Month: August 2015

Getting Back to Principles


Often, things aren’t what they seem.

Take the image above, for example. Which shade of gray is darker? A or B? Look closely. I wouldn’t want you to miss this one.

Now, place your finger horizontally between A and B. Cover up the transition zone between the letters. Block the area with all the shadows. Look again.

Very interesting, right? The two colors are the same. Remember, things aren’t always what they appear to be. In fact, when you find yourself on the side of the majority, you should think even harder.

We already discussed causation and correlation, but it’s time to go deeper than that. Stuff just happens all the time for reasons that we seem to miss. We assume the problem is one thing. At least, it appears to be acting that way on our stage. But, if only we could see deeper. Far below the surface. Would we see things the same way?

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Informed Madness


You are having a heart attack.

Uncomfortable doesn’t really describe what you are feeling. You have severe penetrating pain in the chest. Excruciating discomfort.

You are breathless. You lie on a stretcher moving rapidly through an emergency department. You are on your way to a heart catheterization lab on the hospital’s second floor. You need an immediate procedure in order to save your dying heart muscle.

I meet you in the hallway and keep pace with the team of individuals who are transporting you. I’m the first physician you have seen. Everything is moving quickly and this is actually a good thing for you. Time is muscle.

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You Can Expect to Die If You Live


“Life expectancy in the United States lags behind other countries.”

I hear that statement a good bit when people try to explain America’s healthcare problems to me.

The statement almost always precedes this one:

“The United States is spending tons of dollars on healthcare and getting far less return on its investment than other countries.”

Basically, there are problems with healthcare in America and this results in lower-than-hoped-for life expectancy.

We spend too much on medical tests. We diagnosis many diseases. But, we don’t follow through with managing them well, so our population doesn’t live as long as our competitors.

I’ve even found myself, from time to time, nodding along with people making these statements and using this kind of reasoning. Then, it finally occurred to me.

We actually have no idea what we are talking about.

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How to Spend Eleven Billion Dollars


Eleven billion dollars.

Sounds like a lot of money, doesn’t it?

It is. But, I’ll give you even more perspective, Tony Robbins style.

Eleven seconds ago you started reading this page. A few blinks of an eye. But, eleven million seconds? That was a few months back. 127 days to be exact. Can you remember what you were doing then? Eleven million seconds have passed since you did it.

But, when you jump to billions, you’ll begin to see my point. Take eleven billion seconds. How many days ago was that? Not days, really. Try years. I’ll give you a hint. You weren’t born yet. Our country wasn’t even born yet. Eleven billion seconds ago was almost 350 years in the past. It becomes days versus centuries when you go from millions to billions. They are solar systems apart, even when traveling at the speed of light.

So, back to eleven billion dollars.

Remember, as Everett Dirksen once said, “a billion here, a billion there, and pretty soon you’re talking about real money.”

Eleven billion dollars is what the Department of Defense (DoD) is about to spend to revamp their electronic health record (EHR) system. That’s right. Computer software. For medicine.

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