Hey, they're students, it's not like *they* are working
Never been a medical student, I see. Med students carry what can only be described as a crushing class and clinical load. This was something these students did over and above their regular work, on their own time, and for all the right reasons, philanthropy predominant among them.
This program wouldn't have been affected by anyone's job... it was aimed squarely at welfare families... you generally can't work two jobs and still qualify for welfare (ironic that some people are better off on public assistance, complete with medicaid card, when compared to actually working and having to buy their own health insurance).
Not that medicaid is great... I have colleagues who treat medicaid patients for free, rather than attempt to bill medicaid. Why? As it turns out, it costs them more in extra overhead to try to get reimbursed from the medicaid program than they get back in actual payment. You know something's wrong when free is cheaper than getting paid...
how many parents are against vaccination programs... I'm not even talking MANDATORY vaccination programs, I'm talking vaccines in general. Probably as many are motivated by fear as are motivated by religion.
There are people out there who preach that vaccines are a scam; nothing but evil, drug company money-makers. They look at the very small numbers of adverse reactions, where vaccines make people sick (a few hundred cases, generally out of millions of doses), and use those incidents to frighten parents into avoiding vaccination. Some use the logic that "if everyone else is vaccinated, you won't have to be, because you'll never come into contact with a diseased person!" Well, that might have been true before the jet age... but I've seen rare-in-the-US diseases in my ER, sometimes in immigrants, (sitting next to your child in the waiting room), sometimes not. Some vaccines don't induce an immune response in certain people, so they are potential infectious sources. Bottom line: there is always a small reservoir of people out there who can infect you. The choice of whether to get a shot or not is really up to the individual.
Personally, I'm generally a fan of vaccinations (with some exceptions)... but not all doctors are. If you meet one who's not a fan, ask him why. If he starts spieling some wide-eyed conspiracy theory stuff, RUN the other way. On the other hand, If he starts talking about odds ratios, attack rates, and slightly increased complication rates for certain age groups, he may know what he's talking about... consider listening, then check it out for yourself.
Just remember, not all doctors who are against certain vaccines are crackpots.
It's no crime to be poor... it is a crime to steal. If some guy only makes 20K per year, maybe he'd better think twice about having a big family to support, or getting a car (public transportation will get you to work).
I'd rather people work hard and better themselves... if immigrants can come to the US, unable to speak the language, and better themselves through hard work, anyone can do it.
Are you really making the argument that people deserve "X" standard of living, simply because they exist? And that they can commit crimes to get there if their McDonalds job isn't making it?
At my medical school, a bunch of students did a free vaccine drive for inner city kids. All their mothers had to do was show up with their little ones... no fee, no hassle, no problem.
Well, one problem... only about six people showed up, and this was after they advertised beforehand, posted it in the innner-city clinics, etc.
So yes, some people could care less... it was a very eye-opening experience for a group of well-meaning young physicians.
But to address the original point, there is NO justification to sanction the whole because of the actions of the few... that's a lazy and ineffective strategy.
being poor does not make you a felon... committing the appropriate crime makes you a felon.
Apart from a few high-profile cases (eg. OJ Simpson), I would hardly say that buying justice is the norm. Even the poor are afforded legal representation in the form of a public defender... he/she may not be Johnny Cochran, but he/she IS an attorney.
All legal represenation is not created equal, just as all medical care is not the same. All poor people may not get their broken leg fixed at the Mayo clinic, but they DO get medical care... all they have to do is show up at the hospital's ER.
All poor people may not be defended by Mark Geragos, but they do get a lawyer. To imply that anyone who gets convicted of a felony just didn't have a big enough lawyer is nonsense... Charges come with specifications that increase or decrease the penalty... plea bargains only work if the prosecution is willing to deal, and state law is what makes a criminal act a felony, not the lawyer.
Most of the websites and statistics regarding felon "disenfrachnisement" come from drug and prisoner advocacy groups, like the sentencing project... this makes their statistics suspect from the start. Many of these groups use these statistics to make voting for felons a "racist" issue. Also, some of them consider it "disenfranchisement" if a state does not automatically restore your civil rights after your sentence is served. Personally, I see no problem with making a felon fill out a form to get his voting rights back.
Further, some of the states they cite as "permanently" disenfranchising felons DO have procedures in place to restore civil rights... Florida (where I live) is a good example. Florida is often cited as one of the 10 (some sources cite 14 states) that permanently keep felons from voting... NOT TRUE. Check out this press release from the ACLU
Some states give voting rights back automatically... some have a few hoops you must jump through. Either way, committing a felony costs you. Now, I'm not aware of a single state that does not have procedures in place for restoration of civil rights. If someone wants to correct me, please do so.
Felon has a very specific legal definition (and also refers, in a medical context, to an infection of the fingertip).
Being convicted of a Felony in the United States (this varies somewhat by state law... some crimes are felonies in some states, misdemeanors in others) causes a loss of some civil rights, like the right to vote, and the right to own a gun.
These rights can be restored by a court order after you have served your sentence. Speaking only for myself, however, I want that process to stay in place. If you are a felon, and too damned lazy to petition the court to get your civil rights back after you get out of jail, I don't want you voting.
If you cater to a socioeconomic group with a high number of felons in it, then I'm sorry... get a higher-quality constituency. People who consistently violate the law, particularly in a violent fashion, SHOULDN'T vote... they don't respect society's mores and laws, so why should society feel an obligation to cut them any slack in regards to their vote, especially if they haven't yet payed their debt to society? After they rehabilitate themselves, pay their debt to society, and the court has decided to restore their civil rights, fine... before then, no way.
I may have fallen for a troll here... "code for minorities and democrats" indeed.
Republicans have committed election fraud... but election fraud also has a long and proud tradition in the democratic party, so let's smear a democrat or two, just to keep it even.
Why don't we talk about old Dan Rostenkowski? Yes, that one... one of the most corrupt members of congress in recent memory. He was a master at all kinds of shenanigans, including dead people voting... he netted a 17-count indictment.
What party was Rostenkowski? That's right... Democrat.
He was even pardoned by a Democrat (Clinton).
Save the republicans-are-evil-killers-and-eaters-of-newborn -babies crap. I personally think that election fraudsters are the worst sort of scum, but they're in BOTH parties, not just the GOP.
What I was referring to is the now-large age differential between Tony and the average teenage punk-skater.
Back when I and my friends were teenage punk skaters, Tony was at least of a similar age... I don't know how the young punk skaters of today relate to a guy old enough to be their dad.
fond memories of the Dead Kennedys... timeless classics like "holiday in Cambodia," "California Uber Alles," and "Nazi punks f*ck off"...
Jello Biafra is/was quite a character... thanks for bringing back those skate-punk memories (back when Tony Hawk was the same age as the rest of us, and not doing Apple commercials).
You are still in school, and you were writing papers back in the C-64 days? Most kids don't start writing papers until last elementary school/junior high... what kind of eternal student plan are you on?
The shoe is on the other foot, isn't it? That was certainly a fortunate glitch.
I wonder how the spammers feel now that their personal information and identity is being passed around the internet. I wonder if they are receiving "unsolicited" email.
I'll admit I'm kind of curious myself... I read slashdot pretty regularly, but I have no recollection of a big blow-up between Michael and Speakeasy... though apparently somebody's got a beef.
I thought Speakeasy was supposed to be pretty geek friendly.
Somebody on the inner circle want to enlighten me?
The chain of command that you reference applies most generally to residency/academic programs... and for one reason only: supervision of trainees.
A resident may have some training, but he is often not able to practice his discipline independently... at least not until he has graduated from his residency (He may or may not seek board certification after that... some hospitals require it).
In the private practice world, virtually nobody orders around an attending physician... it's his license to use or lose, and the buck stops with him. This is as it should be... the only reason a chain-of-command exists in residency programs is because the attending bears the ultimate responsibility (legally speaking) for the actions of his/her subordinates. Now, mechanisms DO exist for peer review, QA, impaired physicians, and removal of incompetent physicans (board-of-medicine complaints, etc), but that is not truly day-to-day supervision.
I don't let ANYONE tell me to do something improper for a patient... and in the past, I have told superiors to get bent (I'd recommend something more diplomatic, unless you are comfortable with confrontation). Then again, if it's a suggestion, and a reasonable one, from someone in a position to know (ie. similarly or better-trained/experienced than myself), I will always consider it.
The first thing you learn (or should learn) in medicine is that you can't know everything... and listen to others. It's a poor physician who routinely ignores the advice of a 20+year experienced nurse, for example.
But to readdress your initial point, I tend to take advice given by administrators regarding patient care with a grain of salt. Some of these types haven't set foot in a clinical environment in years, which in my mind makes their expert advice immediately suspect. That's not to say they may not be right, but I'd have to look at the merits of their suggestion. I'd surely evaluate for myself before taking a clinical care recommendation from such an individual.
I wouldn't put too much stock in that Kuro5hin article... full of typos and inaccuracies.
Some of their data on the 5.56 NATO, particularly regarding wound ballistics, was incorrect.
Some of their statements about armor-piercing ammunition were bogus.
I used to regularly give wound ballistics lectures to my students and residents, and I'd have to say that there are far better sources out there than that article. Getting gun info off the internet is always a dicey affair. I'd recommend sticking to military and medical/surgical publications if you really want to know what a bullet does to the human body.
For further reference, I'd recommend the International Wound Ballistics Association. I'd also recommend doing a search for articles by one of its members, Dr. Martin Fackler... his writings are fairly illuminating.
Fair warning before you go internet-researching: some of the material is gruesome. I have to know about this stuff professionally... it's part of my job, but it's not for everyone. If, however, you really want to know what happens when bullet meets flesh, I'd start there.
My sole responsibility is to my patients, first and foremost. Some corporate management types have attempted to apply a customer service model to medicine, but it's not a good fit. The patient is my customer, and my supervisor (that would be my department director) is there to resolve problems and put out fires. Customer satisfaction is A goal, but it's not THE goal...
I have the luxury of being in a profession where I am not beholden to any corporate masters... my license to practice medicine is MINE, and hard-won it was. I practice good medicine, guided by my ethics and professional obligations to follow the standard of care. My patients come to me for that and NOTHING ELSE, and by God, they get it (though sometimes that's not exactly what they wanted... read on)
That doesn't mean everyone leaves satisfied. As a point of fact, some are very DISsatisfied. Many patients, either from having an unspoken agenda, unrealistic expectations, or fancy some illicit narcotic diversion, DO NOT leave satisified. The first two types of patients are best dealt with by thorough, insightful history-taking, and education. The latter, however, are often angry, belligerent, and threatening (can't count the number of times I've been threatened)... but that's what happens when manipulative narcotic-seekers don't get their fix. Want an even better example? Try giving one some Narcan (extremely effective narcotic antidote) when they come in OD'd with respiratory depression... they're on their feet in a matter of minutes screaming at you for taking their high away... there's gratitude for you.
It's worth remembering that some customers will NEVER be satisfied, no matter what you do. Learn to spot these types and AVOID THEM... don't waste your time. Fulfill the letter of your obligation to them and move on... either that or charge them enough to make it worth the hassle.
Also, on the topic of saying "No," I've had to do it myself. I used to work at a place where the ER was not sufficiently staffed (ie. not enough docs). Those of us that were there were running our asses off, and seeing way too many patients. Now, the sweet spot, according to our college, is about 2.5 patients per hour. Now, that number will go up or down depending on how sick the patients are... I've seen six or more per hour when they are not sick... I've spent more than an hour with a single patient when profoundly critically ill. I had to stop working at that hospital... they kept calling me, and I had to tell the director no, because I felt like I was practicing outside my margin of safety. No is important... particularly when it's the right thing to do.
Anyway, good luck with your job... saying No is a major step, but you need to be able to do it. You owe it to your mental health.
Hahahah... you gave me a great chuckle, the mental picture I had of the mall police taking up arms. I'm not sure whose side I'd want some of those guys on;)
But seriously, thank you for posting that. When discussing similar hypothetical situations concerning martial law/oppression with other officers, including my tactical teammates, their response was identical to mine: "No and hell no"
Just based on the subject line and my own experience/education (IIADoctor), he's likely to be right... he's definitely right about biological systems.
Repeated challenges to your immune system keep it strong, and may render you at least partially immune to related infections. Immunity to one infection may lend immunity to others... Vaccinia infection protects against smallpox, for example. Exposure to some animal forms of rotavirus (common cause of diarrhea in infants... and adults. The immunity wanes later in life) may lend partial immunity to the human form of the disease.
Aside from generating similar antibodies, your immune system also generates cytokines and other proteins that assist your immune system in fighting off infection. The interferons are a good example (and are used to treat some viral infections, like Hep C). TNF (tumor necrosis factor) is another example.
Now, this probably also applies to computers, though the mechanisms differ. Attention to one vulnerability may shed light on another... patching one hole may protect from several viruses/worms.
I didn't really consider what he wrote to be a physical threat to anyone, though it's certainly a legal gauntlet he's thrown down (or rather picked up, since SCO is the one who initiated this legal mess).
ESR has written some faily provocative material, but I think he's really trying to provoke thought, rather than violence. He's a self-proclaimed "gun nut," but why does that worry anyone? He's never used a weapon on anyone that I'm aware of, and until he shows a proclivity towards unjustifiable lethal violence, it's difficult to justify any sort of sanction. Prior restraint, whether physical or intellectual, is hardly justifiable in this instance. It's also worth remembering that violence is not always the wrong path (here come the pacifist flames), despite what they are teaching in school these days.
For example: his article on "when to shoot a policeman." At first blush, this kind of thing immediately raises my antennae; I used to be an LEO, of the tactical-team variety. If anyone's likely to be a target for killing, it would be a fellow like myself... yet I didn't find the article terribly alarming. He actually argues AGAINST the killing of policemen, except in very extreme circumstances (total breakdown of civil liberties... where the police become a tool of tyranny). Frankly, I'm glad people like ESR feel passionately about their rights, and are willing to defend tham... civil rights are what separates the US from the world of brutal dictatorial regimes. Frankly, if I were a policeman under such conditions, I would give up my badge; I would not be party to gratuitious abrogation of the rights of others... THEIR loss of rights is MY loss of rights. This might come as a surprise to some Slashdotters, but virtually all the cops I've ever known were able to make that intellectual leap.
Most LEOs would never be a part of such wholesale represssion. Such atrocity creates an unholy bond between the masters and their agents, one that binds them to the same fate, usually a bloody one. ESR simply states a willingness to use the "final option" against a repressive, tyrannical government. This discussion may make people, myself included, uncomfortable, but discussions about revolution are hardly comfortable things. Now personally, I would look a bit askance at an individual who considered mass violence, societal upheaval, revolution, and bloodshed comfortable everyday topics... yet some simple intellectual discourse about such things should not be cause for sanction. ESR may be a strange guy, but I respect his intellect, and trust that he knows the difference between philosophical debate and action.
But back to the topic at hand, I actually liked his letter to McBride. Some people will no doubt attack it as juvenile... I thought it was hilarious.
Beautiful, isn't it? Just like in nature... evolve and adapt, differentiate, or perish.
That wonderful variety is what keeps half of the net functioning while the other half is patching their boxen.
In nature it's thanks to a bit of UV light, background radiation producing random mutations, strange chromosomal breakage during meiosis... in programming it's the constant drive to improve the code.
Just as some fun additional reading (if you can tolerate the legalese), there are some cases out there that are thankfully chipping away at ERISA.
One, appropriately enough, just happened a few months ago before the Florida Supreme Court, so its effects are yet to be realized. That case was Villazon Versus Prudential Healthcare Plan.
Another case that has come down against HMOs and ERISA was a case in Pennsylvania, Pappas Versus Asbel (see the second case, Pappas II, since it was sent back from the SCOTUS for revision by the lower court).
All these cases have touched on vicarious liability for HMOs, with the argument that the HMO cannot make treatment decision (that are not a matter of internal HMO policy) and escape the resulting liability for those actions.
Can't have power and responsibility separated from one another... results in tragedy and injustice.
When did they give HMO's a get-out-of-lawsuit free card? If you're referring to the most-recent legislation, that was about giving Florida doctors some relief (I should know, I am an ER doc in Florida). They actually capped my liability, which is a welcome relief... ER docs get sued often, and I can't remember the last time one of my colleagues or friends got involved in an ER case that had real merit. I'm sorry to say, but most malpractice lawsuits are for stuff that's clearly objectively reasonable care, which is probably why doctors prevail in almost 90% of those cases. Those numbers should tell you something...
HMOs, however, have had protection from lawsuits for years... it's a federal law called ERISA, and it prevents pension plans, etc from being emptied by lawsuits. Since Health Insurance is considered an employee benefit (like a pension), it creates a very effective shield against litigation.
Were you referring to some other legislation that I'm unaware of?
Slashdot Mirror
Hey, they're students, it's not like *they* are working
Never been a medical student, I see. Med students carry what can only be described as a crushing class and clinical load. This was something these students did over and above their regular work, on their own time, and for all the right reasons, philanthropy predominant among them.
This program wouldn't have been affected by anyone's job... it was aimed squarely at welfare families... you generally can't work two jobs and still qualify for welfare (ironic that some people are better off on public assistance, complete with medicaid card, when compared to actually working and having to buy their own health insurance).
Not that medicaid is great... I have colleagues who treat medicaid patients for free, rather than attempt to bill medicaid. Why? As it turns out, it costs them more in extra overhead to try to get reimbursed from the medicaid program than they get back in actual payment. You know something's wrong when free is cheaper than getting paid...
how many parents are against vaccination programs... I'm not even talking MANDATORY vaccination programs, I'm talking vaccines in general. Probably as many are motivated by fear as are motivated by religion.
There are people out there who preach that vaccines are a scam; nothing but evil, drug company money-makers. They look at the very small numbers of adverse reactions, where vaccines make people sick (a few hundred cases, generally out of millions of doses), and use those incidents to frighten parents into avoiding vaccination. Some use the logic that "if everyone else is vaccinated, you won't have to be, because you'll never come into contact with a diseased person!" Well, that might have been true before the jet age... but I've seen rare-in-the-US diseases in my ER, sometimes in immigrants, (sitting next to your child in the waiting room), sometimes not. Some vaccines don't induce an immune response in certain people, so they are potential infectious sources. Bottom line: there is always a small reservoir of people out there who can infect you. The choice of whether to get a shot or not is really up to the individual.
Personally, I'm generally a fan of vaccinations (with some exceptions)... but not all doctors are. If you meet one who's not a fan, ask him why. If he starts spieling some wide-eyed conspiracy theory stuff, RUN the other way. On the other hand, If he starts talking about odds ratios, attack rates, and slightly increased complication rates for certain age groups, he may know what he's talking about... consider listening, then check it out for yourself.
Just remember, not all doctors who are against certain vaccines are crackpots.
It's no crime to be poor... it is a crime to steal. If some guy only makes 20K per year, maybe he'd better think twice about having a big family to support, or getting a car (public transportation will get you to work).
I'd rather people work hard and better themselves... if immigrants can come to the US, unable to speak the language, and better themselves through hard work, anyone can do it.
Are you really making the argument that people deserve "X" standard of living, simply because they exist? And that they can commit crimes to get there if their McDonalds job isn't making it?
At my medical school, a bunch of students did a free vaccine drive for inner city kids. All their mothers had to do was show up with their little ones... no fee, no hassle, no problem.
Well, one problem... only about six people showed up, and this was after they advertised beforehand, posted it in the innner-city clinics, etc.
So yes, some people could care less... it was a very eye-opening experience for a group of well-meaning young physicians.
But to address the original point, there is NO justification to sanction the whole because of the actions of the few... that's a lazy and ineffective strategy.
being poor does not make you a felon... committing the appropriate crime makes you a felon.
Apart from a few high-profile cases (eg. OJ Simpson), I would hardly say that buying justice is the norm. Even the poor are afforded legal representation in the form of a public defender... he/she may not be Johnny Cochran, but he/she IS an attorney.
All legal represenation is not created equal, just as all medical care is not the same. All poor people may not get their broken leg fixed at the Mayo clinic, but they DO get medical care... all they have to do is show up at the hospital's ER.
All poor people may not be defended by Mark Geragos, but they do get a lawyer. To imply that anyone who gets convicted of a felony just didn't have a big enough lawyer is nonsense... Charges come with specifications that increase or decrease the penalty... plea bargains only work if the prosecution is willing to deal, and state law is what makes a criminal act a felony, not the lawyer.
Most of the websites and statistics regarding felon "disenfrachnisement" come from drug and prisoner advocacy groups, like the sentencing project... this makes their statistics suspect from the start. Many of these groups use these statistics to make voting for felons a "racist" issue. Also, some of them consider it "disenfranchisement" if a state does not automatically restore your civil rights after your sentence is served. Personally, I see no problem with making a felon fill out a form to get his voting rights back.
Further, some of the states they cite as "permanently" disenfranchising felons DO have procedures in place to restore civil rights... Florida (where I live) is a good example. Florida is often cited as one of the 10 (some sources cite 14 states) that permanently keep felons from voting... NOT TRUE. Check out this press release from the ACLU
Some states give voting rights back automatically... some have a few hoops you must jump through. Either way, committing a felony costs you. Now, I'm not aware of a single state that does not have procedures in place for restoration of civil rights. If someone wants to correct me, please do so.
Felon has a very specific legal definition (and also refers, in a medical context, to an infection of the fingertip).
Being convicted of a Felony in the United States (this varies somewhat by state law... some crimes are felonies in some states, misdemeanors in others) causes a loss of some civil rights, like the right to vote, and the right to own a gun.
These rights can be restored by a court order after you have served your sentence. Speaking only for myself, however, I want that process to stay in place. If you are a felon, and too damned lazy to petition the court to get your civil rights back after you get out of jail, I don't want you voting.
If you cater to a socioeconomic group with a high number of felons in it, then I'm sorry... get a higher-quality constituency. People who consistently violate the law, particularly in a violent fashion, SHOULDN'T vote... they don't respect society's mores and laws, so why should society feel an obligation to cut them any slack in regards to their vote, especially if they haven't yet payed their debt to society? After they rehabilitate themselves, pay their debt to society, and the court has decided to restore their civil rights, fine... before then, no way.
I may have fallen for a troll here... "code for minorities and democrats" indeed.
Republicans have committed election fraud... but election fraud also has a long and proud tradition in the democratic party, so let's smear a democrat or two, just to keep it even.
n -babies crap. I personally think that election fraudsters are the worst sort of scum, but they're in BOTH parties, not just the GOP.
Why don't we talk about old Dan Rostenkowski? Yes, that one... one of the most corrupt members of congress in recent memory. He was a master at all kinds of shenanigans, including dead people voting... he netted a 17-count indictment.
What party was Rostenkowski? That's right... Democrat.
He was even pardoned by a Democrat (Clinton).
Save the republicans-are-evil-killers-and-eaters-of-newbor
Only the the age/time warp of my own mind...
What I was referring to is the now-large age differential between Tony and the average teenage punk-skater.
Back when I and my friends were teenage punk skaters, Tony was at least of a similar age... I don't know how the young punk skaters of today relate to a guy old enough to be their dad.
fond memories of the Dead Kennedys... timeless classics like "holiday in Cambodia," "California Uber Alles," and "Nazi punks f*ck off"...
Jello Biafra is/was quite a character... thanks for bringing back those skate-punk memories (back when Tony Hawk was the same age as the rest of us, and not doing Apple commercials).
Boy, seems like such a long time ago...
You are still in school, and you were writing papers back in the C-64 days? Most kids don't start writing papers until last elementary school/junior high... what kind of eternal student plan are you on?
I've heard of Ph.D's taking a while, but wow...
The shoe is on the other foot, isn't it? That was certainly a fortunate glitch.
I wonder how the spammers feel now that their personal information and identity is being passed around the internet. I wonder if they are receiving "unsolicited" email.
Muhahahah...
I'll admit I'm kind of curious myself... I read slashdot pretty regularly, but I have no recollection of a big blow-up between Michael and Speakeasy... though apparently somebody's got a beef.
I thought Speakeasy was supposed to be pretty geek friendly.
Somebody on the inner circle want to enlighten me?
The chain of command that you reference applies most generally to residency/academic programs... and for one reason only: supervision of trainees.
A resident may have some training, but he is often not able to practice his discipline independently... at least not until he has graduated from his residency (He may or may not seek board certification after that... some hospitals require it).
In the private practice world, virtually nobody orders around an attending physician... it's his license to use or lose, and the buck stops with him. This is as it should be... the only reason a chain-of-command exists in residency programs is because the attending bears the ultimate responsibility (legally speaking) for the actions of his/her subordinates. Now, mechanisms DO exist for peer review, QA, impaired physicians, and removal of incompetent physicans (board-of-medicine complaints, etc), but that is not truly day-to-day supervision.
I don't let ANYONE tell me to do something improper for a patient... and in the past, I have told superiors to get bent (I'd recommend something more diplomatic, unless you are comfortable with confrontation). Then again, if it's a suggestion, and a reasonable one, from someone in a position to know (ie. similarly or better-trained/experienced than myself), I will always consider it.
The first thing you learn (or should learn) in medicine is that you can't know everything... and listen to others. It's a poor physician who routinely ignores the advice of a 20+year experienced nurse, for example.
But to readdress your initial point, I tend to take advice given by administrators regarding patient care with a grain of salt. Some of these types haven't set foot in a clinical environment in years, which in my mind makes their expert advice immediately suspect. That's not to say they may not be right, but I'd have to look at the merits of their suggestion. I'd surely evaluate for myself before taking a clinical care recommendation from such an individual.
I wouldn't put too much stock in that Kuro5hin article... full of typos and inaccuracies.
Some of their data on the 5.56 NATO, particularly regarding wound ballistics, was incorrect.
Some of their statements about armor-piercing ammunition were bogus.
I used to regularly give wound ballistics lectures to my students and residents, and I'd have to say that there are far better sources out there than that article. Getting gun info off the internet is always a dicey affair. I'd recommend sticking to military and medical/surgical publications if you really want to know what a bullet does to the human body.
For further reference, I'd recommend the International Wound Ballistics Association. I'd also recommend doing a search for articles by one of its members, Dr. Martin Fackler... his writings are fairly illuminating.
Fair warning before you go internet-researching: some of the material is gruesome. I have to know about this stuff professionally... it's part of my job, but it's not for everyone. If, however, you really want to know what happens when bullet meets flesh, I'd start there.
Just my $.02
My sole responsibility is to my patients, first and foremost. Some corporate management types have attempted to apply a customer service model to medicine, but it's not a good fit. The patient is my customer, and my supervisor (that would be my department director) is there to resolve problems and put out fires. Customer satisfaction is A goal, but it's not THE goal...
I have the luxury of being in a profession where I am not beholden to any corporate masters... my license to practice medicine is MINE, and hard-won it was. I practice good medicine, guided by my ethics and professional obligations to follow the standard of care. My patients come to me for that and NOTHING ELSE, and by God, they get it (though sometimes that's not exactly what they wanted... read on)
That doesn't mean everyone leaves satisfied. As a point of fact, some are very DISsatisfied. Many patients, either from having an unspoken agenda, unrealistic expectations, or fancy some illicit narcotic diversion, DO NOT leave satisified. The first two types of patients are best dealt with by thorough, insightful history-taking, and education. The latter, however, are often angry, belligerent, and threatening (can't count the number of times I've been threatened)... but that's what happens when manipulative narcotic-seekers don't get their fix. Want an even better example? Try giving one some Narcan (extremely effective narcotic antidote) when they come in OD'd with respiratory depression... they're on their feet in a matter of minutes screaming at you for taking their high away... there's gratitude for you.
It's worth remembering that some customers will NEVER be satisfied, no matter what you do. Learn to spot these types and AVOID THEM... don't waste your time. Fulfill the letter of your obligation to them and move on... either that or charge them enough to make it worth the hassle.
Also, on the topic of saying "No," I've had to do it myself. I used to work at a place where the ER was not sufficiently staffed (ie. not enough docs). Those of us that were there were running our asses off, and seeing way too many patients. Now, the sweet spot, according to our college, is about 2.5 patients per hour. Now, that number will go up or down depending on how sick the patients are... I've seen six or more per hour when they are not sick... I've spent more than an hour with a single patient when profoundly critically ill. I had to stop working at that hospital... they kept calling me, and I had to tell the director no, because I felt like I was practicing outside my margin of safety. No is important... particularly when it's the right thing to do.
Anyway, good luck with your job... saying No is a major step, but you need to be able to do it. You owe it to your mental health.
They're using those to play "Global Thermonuclear War"
Being former SWAT, I almost peed my pants reading that one.
Some of those are actual SWAT hand signals too (though the translation is a bit off).
Too funny... thanks for the morning chuckle!
That goes in my bookmarks.
Hahahah... you gave me a great chuckle, the mental picture I had of the mall police taking up arms. I'm not sure whose side I'd want some of those guys on ;)
But seriously, thank you for posting that. When discussing similar hypothetical situations concerning martial law/oppression with other officers, including my tactical teammates, their response was identical to mine: "No and hell no"
Spoil my superfriends memories for ever and ever, you insensitive clod.
But nobody can cheapen what Wonder-woman and I had together... mmmmm... that golden lasso...
Just based on the subject line and my own experience/education (IIADoctor), he's likely to be right... he's definitely right about biological systems.
Repeated challenges to your immune system keep it strong, and may render you at least partially immune to related infections. Immunity to one infection may lend immunity to others... Vaccinia infection protects against smallpox, for example. Exposure to some animal forms of rotavirus (common cause of diarrhea in infants... and adults. The immunity wanes later in life) may lend partial immunity to the human form of the disease.
Aside from generating similar antibodies, your immune system also generates cytokines and other proteins that assist your immune system in fighting off infection. The interferons are a good example (and are used to treat some viral infections, like Hep C). TNF (tumor necrosis factor) is another example.
Now, this probably also applies to computers, though the mechanisms differ. Attention to one vulnerability may shed light on another... patching one hole may protect from several viruses/worms.
No pain no gain, I suppose.
I didn't really consider what he wrote to be a physical threat to anyone, though it's certainly a legal gauntlet he's thrown down (or rather picked up, since SCO is the one who initiated this legal mess).
ESR has written some faily provocative material, but I think he's really trying to provoke thought, rather than violence. He's a self-proclaimed "gun nut," but why does that worry anyone? He's never used a weapon on anyone that I'm aware of, and until he shows a proclivity towards unjustifiable lethal violence, it's difficult to justify any sort of sanction. Prior restraint, whether physical or intellectual, is hardly justifiable in this instance. It's also worth remembering that violence is not always the wrong path (here come the pacifist flames), despite what they are teaching in school these days.
For example: his article on "when to shoot a policeman." At first blush, this kind of thing immediately raises my antennae; I used to be an LEO, of the tactical-team variety. If anyone's likely to be a target for killing, it would be a fellow like myself... yet I didn't find the article terribly alarming. He actually argues AGAINST the killing of policemen, except in very extreme circumstances (total breakdown of civil liberties... where the police become a tool of tyranny). Frankly, I'm glad people like ESR feel passionately about their rights, and are willing to defend tham... civil rights are what separates the US from the world of brutal dictatorial regimes. Frankly, if I were a policeman under such conditions, I would give up my badge; I would not be party to gratuitious abrogation of the rights of others... THEIR loss of rights is MY loss of rights. This might come as a surprise to some Slashdotters, but virtually all the cops I've ever known were able to make that intellectual leap.
Most LEOs would never be a part of such wholesale represssion. Such atrocity creates an unholy bond between the masters and their agents, one that binds them to the same fate, usually a bloody one. ESR simply states a willingness to use the "final option" against a repressive, tyrannical government. This discussion may make people, myself included, uncomfortable, but discussions about revolution are hardly comfortable things. Now personally, I would look a bit askance at an individual who considered mass violence, societal upheaval, revolution, and bloodshed comfortable everyday topics... yet some simple intellectual discourse about such things should not be cause for sanction. ESR may be a strange guy, but I respect his intellect, and trust that he knows the difference between philosophical debate and action.
But back to the topic at hand, I actually liked his letter to McBride. Some people will no doubt attack it as juvenile... I thought it was hilarious.
Beautiful, isn't it? Just like in nature... evolve and adapt, differentiate, or perish.
That wonderful variety is what keeps half of the net functioning while the other half is patching their boxen.
In nature it's thanks to a bit of UV light, background radiation producing random mutations, strange chromosomal breakage during meiosis... in programming it's the constant drive to improve the code.
Three cheers for reinventing the wheel.
IANAL, but here's some more info:
Just as some fun additional reading (if you can tolerate the legalese), there are some cases out there that are thankfully chipping away at ERISA.
One, appropriately enough, just happened a few months ago before the Florida Supreme Court, so its effects are yet to be realized. That case was Villazon Versus Prudential Healthcare Plan.
Another case that has come down against HMOs and ERISA was a case in Pennsylvania, Pappas Versus Asbel (see the second case, Pappas II, since it was sent back from the SCOTUS for revision by the lower court).
All these cases have touched on vicarious liability for HMOs, with the argument that the HMO cannot make treatment decision (that are not a matter of internal HMO policy) and escape the resulting liability for those actions.
Can't have power and responsibility separated from one another... results in tragedy and injustice.
When did they give HMO's a get-out-of-lawsuit free card? If you're referring to the most-recent legislation, that was about giving Florida doctors some relief (I should know, I am an ER doc in Florida). They actually capped my liability, which is a welcome relief... ER docs get sued often, and I can't remember the last time one of my colleagues or friends got involved in an ER case that had real merit. I'm sorry to say, but most malpractice lawsuits are for stuff that's clearly objectively reasonable care, which is probably why doctors prevail in almost 90% of those cases. Those numbers should tell you something...
HMOs, however, have had protection from lawsuits for years... it's a federal law called ERISA, and it prevents pension plans, etc from being emptied by lawsuits. Since Health Insurance is considered an employee benefit (like a pension), it creates a very effective shield against litigation.
Were you referring to some other legislation that I'm unaware of?