Category: Conflicts of Interest

The Butterfly Effect on Me


After reading my latest post about conflicts of interest in healthcare, my wife suggested that I write a piece about butterflies. Something pretty, she said. Natural. Peaceful.

Since hostility is never my goal, I thought I’d give it a try.

I read for an entire evening on butterflies–their life cycle, behavior, mechanisms for protection, and how different cultures view them. All I could keep thinking about was how much my grandmother liked them. She lived for nature. Flowers. Birds. Butterflies. She stayed with me once as a child when my parents were out of town. She would literally drive only 10 MPH on the road if anything remotely beautiful were visible out the window. Butterflies included. During her visit that year, I intentionally directed her down the ugliest roads in town so we could get to where we were going more quickly. I know it sounds bad, but that’s what I did.

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Emptying the Talent


Nobody is waiting to hear your opinion.

People are not on the edge of their seat anticipating what you might say.

We often think we have an audience. But, the theater is frequently empty. People are looking for popcorn elsewhere. They are not waiting on your masterpiece.

Now, usually, this doesn’t stop us from putting on a show. People are actually hired all the time to give their opinion. All the time. Billions of dollars are spent on opinions. Some of this money comes from tax-payers. In fact, in medicine, it seems as if a degree in public health is all that’s required to provide advice.

Knowledge of time and place regarding the delivery of healthcare is not needed to wage an opinion about it. Just form a committee or an institution. Schedule a meeting. Advocate public protection or patient safety. Tell people what to fear, proclaim purity in your quest, and you’re off and running. You will probably even get funding from somebody. Maybe, it will be our government if your opinion advocates a need for more medical regulations to come from it.

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Purifying Healthcare (Part 2): One Desolate Place Without Industry


Essentially every concept has positives and negatives.

No matter how opinionated a player on one side wants to be, there are usually always some benefits to the opposing team’s approach to the game.

In healthcare, whether you think we need a single-payer system, a multi-payer system, or no system at all, I can find you a simulator that will reveal perceived benefits for each of these strategies. The simulator will tell you the negatives, too. And, then, no matter how robust it may be, the simulator will still manage to imperfectly predict real life.

You see, what often makes sense to a simulator becomes bizarely twisted in application. Human beings display surprisingly self-directed and unpredictable behaviors. Uncertainty is a certainty.

Cause and effect are challenging to prove and our own observations even interfere. For example, there was a time when we wrongly associated ice cream consumption with the spread of the Poliovirus, merely because both were more prominent in the summer months. Life is complicated. And, everyone has an angle.

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Purifying Healthcare (Part 1): Just Another Invented Game?


Everyone has an angle. Everyone.

Your doctor? Sure. But, he or she isn’t the only one. The pharmaceutical company? Of course. The medical device company? The hospital? The insurance company? You get the point. Everyone has an angle. Everyone has a conflict of interest. Know it. Get over it. It’s time to focus on something else.

Like filling up your car with gas. In fact, you better plug your ears when you do it. Heaven forbid one of those automated messages at the pump convinces you to buy a 42 ounce gulp of Pepsi. Just another angle, my friends. It’s called life.

But, medicine isn’t supposed to have any conflicts of interest, right? Healthcare instead should be like religion, or maybe, like politics… sorry, I’m now getting confused what’s supposed to be pure.

We just live at a time in America where so much of healthcare has become invented. And, the more we keep inventing, the more it seems that we lose track of what matters: the hopelessly out-of-date concept known as the patient-physician relationship.

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