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About bcl05

  • Rank
    The Special Teams Ace
  • Birthday 03/13/1975

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  • Redskins Fan Since
    All 36 years of my life
  • Favorite Redskin
    Jim Lachey
  • Location
    Rochester, MN
  • Zip Code
  • Interests
  • Occupation

Profile Information

  • Birthdate
    March 13
  • Interests
    Birding, medicine, cooking, crosswords

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1,907 profile views
  1. Taxi Driver Godfather, part II Night of the Hunter The Wild Bunch Akira Kurosawa's Dreams
  2. Dr. Tobias Funke (Arrested Development) Bronn (GoT) Walter White (Breaking bad) Dwight Schrute (Office) Dale Cooper (Twin Peaks)
  3. Wow. Murph just scored on a sac fly. From 2nd. Not something you see every day...
  4. Dan Kolko tweet: Nats have acquired RHP Ryan Madson and LHP Sean Doolittle from A's in exchange for Blake Treinen and prospects Jesus Luzardo & Sheldon Neuse
  5. Can you imagine this lineup with Trea and Eaton at the top instead of Goodwin/Difo?
  6. It was surreal listening to the TV team go on and on about how great Gott's stuff is and how hard his arm action is to pick up and yet to watch him get lit up like batting practice. Groan...
  7. I don't think Gott is the answer...
  8. Still not an all star. What a lineup.
  9. Sendley... That's an out in little league.
  10. That homer was hit as hard as I've ever seen a ball get hit. He destroyed it.
  11. I don't think the answer is simply to do less. I think it is to do smarter health care. I think there is a lot of health care happening that doesn't need to, and a lot that should be happening that isn't. If we spent more on prevention, population health, early detection screening, etc, we could be a lot healthier as a country. That should be the goal, I think. I think we need a system that incentivizes health and best practices, which would be very different than the system we have today. The goal shouldn't be to simply spend less. It should be to make our people healthier. I think if we do that, our health care costs would drop.
  12. I want to be clear about what I'm saying. I am not saying that docs are doing clearly unnecessary tests or are intentionally misdiagnosing patients for purely financial reasons. Our administrators don't come out and say "do more of X." They do, however, have monthly meetings where they show us highly detailed metrics regarding patient volumes, charges, reimbursements, etc. They don't come and show us metrics of how healthy our patients are, how scientifically sound our decisions were, etc. Decision making in medicine is rarely black-and-white. How sick does someone have to be to get a chest x-ray? How many blood tests do you need to reassure yourself that this fever is just the flu and not leukemia? Are you sure you don't need an MRI for this patient with a headache? It could be a tumor... etc.etc.etc. There are many things that weigh into these decisions. The financial piece is a constant background pressure. I don't think any docs that I know actively and consciously choose things for purely financial reasons (I'm sure there are some out there). However, I think it definitely seeps into our background/unconscious decision making and keeps pushing us to do more and more. One of the problems is that this is all so opaque. There isn't anyone in the health care industry who is incentivized to reign in spending. Right now, we incentivize health care activity, not health care outcomes. If we can somehow incentivize the industry to keep people healthier, rather than keep people more engaged in the health care industry, we can actually make progress. I don't really know how that would work. I think Obamacare was a tiny step in the right direction, though was really inadequate to make the big changes that need to happen. I know the republican plan currently out there would be a huge step in the wrong direction.
  13. It's not an either/or. We consume more health care because it is profitable. We incentivize every layer of the health care industry to do more. More testing, more intensive care, more surgery, more medications, more imaging, etc. Much of those decisions are driven by profit/insurance reimbursement. I am a doc, and my administrative overseers are constantly trying to nudge us to into spending more time and effort on patients and problems for which reimbursement/profit is highest. We try to resist, to make sure our decisions are based on science and need, not profit, but the pressure is constant. For all that consumption and spending, we have some of the poorest health metrics amongst all modern westernized societies. This system is clearly grossly inefficient and ineffective at making our population healthier.
  14. That is one delicious victory.
  15. Holy crap. I saw his tweet earlier but didn't press play. I figured it must just be an anodyne video of a choir doing the anthem or some other patriotic song. That is Leni Reifenstahl level creepy...