
>>
>> I touched on a few other negative trends earlier.  A mixed bag at best,
>> at great cost both in suffering and in dollars.
>
>Medical care has never been perfect, and never will be perfect. Like
>now, it's always been better in some places and worse in others. But as
>far as I can tell, the general trend has been toward improvement.
>
>One thing unusual about the current situation is that the nation with
>the highest health care cost has far, far from the best outcomes. And
>for some reason, people on the right prefer not to change that. But
>we've discussed that before.
>
>To focus instead on "degradation":
>
>If you were given a time machine and the ability to go back in time,
>what era you would choose to get your medical care?

On 3/31/2022 6:54 PM, John B. wrote:
> On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <am@yellowjersey.org> wrote:
>
>> On 3/30/2022 8:46 PM, John B. wrote:
>>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>>
>>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>>
>>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>>
>>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>>>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>>>>>>>>>>>>
>>>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>>>>>>>>>>>>
>>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>>>>>>>>>>>>
>>>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>>>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>>>>>>>>>>>
>>>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>>>>>>>>>>
>>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>>>>>>>>>>
>>>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>>> --
>>>>>>>>> Cheers,
>>>>>>>>>
>>>>>>>>> John B.
>>>>>>>>
>>>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>>>>>>>
>>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>>> start to exercise.
>>>>>>>
>>>>>>> Which is the better doctor?
>>>>>>>
>>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>>
>>>>>>
>>>>>> That's a complex question. The brother of a good friend is
>>>>>> a suburban GP who says that mothers bring children in with
>>>>>> viruses and demand antibiotics. His choice is either to do
>>>>>> the right thing and say no, resulting in a reputation as a
>>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>>> with the understanding that most childhood viruses will
>>>>>> clear them selves in a few days with rest.
>>>>>>
>>>>>> And you can double that problem for doctors asked to
>>>>>> prescribe morphine and similar. The patient knows that
>>>>>> someone else (insurance company or welfare) will pick up
>>>>>> most of the office visit and prescription charges, leaving
>>>>>> the patient with a saleable item.
>>>>>>
>>>>>> Add in that few MDs are independent professionals now.
>>>>>> They're employees of large entities and capitated, which
>>>>>> means time spent with a patient is strongly discouraged.
>>>>>>
>>>>>> How to approach that problem? Systematize pill pushing!
>>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>>
>>>>>> Define 'good doctor' any way you like but the degradation of
>>>>>> the medical industry (from the patient's view, not the
>>>>>> revenue side of the industry) continues.
>>>>>
>>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>>>> heart beating regularly. Not that many years ago there weren't any
>>>>> such devices and I'd likely be dead today.
>>>>>
>>>>> Hardly degradation (:-)
>>>>>
>>>>
>>>> I wrote 'degradation' not 'disappearance'.
>>>>
>>>> Pacemakers have been around for some 70 years or so (with
>>>> regular improvement I might add) which makes them hardly an
>>>> exemplar of the current problems.
>>>
>>> 62 years actually. the first pacemaker was implanted in a human, in
>>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>>
>>> But, I'm still not sure about "degradation" as that implies that
>>> medical care is less, or less well done, today then it was in the
>>> past, while I'm seeing things done today that would have been
>>> considered impossible a generation ago.
>>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>>
>>
>> My first comments on this subject above were, "It's complex".
>>
>> Yes, innovation continues apace, as you note. Which is good.
>>
>> Systemic difficulties continue as well:
>> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>>
>> I touched on a few other negative trends earlier. A mixed
>> bag at best, at great cost both in suffering and in dollars.
>
> Well, I did read your reference, above, but essentially it seemed to
> say that the acquired infection market is growing as certainly one
> would assume that it must given the population growth, i.e. more
> people, more possible infections.
>
> Example, the "black death" is estimated to have killed some 25
> million people in Europe, estimated to have been between 30% and 60%
> of the population. Today, a disease that killed 30 - 60 percent of the
> European population would kill 225 to 450 million.
>
> Added to that is the U.S. capitalistic system of charging all the
> market will stand and I'm sure that the cost of sickness, in the U.S.
> is skyrocketing.
>
> Here the government buys medicines on the open market with competitive
> bidding and, I'm guessing here, my monthly medicine costs are far
> lower, maybe 1/4, or less, that which you would pay in the U.S.
> Goodness! You can just go to Canada or Mexico and get lower medicine
> costs.
>

On Thu, 31 Mar 2022 20:00:16 -0400, Frank Krygowski
<frkrygow@sbcglobal.net> wrote:

>On 3/31/2022 2:30 PM, funkma...@hotmail.com wrote:
>> On Thursday, March 31, 2022 at 11:42:51 AM UTC-4, timoth...@gmail.com wrote:
>>> On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
>>>>>
>>>> Moral Hazard is a well-known factor in the insurance industry.
>>>>
>>>> https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
>>>> "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
>>>>
>>> Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
>>> Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
>>> Or are kids that age not really capable of making that kind of association anyway?
>>
>> I don't believe children take such risks with the understanding they will be taken care of, but as they grow older and see a lack of a downside towards their actions they are likely to take more risks. A friend of mine has a son who started get into downhill racing when he was a teen. His parents indulged only on the condition that he wouldn't try riding extreme terrain without them around. The predictable happened, he went out to the local abandoned quarry after school with his friends in his new full body armor. Fortunately the result was only a broken collarbone and a few cracked ribs. He admitted he took a risk on a big drop because he thought the suit would protect him.
>
>A detail: As I understand it, "moral hazard" differs a bit from "risk
>compensation" (or "risk homeostasis") in that in a "moral hazard"
>situation, the risk is borne by another - say, the insurance company. In
>"risk compensation" the risk is borne by the participant.
>
>So I'd say Funk's example is risk compensation. Which, I'll add, is not
>always unreasonable. If the increase in risk the person assumes is
>comesurate with the increase in protection provided by the new
>protection measure, it can be a wash. And example might be adding a
>handrail to a staircase, then descending a bit more rapidly with hands
>on the rails.
>
>The problem arises when someone has been convinced that the protection
>makes them bulletproof, then takes risks that exceed the protective
>capacity. Like downhiller body armor. Or like bike helmets.

I've known a number of people that engaged in activities that could
result in injury or even death and the impression I got was that they
believed that "It Won't Happen to Me!"

The most obvious was an ex-Special Forces Medic, 3 tours in Vietnam,
two of which he volunteered for and wounded each time. When I knew him
he had "resigned" from Special Forces and was finishing out his
enlistment as medic at an induction center in Ohio.

The only reason he "resigned" was that after fainting "dead away" on
the front porch, three times, when notified that he was wounded his
wife had enough and told him to either quit jumping out of airplanes
or she'd take the kid and go home to mother.

He privately told me that he had enough GI bill to go to medical
school and when he got his degree was going right back to Special
Forces
--
Cheers,

John B.

On 3/31/2022 9:02 PM, AMuzi wrote:
> On 3/31/2022 6:54 PM, John B. wrote:
>> On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 3/30/2022 8:46 PM, John B. wrote:
>>>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org>
>>>>>> wrote:
>>>>>>
>>>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT),
>>>>>>>> "russellseaton1@yahoo.com"
>>>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>>>
>>>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>>>
>>>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5,
>>>>>>>>>>> cycl...@gmail.com wrote:
>>>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7,
>>>>>>>>>>>> timoth...@gmail.com wrote:
>>>>>>>>>>>>> This is one of those rare occasions where I have to
>>>>>>>>>>>>> partially side with Tom.
>>>>>>>>>>>>>
>>>>>>>>>>>>> When you need a neurologist you need a good one, and my
>>>>>>>>>>>>> experiences had me shopping a bit to find one that was a
>>>>>>>>>>>>> good fit. The first one was totally useless - perhaps he
>>>>>>>>>>>>> would have been good if my symptoms had been different but
>>>>>>>>>>>>> for me he was the wrong one.
>>>>>>>>>>>>>
>>>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to
>>>>>>>>>>>>> work. You don't know what your problem is going to be, and
>>>>>>>>>>>>> as has been pointed out bicycle injuries are not the
>>>>>>>>>>>>> majority of reasons to see one; add to that by the time you
>>>>>>>>>>>>> need one the local guy will have retired or been bought out.
>>>>>>>>>>>>>
>>>>>>>>>>>>> The strategy I recommend is first trust your primary care
>>>>>>>>>>>>> to recommend someone, then if you have the slightest doubt
>>>>>>>>>>>>> demand a second opinion. That's what I did and it worked
>>>>>>>>>>>>> out well.
>>>>>>>>>>>> Well you're correct that some neurologists are not good.
>>>>>>>>>>>> They mostly treat various forms of dementia and entirely
>>>>>>>>>>>> forget treating concussion. But knowing where a couple of
>>>>>>>>>>>> neurologists are is important if you need a good one. I was
>>>>>>>>>>>> initially sent to a very bad one by my MD and he didn't know
>>>>>>>>>>>> anything. And then my MD refused to look any further. Thanks
>>>>>>>>>>>> to my friend he got me to a good one at Stanford (I suppose
>>>>>>>>>>>> having football team members there doesn't hurt).
>>>>>>>>>>>>
>>>>>>>>>>>> I showed how many head injuries there are each year and
>>>>>>>>>>>> while fewer of those are concussions than football causes
>>>>>>>>>>>> that is STILL a considerable number of serious concussions.
>>>>>>>>>>>> Apparently the "group of 5" don't believe in being prepared.
>>>>>>>>>>>
>>>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor
>>>>>>>>>>> for the following much more likely physical problems:
>>>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>>>> 10. And last but certainly not least, actually this is the
>>>>>>>>>>> most important doctor of all for you Tommy to research and
>>>>>>>>>>> find a really good one, a PSYCHIATRIST for all of Tommy boy's
>>>>>>>>>>> mental irregularities. And Tommy, add in a Psychologist too.
>>>>>>>>>>> They are not medical doctors, but your problems are far more
>>>>>>>>>>> mental than physical, so a Psychologist will be able to help
>>>>>>>>>>> you a lot.
>>>>>>>>>>>
>>>>>>>>>>> Tommy, if you have not researched and found a good doctor for
>>>>>>>>>>> all of these likely issues, then you are just lying and
>>>>>>>>>>> yipping and yapping about your neurologist. These are more
>>>>>>>>>>> likely to occur and much higher up on the list of doctors for
>>>>>>>>>>> you to research. Get to it Tommy boy. Report back when you
>>>>>>>>>>> have every one of these doctors on your speed dial.
>>>>>>>>>> But, how does one select a "good" doctor? Do doctors publish
>>>>>>>>>> their
>>>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>>>> --
>>>>>>>>>> Cheers,
>>>>>>>>>>
>>>>>>>>>> John B.
>>>>>>>>>
>>>>>>>>> To be honest, I don't think you know they are "good" until
>>>>>>>>> after you see them for awhile. And I suppose you judge how
>>>>>>>>> "good" they were by whether you got better.  In my lifetime of
>>>>>>>>> doctor seeing, I have been fortunate enough to have had some
>>>>>>>>> really "good" doctors.  And would recommend them to others if I
>>>>>>>>> was asked.  But it took a number of years for me to decide they
>>>>>>>>> were "good".
>>>>>>>>
>>>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>>>> cholesterol, one doctor might recommend that you take LIVALO for
>>>>>>>> your
>>>>>>>> problem, but another doctor might recommend lower doses of
>>>>>>>> LIVALO but
>>>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>>>> start to exercise.
>>>>>>>>
>>>>>>>> Which is the better doctor?
>>>>>>>>
>>>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>>>
>>>>>>>
>>>>>>> That's a complex question.  The brother of a good friend is
>>>>>>> a suburban GP who says that mothers bring children in with
>>>>>>> viruses and demand antibiotics. His choice is either to do
>>>>>>> the right thing and say no, resulting in a reputation as a
>>>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>>>> with the understanding that most childhood viruses will
>>>>>>> clear them selves in a few days with rest.
>>>>>>>
>>>>>>> And you can double that problem for doctors asked to
>>>>>>> prescribe morphine and similar. The patient knows that
>>>>>>> someone else (insurance company or welfare) will pick up
>>>>>>> most of the office visit and prescription charges, leaving
>>>>>>> the patient with a saleable item.
>>>>>>>
>>>>>>> Add in that few MDs are independent professionals now.
>>>>>>> They're employees of large entities and capitated, which
>>>>>>> means time spent with a patient is strongly discouraged.
>>>>>>>
>>>>>>> How to approach that problem? Systematize pill pushing!
>>>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>>>
>>>>>>>
>>>>>>> Define 'good doctor' any way you like but the degradation of
>>>>>>> the medical industry (from the patient's view, not the
>>>>>>> revenue side of the industry) continues.
>>>>>>
>>>>>> I'm not sure that I agree with you. I have a pacemaker, which
>>>>>> keeps my
>>>>>> heart beating regularly. Not that many years ago there weren't any
>>>>>> such devices and I'd likely be dead today.
>>>>>>
>>>>>> Hardly degradation (:-)
>>>>>>
>>>>>
>>>>> I wrote 'degradation' not 'disappearance'.
>>>>>
>>>>> Pacemakers have been around for some 70 years or so (with
>>>>> regular improvement I might add) which makes them hardly an
>>>>> exemplar of the current problems.
>>>>
>>>> 62 years actually. the first pacemaker was implanted in a human, in
>>>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>>>
>>>> But, I'm still not sure about "degradation" as that implies that
>>>> medical care is less, or less well done, today then it was in the
>>>> past, while I'm seeing things done today that would have been
>>>> considered impossible a generation ago.
>>>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>>>
>>>>
>>>
>>> My first comments on this subject above were, "It's complex".
>>>
>>> Yes, innovation continues apace, as you note. Which is good.
>>>
>>> Systemic difficulties continue as well:
>>> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>>>
>>>
>>> I touched on a few other negative trends earlier.  A mixed
>>> bag at best, at great cost both in suffering and in dollars.
>>
>> Well, I did read your reference, above, but essentially it seemed to
>> say that the acquired infection market is growing as certainly one
>> would assume that it must given the population growth, i.e. more
>> people, more possible infections.
>>
>> Example, the "black death" is estimated to have killed  some 25
>> million people in Europe, estimated to have been between 30% and 60%
>> of the population. Today, a disease that killed 30 - 60 percent of the
>> European population would kill 225 to 450 million.
>>
>> Added to that is the U.S. capitalistic system of charging all the
>> market will stand and I'm sure that the cost of sickness, in the U.S.
>> is skyrocketing.
>>
>> Here the government buys medicines on the open market with competitive
>> bidding and, I'm guessing here, my monthly medicine costs are far
>> lower, maybe 1/4, or less, that which you would pay in the U.S.
>> Goodness! You can just go to Canada or Mexico and get lower medicine
>> costs.
>>
>
> Without engaging that discussion here, much is made of roughly 20,000
> USA firearms homicides per year but nobody much cares about 70,000
> people who are admitted to a hospital and, while there, contract
> infection and die as a result. That's a large number of people.

On Thursday, March 31, 2022 at 6:54:15 PM UTC-5, John B. wrote:
> On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <a...@yellowjersey.org> wrote:
>
> >On 3/30/2022 8:46 PM, John B. wrote:
> >> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >>
> >>> On 3/30/2022 6:01 PM, John B. wrote:
> >>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >>>>
> >>>>> On 3/30/2022 3:05 AM, John B. wrote:
> >>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russell...@yahoo.com"
> >>>>>> <ritzann...@gmail.com> wrote:
> >>>>>>
> >>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
> >>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
> >>>>>>>> <ritzann...@gmail.com> wrote:
> >>>>>>>>
> >>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
> >>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
> >>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
> >>>>>>>>>>>
> >>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
> >>>>>>>>>>>
> >>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work.. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
> >>>>>>>>>>>
> >>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
> >>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
> >>>>>>>>>>
> >>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
> >>>>>>>>>
> >>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
> >>>>>>>>> 1. Orthopedist for osteoporosis.
> >>>>>>>>> 2. Rheumatologist for arthritis.
> >>>>>>>>> 3. Cardiologist for heart attack.
> >>>>>>>>> 4. Proctologist for hemorrhoids.
> >>>>>>>>> 5. Podiatrist for foot problems.
> >>>>>>>>> 6. Ophthalmologist for eye problems.
> >>>>>>>>> 7. Nephrologist for your kidney disease.
> >>>>>>>>> 8. Hematologist for blood clots.
> >>>>>>>>> 9. Otolaryngologist for hearing loss.
> >>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
> >>>>>>>>>
> >>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
> >>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
> >>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
> >>>>>>>> patients cured/died? How does one pick a "good" doctor?
> >>>>>>>> --
> >>>>>>>> Cheers,
> >>>>>>>>
> >>>>>>>> John B.
> >>>>>>>
> >>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
> >>>>>>
> >>>>>> But what is good, or what is better? If, for example. you have high
> >>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
> >>>>>> problem, but another doctor might recommend lower doses of LIVALO but
> >>>>>> also strongly recommend that you change your diet, lose weight and
> >>>>>> start to exercise.
> >>>>>>
> >>>>>> Which is the better doctor?
> >>>>>>
> >>>>>> And which is the doctor that most will recommend to their friends?
> >>>>>>
> >>>>>
> >>>>> That's a complex question. The brother of a good friend is
> >>>>> a suburban GP who says that mothers bring children in with
> >>>>> viruses and demand antibiotics. His choice is either to do
> >>>>> the right thing and say no, resulting in a reputation as a
> >>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
> >>>>> with the understanding that most childhood viruses will
> >>>>> clear them selves in a few days with rest.
> >>>>>
> >>>>> And you can double that problem for doctors asked to
> >>>>> prescribe morphine and similar. The patient knows that
> >>>>> someone else (insurance company or welfare) will pick up
> >>>>> most of the office visit and prescription charges, leaving
> >>>>> the patient with a saleable item.
> >>>>>
> >>>>> Add in that few MDs are independent professionals now.
> >>>>> They're employees of large entities and capitated, which
> >>>>> means time spent with a patient is strongly discouraged.
> >>>>>
> >>>>> How to approach that problem? Systematize pill pushing!
> >>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
> >>>>>
> >>>>> Define 'good doctor' any way you like but the degradation of
> >>>>> the medical industry (from the patient's view, not the
> >>>>> revenue side of the industry) continues.
> >>>>
> >>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
> >>>> heart beating regularly. Not that many years ago there weren't any
> >>>> such devices and I'd likely be dead today.
> >>>>
> >>>> Hardly degradation (:-)
> >>>>
> >>>
> >>> I wrote 'degradation' not 'disappearance'.
> >>>
> >>> Pacemakers have been around for some 70 years or so (with
> >>> regular improvement I might add) which makes them hardly an
> >>> exemplar of the current problems.
> >>
> >> 62 years actually. the first pacemaker was implanted in a human, in
> >> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
> >>
> >> But, I'm still not sure about "degradation" as that implies that
> >> medical care is less, or less well done, today then it was in the
> >> past, while I'm seeing things done today that would have been
> >> considered impossible a generation ago.
> >> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
> >>
> >
> >My first comments on this subject above were, "It's complex".
> >
> >Yes, innovation continues apace, as you note. Which is good.
> >
> >Systemic difficulties continue as well:
> >https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
> >
> >I touched on a few other negative trends earlier. A mixed
> >bag at best, at great cost both in suffering and in dollars.
> Well, I did read your reference, above, but essentially it seemed to
> say that the acquired infection market is growing as certainly one
> would assume that it must given the population growth, i.e. more
> people, more possible infections.
>
> Example, the "black death" is estimated to have killed some 25
> million people in Europe, estimated to have been between 30% and 60%
> of the population. Today, a disease that killed 30 - 60 percent of the
> European population would kill 225 to 450 million.
>
> Added to that is the U.S. capitalistic system of charging all the
> market will stand and I'm sure that the cost of sickness, in the U.S.
> is skyrocketing.
>
> Here the government buys medicines on the open market with competitive
> bidding and, I'm guessing here, my monthly medicine costs are far
> lower, maybe 1/4, or less, that which you would pay in the U.S.
> Goodness! You can just go to Canada or Mexico and get lower medicine
> costs.
> --
> Cheers,
>
> John B.

On Thursday, March 31, 2022 at 7:00:22 PM UTC-5, Frank Krygowski wrote:
> On 3/31/2022 2:30 PM, funkma...@hotmail.com wrote:
> > On Thursday, March 31, 2022 at 11:42:51 AM UTC-4, timoth...@gmail.com wrote:
> >> On Wednesday, March 30, 2022 at 11:49:44 AM UTC-4, funkma...@hotmail.com wrote:
> >>>>
> >>> Moral Hazard is a well-known factor in the insurance industry.
> >>>
> >>> https://en.wikipedia.org/wiki/Moral_hazard#Insurance_industry
> >>> "Two types of behavior can change. One type is the risky behavior itself, resulting in a before the event moral hazard. Insured parties then behave in a more risky manner, resulting in more negative consequences that the insurer must pay for. "
> >>>
> >> Something I've wondered about. Most industrialized countries outside the US have some version of universal health care.
> >> Are young males more likely to do violent acts (like soccer hoolaganism, etc.) knowing that medical care will be available and free?
> >> Or are kids that age not really capable of making that kind of association anyway?
> >
> > I don't believe children take such risks with the understanding they will be taken care of, but as they grow older and see a lack of a downside towards their actions they are likely to take more risks. A friend of mine has a son who started get into downhill racing when he was a teen. His parents indulged only on the condition that he wouldn't try riding extreme terrain without them around. The predictable happened, he went out to the local abandoned quarry after school with his friends in his new full body armor. Fortunately the result was only a broken collarbone and a few cracked ribs. He admitted he took a risk on a big drop because he thought the suit would protect him.
> A detail: As I understand it, "moral hazard" differs a bit from "risk
> compensation" (or "risk homeostasis") in that in a "moral hazard"
> situation, the risk is borne by another - say, the insurance company. In
> "risk compensation" the risk is borne by the participant.
>
> So I'd say Funk's example is risk compensation. Which, I'll add, is not
> always unreasonable. If the increase in risk the person assumes is
> comensurate with the increase in protection provided by the new
> protection measure, it can be a wash. And example might be adding a
> handrail to a staircase, then descending a bit more rapidly with hands
> on the rails.
>
> The problem arises when someone has been convinced that the protection
> makes them bulletproof, then takes risks that exceed the protective
> capacity. Like downhiller body armor. Or like bike helmets.
>
> --
> - Frank Krygowski

Not sure how this story fits in here. Whether it is "moral hazard" or "risk compensation". But a LONG time ago I played high school football. For the Europeans participating in this forum, I mean American football, not soccer. Us kids wore shoulder pads and helmets. Big heavy plastic good helmets. You could probably take a baseball bat and hit someone with a helmet and they would be OK. But even as a teenage boy, I knew you did not use your helmeted head to spear someone. It would hurt. Most likely your neck. You hit people with your shoulder, not hour head. Despite having a big plastic protective helmet on your head.

I don't rate the majority of human beings as too smart or savvy. But even the dumbest ones have a lot of self preservation motivation. So I am a little bit skeptical of people with protective gear such as helmets taking extra risk. A helmet, bicycle or skateboard or skiing, may keep you from getting brain dead. But you will still get cut and skinned up and broken bones and bruises. You will still feel lots of pain even if the injury is not super serious. Almost all humans try to avoid pain. Unless you are one of those S&M folks.

On Thursday, March 31, 2022 at 8:02:18 PM UTC-5, AMuzi wrote:
> On 3/31/2022 6:54 PM, John B. wrote:
> > On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >
> >> On 3/30/2022 8:46 PM, John B. wrote:
> >>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >>>
> >>>> On 3/30/2022 6:01 PM, John B. wrote:
> >>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <a...@yellowjersey.org> wrote:
> >>>>>
> >>>>>> On 3/30/2022 3:05 AM, John B. wrote:
> >>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russell...@yahoo.com"
> >>>>>>> <ritzann...@gmail.com> wrote:
> >>>>>>>
> >>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
> >>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
> >>>>>>>>> <ritzann...@gmail.com> wrote:
> >>>>>>>>>
> >>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail..com wrote:
> >>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
> >>>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
> >>>>>>>>>>>>
> >>>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
> >>>>>>>>>>>>
> >>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
> >>>>>>>>>>>>
> >>>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
> >>>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
> >>>>>>>>>>>
> >>>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
> >>>>>>>>>>
> >>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
> >>>>>>>>>> 1. Orthopedist for osteoporosis.
> >>>>>>>>>> 2. Rheumatologist for arthritis.
> >>>>>>>>>> 3. Cardiologist for heart attack.
> >>>>>>>>>> 4. Proctologist for hemorrhoids.
> >>>>>>>>>> 5. Podiatrist for foot problems.
> >>>>>>>>>> 6. Ophthalmologist for eye problems.
> >>>>>>>>>> 7. Nephrologist for your kidney disease.
> >>>>>>>>>> 8. Hematologist for blood clots.
> >>>>>>>>>> 9. Otolaryngologist for hearing loss.
> >>>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
> >>>>>>>>>>
> >>>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
> >>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
> >>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
> >>>>>>>>> patients cured/died? How does one pick a "good" doctor?
> >>>>>>>>> --
> >>>>>>>>> Cheers,
> >>>>>>>>>
> >>>>>>>>> John B.
> >>>>>>>>
> >>>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
> >>>>>>>
> >>>>>>> But what is good, or what is better? If, for example. you have high
> >>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
> >>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
> >>>>>>> also strongly recommend that you change your diet, lose weight and
> >>>>>>> start to exercise.
> >>>>>>>
> >>>>>>> Which is the better doctor?
> >>>>>>>
> >>>>>>> And which is the doctor that most will recommend to their friends?
> >>>>>>>
> >>>>>>
> >>>>>> That's a complex question. The brother of a good friend is
> >>>>>> a suburban GP who says that mothers bring children in with
> >>>>>> viruses and demand antibiotics. His choice is either to do
> >>>>>> the right thing and say no, resulting in a reputation as a
> >>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
> >>>>>> with the understanding that most childhood viruses will
> >>>>>> clear them selves in a few days with rest.
> >>>>>>
> >>>>>> And you can double that problem for doctors asked to
> >>>>>> prescribe morphine and similar. The patient knows that
> >>>>>> someone else (insurance company or welfare) will pick up
> >>>>>> most of the office visit and prescription charges, leaving
> >>>>>> the patient with a saleable item.
> >>>>>>
> >>>>>> Add in that few MDs are independent professionals now.
> >>>>>> They're employees of large entities and capitated, which
> >>>>>> means time spent with a patient is strongly discouraged.
> >>>>>>
> >>>>>> How to approach that problem? Systematize pill pushing!
> >>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
> >>>>>>
> >>>>>> Define 'good doctor' any way you like but the degradation of
> >>>>>> the medical industry (from the patient's view, not the
> >>>>>> revenue side of the industry) continues.
> >>>>>
> >>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
> >>>>> heart beating regularly. Not that many years ago there weren't any
> >>>>> such devices and I'd likely be dead today.
> >>>>>
> >>>>> Hardly degradation (:-)
> >>>>>
> >>>>
> >>>> I wrote 'degradation' not 'disappearance'.
> >>>>
> >>>> Pacemakers have been around for some 70 years or so (with
> >>>> regular improvement I might add) which makes them hardly an
> >>>> exemplar of the current problems.
> >>>
> >>> 62 years actually. the first pacemaker was implanted in a human, in
> >>> 1960, in a 77-year-old man, who lived for 10 months after the surgery..
> >>>
> >>> But, I'm still not sure about "degradation" as that implies that
> >>> medical care is less, or less well done, today then it was in the
> >>> past, while I'm seeing things done today that would have been
> >>> considered impossible a generation ago.
> >>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
> >>>
> >>
> >> My first comments on this subject above were, "It's complex".
> >>
> >> Yes, innovation continues apace, as you note. Which is good.
> >>
> >> Systemic difficulties continue as well:
> >> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
> >>
> >> I touched on a few other negative trends earlier. A mixed
> >> bag at best, at great cost both in suffering and in dollars.
> >
> > Well, I did read your reference, above, but essentially it seemed to
> > say that the acquired infection market is growing as certainly one
> > would assume that it must given the population growth, i.e. more
> > people, more possible infections.
> >
> > Example, the "black death" is estimated to have killed some 25
> > million people in Europe, estimated to have been between 30% and 60%
> > of the population. Today, a disease that killed 30 - 60 percent of the
> > European population would kill 225 to 450 million.
> >
> > Added to that is the U.S. capitalistic system of charging all the
> > market will stand and I'm sure that the cost of sickness, in the U.S.
> > is skyrocketing.
> >
> > Here the government buys medicines on the open market with competitive
> > bidding and, I'm guessing here, my monthly medicine costs are far
> > lower, maybe 1/4, or less, that which you would pay in the U.S.
> > Goodness! You can just go to Canada or Mexico and get lower medicine
> > costs.
> >
> Without engaging that discussion here, much is made of
> roughly 20,000 USA firearms homicides per year but nobody
> much cares about 70,000 people who are admitted to a
> hospital and, while there, contract infection and die as a
> result. That's a large number of people.

On Thu, 31 Mar 2022 20:02:12 -0500, AMuzi <am@yellowjersey.org> wrote:

>On 3/31/2022 6:54 PM, John B. wrote:
>> On Thu, 31 Mar 2022 10:15:44 -0500, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 3/30/2022 8:46 PM, John B. wrote:
>>>> On Wed, 30 Mar 2022 20:21:56 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 3/30/2022 6:01 PM, John B. wrote:
>>>>>> On Wed, 30 Mar 2022 07:33:01 -0500, AMuzi <am@yellowjersey.org> wrote:
>>>>>>
>>>>>>> On 3/30/2022 3:05 AM, John B. wrote:
>>>>>>>> On Tue, 29 Mar 2022 23:37:56 -0700 (PDT), "russellseaton1@yahoo.com"
>>>>>>>> <ritzannaseaton@gmail.com> wrote:
>>>>>>>>
>>>>>>>>> On Tuesday, March 29, 2022 at 7:57:00 PM UTC-5, John B. wrote:
>>>>>>>>>> On Tue, 29 Mar 2022 14:22:58 -0700 (PDT), "russell...@yahoo.com"
>>>>>>>>>> <ritzann...@gmail.com> wrote:
>>>>>>>>>>
>>>>>>>>>>> On Tuesday, March 29, 2022 at 12:51:18 PM UTC-5, cycl...@gmail.com wrote:
>>>>>>>>>>>> On Tuesday, March 29, 2022 at 8:40:22 AM UTC-7, timoth...@gmail.com wrote:
>>>>>>>>>>>>> This is one of those rare occasions where I have to partially side with Tom.
>>>>>>>>>>>>>
>>>>>>>>>>>>> When you need a neurologist you need a good one, and my experiences had me shopping a bit to find one that was a good fit. The first one was totally useless - perhaps he would have been good if my symptoms had been different but for me he was the wrong one.
>>>>>>>>>>>>>
>>>>>>>>>>>>> That said, lining one up ahead of time seems unlikely to work. You don't know what your problem is going to be, and as has been pointed out bicycle injuries are not the majority of reasons to see one; add to that by the time you need one the local guy will have retired or been bought out.
>>>>>>>>>>>>>
>>>>>>>>>>>>> The strategy I recommend is first trust your primary care to recommend someone, then if you have the slightest doubt demand a second opinion. That's what I did and it worked out well.
>>>>>>>>>>>> Well you're correct that some neurologists are not good. They mostly treat various forms of dementia and entirely forget treating concussion. But knowing where a couple of neurologists are is important if you need a good one. I was initially sent to a very bad one by my MD and he didn't know anything. And then my MD refused to look any further. Thanks to my friend he got me to a good one at Stanford (I suppose having football team members there doesn't hurt).
>>>>>>>>>>>>
>>>>>>>>>>>> I showed how many head injuries there are each year and while fewer of those are concussions than football causes that is STILL a considerable number of serious concussions. Apparently the "group of 5" don't believe in being prepared.
>>>>>>>>>>>
>>>>>>>>>>> Tell us Tommy boy, have you researched and lined up a doctor for the following much more likely physical problems:
>>>>>>>>>>> 1. Orthopedist for osteoporosis.
>>>>>>>>>>> 2. Rheumatologist for arthritis.
>>>>>>>>>>> 3. Cardiologist for heart attack.
>>>>>>>>>>> 4. Proctologist for hemorrhoids.
>>>>>>>>>>> 5. Podiatrist for foot problems.
>>>>>>>>>>> 6. Ophthalmologist for eye problems.
>>>>>>>>>>> 7. Nephrologist for your kidney disease.
>>>>>>>>>>> 8. Hematologist for blood clots.
>>>>>>>>>>> 9. Otolaryngologist for hearing loss.
>>>>>>>>>>> 10. And last but certainly not least, actually this is the most important doctor of all for you Tommy to research and find a really good one, a PSYCHIATRIST for all of Tommy boy's mental irregularities. And Tommy, add in a Psychologist too. They are not medical doctors, but your problems are far more mental than physical, so a Psychologist will be able to help you a lot.
>>>>>>>>>>>
>>>>>>>>>>> Tommy, if you have not researched and found a good doctor for all of these likely issues, then you are just lying and yipping and yapping about your neurologist. These are more likely to occur and much higher up on the list of doctors for you to research. Get to it Tommy boy. Report back when you have every one of these doctors on your speed dial.
>>>>>>>>>> But, how does one select a "good" doctor? Do doctors publish their
>>>>>>>>>> grades in Medical school? Do doctors publish win/loss scores for
>>>>>>>>>> patients cured/died? How does one pick a "good" doctor?
>>>>>>>>>> --
>>>>>>>>>> Cheers,
>>>>>>>>>>
>>>>>>>>>> John B.
>>>>>>>>>
>>>>>>>>> To be honest, I don't think you know they are "good" until after you see them for awhile. And I suppose you judge how "good" they were by whether you got better. In my lifetime of doctor seeing, I have been fortunate enough to have had some really "good" doctors. And would recommend them to others if I was asked. But it took a number of years for me to decide they were "good".
>>>>>>>>
>>>>>>>> But what is good, or what is better? If, for example. you have high
>>>>>>>> cholesterol, one doctor might recommend that you take LIVALO for your
>>>>>>>> problem, but another doctor might recommend lower doses of LIVALO but
>>>>>>>> also strongly recommend that you change your diet, lose weight and
>>>>>>>> start to exercise.
>>>>>>>>
>>>>>>>> Which is the better doctor?
>>>>>>>>
>>>>>>>> And which is the doctor that most will recommend to their friends?
>>>>>>>>
>>>>>>>
>>>>>>> That's a complex question. The brother of a good friend is
>>>>>>> a suburban GP who says that mothers bring children in with
>>>>>>> viruses and demand antibiotics. His choice is either to do
>>>>>>> the right thing and say no, resulting in a reputation as a
>>>>>>> 'bad doctor' or to prescribe a very low dose of antibiotics
>>>>>>> with the understanding that most childhood viruses will
>>>>>>> clear them selves in a few days with rest.
>>>>>>>
>>>>>>> And you can double that problem for doctors asked to
>>>>>>> prescribe morphine and similar. The patient knows that
>>>>>>> someone else (insurance company or welfare) will pick up
>>>>>>> most of the office visit and prescription charges, leaving
>>>>>>> the patient with a saleable item.
>>>>>>>
>>>>>>> Add in that few MDs are independent professionals now.
>>>>>>> They're employees of large entities and capitated, which
>>>>>>> means time spent with a patient is strongly discouraged.
>>>>>>>
>>>>>>> How to approach that problem? Systematize pill pushing!
>>>>>>> https://www.bloombergquint.com/businessweek/cerebral-app-over-prescribed-adhd-meds-ex-employees-say
>>>>>>>
>>>>>>> Define 'good doctor' any way you like but the degradation of
>>>>>>> the medical industry (from the patient's view, not the
>>>>>>> revenue side of the industry) continues.
>>>>>>
>>>>>> I'm not sure that I agree with you. I have a pacemaker, which keeps my
>>>>>> heart beating regularly. Not that many years ago there weren't any
>>>>>> such devices and I'd likely be dead today.
>>>>>>
>>>>>> Hardly degradation (:-)
>>>>>>
>>>>>
>>>>> I wrote 'degradation' not 'disappearance'.
>>>>>
>>>>> Pacemakers have been around for some 70 years or so (with
>>>>> regular improvement I might add) which makes them hardly an
>>>>> exemplar of the current problems.
>>>>
>>>> 62 years actually. the first pacemaker was implanted in a human, in
>>>> 1960, in a 77-year-old man, who lived for 10 months after the surgery.
>>>>
>>>> But, I'm still not sure about "degradation" as that implies that
>>>> medical care is less, or less well done, today then it was in the
>>>> past, while I'm seeing things done today that would have been
>>>> considered impossible a generation ago.
>>>> https://thethaiger.com/news/national/siriraj-hospital-announces-thailands-first-successful-multi-visceral-transplant
>>>>
>>>
>>> My first comments on this subject above were, "It's complex".
>>>
>>> Yes, innovation continues apace, as you note. Which is good.
>>>
>>> Systemic difficulties continue as well:
>>> https://newsmantraa.us/healthcare-acquired-infection-market-research-report-size-share-price-trends-and-forecast-to-2025/
>>>
>>> I touched on a few other negative trends earlier. A mixed
>>> bag at best, at great cost both in suffering and in dollars.
>>
>> Well, I did read your reference, above, but essentially it seemed to
>> say that the acquired infection market is growing as certainly one
>> would assume that it must given the population growth, i.e. more
>> people, more possible infections.
>>
>> Example, the "black death" is estimated to have killed some 25
>> million people in Europe, estimated to have been between 30% and 60%
>> of the population. Today, a disease that killed 30 - 60 percent of the
>> European population would kill 225 to 450 million.
>>
>> Added to that is the U.S. capitalistic system of charging all the
>> market will stand and I'm sure that the cost of sickness, in the U.S.
>> is skyrocketing.
>>
>> Here the government buys medicines on the open market with competitive
>> bidding and, I'm guessing here, my monthly medicine costs are far
>> lower, maybe 1/4, or less, that which you would pay in the U.S.
>> Goodness! You can just go to Canada or Mexico and get lower medicine
>> costs.
>>
>
>Without engaging that discussion here, much is made of
>roughly 20,000 USA firearms homicides per year but nobody
>much cares about 70,000 people who are admitted to a
>hospital and, while there, contract infection and die as a
>result. That's a large number of people.
>
I think that your figures may be outdated. See
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820440/
The estimated deaths associated with HAIs in U.S. hospitals were
98,987