Media and Issues To Consider - 11/5/18

Books, Articles and Thoughts worth a Review…

VOTE!!
It’s not only a right,
it’s also a responsibility. 

 A Change of Focus on Another Issue: Something Bigger Than Politics – Jonathan Swift in 1711 said, “Vision is the art of seeing things invisible.”  We’re there and we’ve got the blinders on.  In the last couple of months, we’ve heard a lot about the trade difficulties with China and other countries, the “unfair” tariffs, the implication of the tax cut passed into law by the Republican Congress – and, a host of other issues.  Mudslinging seems to have become the mainstay.  But, there’s one issue you may not have heard about which is the new, evolving threat to Maine’s lobster industry.  Yes, this is not about health care (yet), it’s about lobsters!! This brief missive is about the severe bait shortage facing lobstermen (and, women).  Now for a foodie – like myself – this is a big issue and for us Mainers, it’s not only a food issue, it’s an economic issue which makes it really BIG!!

You think I jest.  I’m not!!  In essence, regulators held this year’s herring landings at last year’s levels – or, 50,000 metric tons – and, are planning to slash next year’s quota of herring (= the most popular lobster bait) down to 30,000 metric tons. Why?  Well, there is a record low number of newborn herring entering the fishery off the coast of Maine.  Why?  In large measure it’s because the Gulf of Maine is among the fastest-warming bodies of water across the entire globe. It’s been local news since around 2015 and the problem is accelerating.  Due to warming, the lobsters have already moved about 150 miles further north off the coast of Maine in search of cooler waters and, are expected to move even further north.  They’re accompanied in their northerly travels by cod, northern shrimp and a host of other species that dominated the waters in the Gulf of Maine – including the herring!  Then, on top of all of that China and Europe are both threatening a tariff on lobster from the USA.  Need I say more?   Well, just a bit more… 

There is a controversy on what to do about the herring which takes us into a much longer discussion even further away from health care (NOTE: occasionally, that’s a sanity improvement strategy). Leave it to say that there’s a big debate on how to proceed between the New England Fisher Management Council, the Maine Lobstermen’s Association and the National Oceanic and Atmospheric Association (NOAA) on what to do.  But, unlike debates in other parts of our society, this one is civilized and – more importantly – trying to find a solution.  The fly in the ointment is that the problem is global warming.  Yes, you heard it here – global warming. Now, that is an issue that I hope we can all rally around.  Several weeks ago, I noted the invasion of ticks at our southern border due to “global warming” and the diseases that were beginning to show up.  Now, it’s lobsters and herring.  It’s a climate issue today.  It will be a health care issue tomorrow.  Mark my word… 

Kudos to the American College of Physicians (ACP) –  The ACP is one of the largest associations of physicians and a leader among such organizations on all considerations related to health care.  Of note, they just updated their firearms policy paper, “Reducing Firearm-Related Injuries and Deaths in the U.S.” which includes nine (9) evidence-based strategies to help reduce firearms-related injuries and deaths by keeping guns out of the hands of those at risk of harming themselves or others. The new recommendations include such ideas as passing laws to prohibit individuals with a history of domestic violence – including those under restraining orders – from buying or possessing firearms. There is even a call to allow family members to seek an immediate court order for removing guns from a family member who is at risk of using firearms to inflict harm on themselves or others. After the experiences of the last couple of weeks – YET AGAIN – at the Tree of Life Synagogue in Pittsburgh, Pennsylvania and the yoga studio shooting in Tallahassee, Florida we clearly need to address firearms violence and hate crimes which are happening far, far too frequently across the country. Do we make this a healthcare industry issue as well?

 

Media To Consider - 10/11/18

Books and Articles worth a Review…

The Coders of Kentucky – The New York Times recently posted an important article that all of us need to read in this time of revolution.  First, a brief history lesson.  The First Industrial Revolution lasted about 120 years.  It tore apart professions that had been passed down from generation to generation.  In fact, my great-grandfather was a victim in the line of progress.  He was a tanner in Bavaria who lost his job to the looms.  Like many of that generation experienced, there was disruption.  The options were few and far between in Germany at the time plus Otto Von Bismarck was engaging in lots of little wars with his neighbors throughout Europe.  My great-grandfather thought better of fighting wars as an unemployed tanner so he picked up his family and moved to America to become a farmer in Western Nebraska as a homesteader.  There were further revolutions along the way and now we are facing the digital revolution.  The difference is that instead of 120 years it will likely only take 20 years and the disruption will be far more significant.  It will affect not just coal miners and linemen in car factories.  It will also “affect doctors, lawyers and such.”  But, rather than hide or blame immigrants (like my great-grandfather) or engage in other disruptions – we need to learn from the past.  Education is the key.  It is disingenuous to tell coal miners that they will all get their jobs back!  Rather, the US should do what the Times article points out – which is to retrain people with new skills, added knowledge and capabilities for meeting new challenges.  From the hills and hollers of Eastern Kentucky, a new breeding ground of cybercoders has been created that will no doubt change the landscape.  The same type of thinking needs to go into retraining and educating workers so they can hold jobs in new areas.  Just as farming, tanning, car manufacturing and a host of other well-paying professions have radically changed – so it will be as the continuous cycle of change moves society forward.  Continuous education and re-education are the keys to success.  I see it with doctors, lawyers and such – because they’re next…

Thoughts and Readings To Consider - 9/14/18

Thoughts, Books and Articles worth a Review…

 As Simple As A Cup Of Coffee – Several weeks ago, I arrived at Boston Logan for a very early morning flight to someplace.  As I got to the airport, I realized that I had left my credit cards and cash at home due to the very early morning hours of my departure.  So, there I was credit- and cash-less heading out of town on a couple-of-days trip.  But, always the prepared traveler – I have traditionally carried a stash of $100 dollar bills in my briefcase for just such emergencies – which have only occurred twice in 40+ years of continuous travel.  Here’s where the interesting part comes in…  I went to the Starbuck’s, ordered a cup of Vente to get myself going to mentally regroup and offered up one of my $100 dollar bills.  The attendant looked at me and said, “Are you kidding?” and refused to take my money but – she also refused to give me the coffee.  I responded, “No, I’m not kidding.  It’s called money.” – obviously in a bit of snarky retort.  At this point, the Millennial gentleman standing next in line reached over with a $5 dollar bill and said to me and her, “Don’t worry, it’s on me!”  And, I responded, “Are you kidding?” with a laugh, of course.  He said, “No, really!”  I offered to walk away. He insisted. I relented and walked away thinking – yes, the next generation is prepared to assume authority!  I continued to shake my head – in a positive way – as I walked toward my gate thinking it was, in fact, time for my generation (“The Boomers”) to give way to the next generations – all because I got a cup of coffee when I really needed it.  Long story short, after about five minutes, the young man showed up at the gate and was headed to the same city.  I walked up to him, thanked him and gave him my card and offered that if there was anything I could ever do to help him in any way – he should reach out.  I would try to do whatever I could do to help him.  I’m waiting for the call…

Forever In Favor Of Biden – Many do not know this but I served as Joe Biden’s health policy advisor for his Presidential campaign in 1988.  I had high hopes for a corner office in The White House when with a one-two punch the campaign was knocked out rather quickly over the course of a couple of weeks.  First, Biden gave the exact same speech that Neil Kinnock had given in Parliament to a group in Iowa including references to his father – not a good thing to do.  Plagiarism is not a good thing on the campaign trail.  Second, he developed excruciating headaches and was diagnosed with a brain aneurysm which ended the campaign.  So, I’ve been a Biden fan for a very long time!!  But, his eulogy for John McCain, III was not only touching but memorable for what he brought to the forefront for at least a couple of moments – the need for civility in our public discourse.  He articulated so very well the passion that both he and McCain brought to their respective roles in the U.S. Senate which was based on trying to reach an understanding between two different assessments of the same situation.  We sorely need someone like Joe – for as much as I believe him to be the type of person we need as a leader in our nation, the nation probably needs someone other than Joe.  It’s time for the next generation to step forward.  My generation should guide them and support them.  The torch needs to be passed…

Media To Consider - 8/17/18

Books and Articles Worth a Review…

 OyVey – If you haven’t heard the Terri Gross interview on NPR’s Fresh Air from July 19, 2018 – it’s worth the time of listening.  Terri is one of the best interviewers on either television or radio – from my perspective and, she’s extremely fair, always trying to get to the real information.  Check it out!  The interview will make your hair stand on end. 

 The Ongoing Aging Issues – One of the challenges many of us face is the slow moving implications of aging.  Unlike the younger years when we were seemingly invincible, quick and agile – there are times as we age when we begin to feel a bit vulnerable, slower than normal and even a bit clumsy.  While others may not see it, the decline is self-evident.  But, it’s not as bad as it seems AND, we can do something about it.  Forgetfulness is one of the big issues.  Check out the information on WebMD if this is one of your bugaboos.

 Curiosity and Medicine – Atul Gwande, MD recently gave the UCLA commencement address for the School of Medicine graduate in June, 2018.  The address was titled: “Curiosity and What Equality Really Means”.  It is an excellent reflection on the “why?” that many of us learned in medical school and too often let fall by the wayside.  It’s an excellent reminder that as health care professionals, one of the most important elements we bring to the bedside in caring for people is our curiosity.  At least for the moment, no technology, learning machine or protocol will replace that capability.  Consider it…

 

Media To Consider - 7/16/18

Books and Articles worth a Review…

A Quick Read – But, Looming Problem – Sometimes when we are in the thick of the problem right in front of us, we forget about the bigger problem that is on the horizon.  It happens too often.  Then, the bigger problem falls on our doorstep and we are fully unprepared to deal with the crisis. Such is the state of antimicrobial resistance (AMR) which causes an estimated 700,000 deaths annually.  Read the article in the May 18, 2018 issues of Lancet for an overview of the problem titled, “Global Governance and Antimicrobial Resistance”.

And, Another Looming Problem – According to the Centers for Disease Control and Prevention (CDC), 36 252 Americans died because of gun violence in 2015—11.3 deaths per 100 000 people—an average of about 100 gun deaths every day.  By comparison in 2016, the approximate number of firearm-related deaths were about 39,000.  Compare that to motor vehicle-related deaths at 40,000 and drug overdose-related deaths at 64,000.  Yet, while there is substantial ongoing research in both the motor-vehicle area to improve the safety of our cars and in drug overdose to make treatment more effective (although not enough resources, I might add) – there are almost NONE allocated to gun research.  As a clinician, I’m very data driven.  But, the CDC nor any of the other branches of government – which fund research on all matter of other problems – discontinued gun-related research after the Dickey amendment took effect in 1996 which states that “…none of the funds made available for injury prevention and control at the [CDC] may be used to advocate or promote gun control…”.  And, the Trump Administration has continued to provide only funds for monitoring the situation.  In another Lancet issue on June 23, 2018 the article, “Gun violence research in the USA: the CDC's impasse” touches on a big issue.  Consider it. Think about it.  Act on your thoughts…

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