it's called the "captain of the ship" doctrine in legal terms. It dates back to english common law and the era where many were slave owners... a slave owner could be held liable for the actions of a slave that he owned.
It's what allows me to be sued if someone (including one of my nurses or another doctor treating their patient in the ER) does something inappropriate in my department. Even if it's not my patient, theoretically EVERY patient in the ER is my patient, since I'm the ranking doc in charge of the department.
It sucks, and it's vicarious liability, but it does happen (though some modern courts have started to rein this nonsense in)
Same thing with medicare fraud... if my billing company commits fraud (they bill in my name), guess who goes down? I do. The medicare and medicade regulations are extremely convoluted, and get changed very frequently... if my billing company doesn't keep track, and they bill wrong, they may get flagged as a potential fraud. The pressure to get successful prosecutions of fraudsters is VERY high, and agents go after doctors relentlessly... and the doctor takes the fall, even if someone else is doing their billing.
It's outrageous that you can be held to account for the actions of others, particularly if you don't understand their job, lack the expertise to oversee them, and don't directly control how they do business... but that's our legal system. It's not right, but it can and does happen.
So yes, I'd say if it's good enough for me, it's good enough for the good Senator Hatch.
My DSL experience has thus far trounced my cable experience soundly.
My current Cox cable barely gives me 3-400kpbs download speeds (based on driver and iso downloads), whereas my ex-DSL provider (Ameritech) gave me a solid 700-800kbps down. Online gaming pings are roughly equivalent. I can't explain the difference, because the costs are very comparable.
My DSL provider also didn't have a problem with me running servers, and the service was greater than 99% available... outages counted on one hand, and never more than a few hours in length.
Now don't get me wrong... dealing with Ameritech can be like a root canal sans anethesia (3 tries to get the installation right), but once it was set up, it ran like a champ.
You could use the principle behind LIDAR (police radar using laser rather than radar) if you wanted a good estimate of speed and distance.
The mechanism by which it measures your speed is a bit different, but it would give you the same data. Lidar sends out a thousands of pulses, and measures the time it takes for the backscatter from the laser to return, rather than relying on the doppler effect (or red shift, in the case of the visible portion of the EM spectrum). This method is more accurate (and thus preferred) by most police agencies.
However, that doesn't answer some of the other questions that have been raised: how does the car know what it's firing at? How does it know whether the object it's tracking is in your lane, or across the median on a long sweeping turn?
That aside, I totally agree with your sentiment regarding letting the computer have control over the vehicle (ie. tapping the brakes for me). Until they can design a system that's better than a NASCAR driver (and the computer controlled car successfully completes the race, no accidents, no skids), I'd much rather rely on my own driving skills and assessment of the road conditions.
It sounds like a neat idea... NO WAY I'd trust my family's life to it... call me a Luddite on this one if you want.
Bush has been eating a big shit sandwich ever since he took office. Unfortunately, much of it is batting cleanup from Clinton's presidency, but that's the way of things. Many problems get dropped into the lap of the subsequent leader, and it happened with Clinton too... but let's give credit where credit is due.
The Economy: already failing when bush took office. inherited from Clinton.
Corporate Scandals: Ongoing when Clinton was in office (part of that artificial economic boom)... the companies simply got caught under Bush's watch. This is one albatross that can be worn by a bunch of people, not just by, or even primarily by, bush.
September 11: Terrorist problem completely neglected under Clinton... inherited by bush (and will be inherited by presidents after bush... these people have been hitting us for a decade, and will continue to do so, at least until we find them and put a bullet into every one of their fanatacism-filled heads). As far as being the "worse" leader in time of crisis, I disagree... he's simply decided to wade in and do the dirty work that other presidents didn't have the stomach for... I'd count that as a plus.
As far as his previous substance abuse problem, if he's dealt with it, does it make him any less of a man? You're awfully judgemental... no problems/mistakes in your past? If he falls off the wagon, or recidivates again and again, I'd probably throw him out faster than you would.
By the way, Clinton didn't just "get a blow job." He's used women like shake and bake bags his entire life, committed perjury when confronted about it in court... this guy subjected our country to the humiliation of seeing his semen spewed onto the dress of some intern, and subsequently sent to the FBI crime lab.
Bush has his flaws, just like all of use do... but let's at least give credit where it's due. Many of these problems were NOT of his making.
*SNIP*
"I do not look up any patents on principle because (a) it's a horrible waste of time and (b) I don't want to know."
"The fact is technical people are better off not looking at patents. If you don't know what they cover and where they are, you won't be knowingly infringing on them," Mr. Torvalds wrote in the e-mail message last August.
In an e-mail interview earlier this month, Mr. Torvalds explained that his was a candid view in the murky, complex realm of software patents these days.
"Hey, one of the advantages of not personally being involved in any of the commercial Linux players is that I can be honest," Mr. Torvalds wrote. "In fact, openness pretty much requires it â" there is no corporate speak here. Ask any lawyer in a tech company (off the record, so that he can be honest too), and he'll tell you that engineers should absolutely not try to look up other people's patents. It's not their job, and you don't want them tainted."
What's so terrible about that? Why would you bias yourself (and waste a LOT of time) by poring over someone's code before writing your own? You may subconsciously emulate what they've done, and taint any originality you might have started with.
Same thing goes for other disciplines. In medicine, one should talk to the patient first, THEN read their medical records... you want an honest gestalt, unbiased by somebody else's interpretation of signs and symptoms. Isn't that what a second opinion is supposed to be?
This sounds to me like the old "better to beg forgiveness than ask permission" philosophy. Big whoop... give linus a break, SCO.
My understanding of these matters is limited, but the description on their website makes it sound like they are using a sort of spread-spectrum scheme.
They claim signal quality equal to FM... but I suppose that depends on how much data redundancy they have across their frequency range. They claim to be able to reconstruct missing or corrupted sections of data... is there some error checking built into this as well?
Thanks... but you know what's funny? I feel the same way about most other slashdot posters (referring to training and experience).
I should point out that I have no formal computer science training, apart from being a self-taught computer geek since the TRS-80 days, so I often find myself in awe of the coding/hacking/mathematical skills of many slashgeeks. This is one forum where I very seldom find myself able to speak authoritatively about the issues at hand... so I end up lurking instead of posting. When I can, however, I try to lend something to the discussion.
Re:DVT? Just increase the fucking legroom.
on
The Buttocks Have It
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· Score: 3, Interesting
I'm a physician... my training and board-certification are in emergency medicine, hence my experience with critically-ill people. Everyone dies sometime, and to be perfectly honest with you, I'm not sure that we have as much to say about it as we think we do...
But anyway, I'm not the only doc who posts on/. (Davak UID#526912 is an internal medicine specialist)... there's also a smattering of paramedics and EMTs who also post here from time to time.
That's one of the things I love about slashdot, penis birds and goatse.cx trolls aside.
Re:DVT? Just increase the fucking legroom.
on
The Buttocks Have It
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· Score: 4, Informative
I echo your sentiment about the legroom... though that in itself might not prevent DVT. In fact, I could see it increasing your risk (more comfortable seat = you stay in it longer = more venous stasis). The way help avoid a DVT is to unbuckle your seatbelt, and move about the cabin... You have to walk a bit, maybe do some knee bends (pretend you're looking for something under your seat if you're concerned about other passengers looking at you funny). I would even consider taking an asprin before a long trip. That single asprin (avg dose 325mg) will "thin" your blood by inhibiting your platelets... irreversibly, I might add. Don't worry... you'll replace those platelets with normal ones over time, assuming you take no more asprin, but it will take you a week or so. Ever wonder why surgeons ask you to stop taking asprin for two weeks before any elective surgery? That's why.
DVTs come from a couple of factors; venous stasis (blood pooling in your veins) is only one. The others are injury (getting kicked in the leg), and any sort of hypercoagulable state... ie. your blood clots more readily than normal. This last category is large, and includes pregnancy, birth control pills, smoking, cancer, genetic problems, etc, etc.
I took one trip that lasted almost 30 hours (20 hours+ of pure flying time)... inbetween sleeping and eating, I got up and walked the length of the airplane any number of times. Not only does it let you get the kinks out and stretch, but it also helps prevent DVTs, and their lethal sequela, the feared pulmonary embolus (PE).
A big PE (so-called "saddle embolus") will turn you out like a light. A large enough clot blocks your blood flow to the lungs, effectively dropping your cardiac output to zero. That, as you might imagine, is rapidly fatal... so rapidly fatal in fact that I've had people have huge PE's right in front of me and die, right there... nothing we could do for them (diagnosis made on autopsy). PEs are one of the major contributors in sudden death cases, though that's gotten a bit better with proper diagnosis and treatment.
While PEs are a problem, they used to be a bigger problem. Years ago, if you broke a hip, you were on bedrest for 6-8 weeks until it healed (these days, whenever possible, aggressive surgical repair and early ambulation are the rule). In retrospect, the bed rest was a bad idea; those folks were dying left and right of pulmonary emboli... thank god for medical progress.
I didn't know that solar power was too weak beyond the mars orbit to power anything; I would have thought it stronger than that.
Our thick atmosphere filters out so much radiation... I would have thought the vacuum of deep space would have allowed solar power to be more effective at a much greater distance than that.
The most common "low voltage" electrical injuries are some kind of cardiac arrhythmia. The 60-cycle current that is the standard in the United States is just right to cause your heart to fibrillate at fairly low amperages. Presumably this is where the old "don't let the current go across your heart" expression comes from.
Once your heart is fibrillating, you rapidly lose consciousness, and are in cardiac arrest... just like the 70yo cardiac patient who collapses in your local Wal-Mart. You have about ten minutes to get defibrillated, or receive some kind of CPR before your odds of any kind of recovery are slim-to-none. The sooner you get defibrillated, the better (odds of survival go down roughly 10% per minute of unresuscitated cardiac arrest). What you require is direct-current defibrillation via your nearest AED, or friendly neighborhood EMS agency.
Now let's talk about high-voltage injury, which can be a bit different. High voltage injuries often cause burns at the entrance and exit site; not unexpected. However, electricity follows the path of least resistance, so any muscle belly inbetween the contact points (full of ions and such to conduct the jolt) is potentially the current's path. Problem is, high voltage will often literally "cook" that muscle belly, causing wholesale cell death and tissue necrosis... a BIG problem if it goes unrecognized.
Once that dead muscle starts to break down, it releases its component proteins into the bloodstream... myoglobin, CPK etc, a condition called rhabdomyolysis. Those proteins circulate until they reach the kidneys, and that's where the secondary problem begins.
The kidneys use their Glomeruli to "filter" the blood, and they do it well under normal circumstances. However, when this avalanche of excess protein hits them, the nephrons clog up, causing ATN (acute tubular necrosis), and renal failure. Unfortunately for you, you are now a dialysis paiient. Your kidneys may recover eventually, so you won't necessarily be a 3x/wk dialysis patient forever... but if this ever happens, I promise you you'll never want to repeat the experience.
There is a way to mitigate this, of course, and it's as simple as recognizing the high voltage injury, and keeping the person's kidneys running at full bore. Yep. That means running massive quantities of fluids into your veins, and watching it come right out of your foley catheter... with diuretic assistance, if necessary (diuretics are drugs that make you urinate).
Massively-high-voltage injuries, like lightning strikes, are another animal entirely. These injuries are less well-understood (probably due to the difficulty in replicating the phenomenon for study).
All of these injuries are bad, and I'd highly recommend avoiding them all... otherwise, you may find yourself in the ER with a guy like me standing over you... truly a horrifying experience.
Wowbagger, I've read a number of your posts, and I must say I've learned something from virtually every one (what my meager Ham-Radio-driven electronics knowledge enables me to understand.)
Your electronic expertise is a welcome addition to this forum, and I, for one, appreciate it.
If a jury has two or more strong personality types the jury could be split or whipsawed by these two playing off each other
An excellent point... one I hadn't considered. I realize a jury is theoretically a team that has to work together to reach a verdict. I always wonder, however, about the value of that one insightful, perhaps personality-dominant juror, ALA "12 Angry Men" (one of my favorite Henry Fonda movies).
And I suppose that leads into the reason why police officers are excluded, and once you put it as you did, it does make sense. Most LEOs are accustomed to persuading/ordering people into compliance, primarily with their verbal skills (arguably the most power weapon the officer has). Also, I can see other jurors defering to the officer, based on his/her courtroom experience and mantle of authority. From your point of view, I can see where you'd want the jury to be listening to you, rather than listening to the cop on the jury... so, point taken.
Also, it is widely regarded that criminal law experience leaves the officer with a cautious or questioning view of their fellow man
So a cynical streak disqualifies as well. That's one I would not have guessed... but you know what's funny? That disqualification leaves out almost anybody who works in emergency services (an ER staffer who doesn't develop a least one cynical bone in their body usually doesn't last long). We are so accustomed to being lied to, assaulted, vomited on, scammed out of drugs, and variously used/abused by our more antisocial patients, that one quickly develops a very keen nose for mendacity.
Interesting. Thanks for your replies; I've learned something today.
First, let me say that I appreciate your comments, and hope my own have not come across as any kind of rant.
You are correct, and I misspoke; a jury is not technically "selected." However, I do stand by my comments regarding attorney attempts to mold their jury (I would also put venue changes in this same category). I certainly understand why they do it... nobody wants to argue their case to a hostile jury... I just wish the process had a little less gamesmanship.
You would also be correct about my law enforcement background making me unlikely to be a juror... personally, I've never known a police officer who survived jury selection, particularly in a criminal case. However, my jury selection experiences were before I was a cop (and they told us we'd been booted by preemptory challenge... we asked). Also, I can't think of anything particularly "strong" about my own personality, apart from the usual geekish non-conformist/iconoclastic streak. Of course, a psychiatrist would say one's "objective" opinion of one's own personality is anything but, considering all of the typical ego defenses we all employ... but I digress.
You've piqued my curiosity, however... the concept that personality traits are incompatible with jury service... That's really quite an interesting point. Setting aside the usual antisocials, what personality types make poor jurors? Clearly, your knowledge and experience in this setting exceeds my own, so I conceed that I may be missing a blindingly obvious point, though it's not obvious to me.
Also, perhaps you can offer some additional enlightenment. I can understand why a defense attorney would not want a police officer to serve on a jury in a criminal case... but why would that hold in a civil case? Is it there some recognized antipathy that police officers hold for lawyers or defendants? There must be a basis for the "cause" that's used to strike a police officer from a civil jury... what is it?
Are juries good enough to decide who lives and who dies? I'd say it depends on who's on it. Death penalty opponents would point to a host of errors in jurys' judgements...
I used to be a police officer, and I've been tapped for jury duty a few times. Guess what... every time, I (along with others) was thrown off the jury via preemptory challenge. Those of us in the "thrown off" groups noticed something; all of us were very well-educated, at least undergraduate or graduate degree, and were of various races. Comparing notes further regarding the other jury selectees we had met, we were probably the best-educated people in the pool. Coincidence? Maybe... or maybe the attorneys wanted a particular kind of jury... one they could lead and mold? I have my suspicions about the jury selection process, confirmed by conversations I've had with attorneys. Jury selection is an art and a game... and anyone with any legal background knows it. Are juries good enough? I guess it depends; what are your jury-selection goals? A black jury? A white jury? A dumb jury? A conservative jury? A rural jury?
Tort reform is not about denying access... nobody is asking for tort abolition. Reform is about weeding out the suits that have no merit, and limiting astronomical jury awards that have no basis in reality. I know one surgeon who was sued for 150 million... It's sticky to put a value on a life... but how do you justify that? 150 million?
Being a trial lawyer, I don't expect you to agree... but to deny that there's a problem, and to say that it's all about the $$$ is a little simplistic. As you well know, most docs make out better financially if they settle. Less time in court, less hassle, less stress, less time away from your practice... So why don't they? It's simple; it's not about the money for docs... it's about standing up for what you did, particularly when you did your best. It's about reputation and professional pride. Settling is like admitting your did something wrong, and that's exactly how every hosptital, HMO, and insurance carrier will view it.
Maybe it's about the $$$ for the attorney... but for the doctor it's about far more. Scoff if you want, but not everyone is motivated by money.
good question... I'll try to answer it, but I'll have to plead ignorance on what the hospitals pay for malpractice, because I honestly have no idea.
Malpractice insurance is very regional, and depends almost entirely on what state you practice in (Bad states include Florida, West Virginia, and others). It also depends on amount of coverage, and type of coverage (occurrence, versus "Claims-made"). Without getting into too much detail, my malpractice insurance as an ER doc is 35,000+ per year for average coverage, with no suits in my past. OB/GYNs have it even worse... some of them pay 100,000+ per year.
100,000K seems like a lot of money (and it is), but believe it or not, they're the lucky ones; some specialists, like neurosurgeons, can't even GET insurance. They have to "go bare" and try like hell to protect their assets, such that if they are sued, they don't end up broke and without a license... (kind of a kick in the teeth after 15 years of training).
I honestly don't know how much it would decrease the cost of medical care. So much of the cost of medical care is out of the control of physicians, and hidden from consumers, that it's extremely difficult to get accurate figures.
I always ask people if they are paying less for their healthcare than they used to, and they inevitably say they are paying more. And yet, physican incomes have actually dropped in recent years. Not kept pace with inflation, not stayed even... dropped. Where did the difference go? Some would say newer/more-expensive treatments, others would say treating the uninsured... I think part of the answer is administrative overhead. More HMO employees, more office staff to file claims, more people to refile those same claims after the insurance company's routine first denial (lather, rinse, repeat). Larger salaries for HMO CEOs... there's an enormous middleman in the health care industry, and I'm not sure malpractice savings wouldn't get added into the bottom line and reappear as a stock dividend.
Yikes... now I'm starting to sound like some of slashdot's anti-corporate anarchists.
I think tort reform would save substantial cash, not only in premiums, but in defensive medicine costs. I know some docs that do a CT scan on every headache, just so they don't get sued for missing that 1-in-a-million 18yo stroke victim, or the early brain tumor. It's horrendously expensive to practice medicine that way. Even so, I understand why they do it... it only takes one weird case to get scared. I've seen people walk into my ER with normal neurological exams, only slightly sleepy, with half their skull full of blood. Scary thing is, by most standards, you could easily justify not scanning that person... (I'm damned glad I did the scan). and that's just one example. I try not to practice defensively, but it can be hard when the patient threatens to sue you before you even find out their name, or they are on the phone with their lawyer from their ER bed (both true stories).
Does that sort of answer your question? I think it would help, and it would go well beyond simple premium savings.
I understand your position, and I agree that bad doctors need to be removed from practice. The devil, as they say, is in the details.
The state medical board is a panel of physicians, and they judge the fitness of their fellow physicians. I think this is the way to go... only another physician would have the necessary expertise. Police officers in use of force cases are judged by the standard of a "reasonable police officer," and I think a similar standard should be applied to physicians.
M&M is brutal, and I've been to my share of them. I believe that only in a closed forum can doctors be absolutely frank about their opinions, and help prevent future errors. If it were otherwise, those opinions could be used against them, or their colleagues in a malpractice suit. Two surgeons can strongly disagree, AND both be advocating medically reasonable treatment. Can you IMAGINE what trial attorneys would pay for a seat at some of those conferences?
I am careful about judging my fellow physicians, as I would want them to be with me, were I to make an honest mistake. I've seen some truly horrifying honest mistakes, but I believe they were truly that... honest. If I thought otherwise, if I thought a doctor was truly a lethal danger to his patients, I'd take their license myself. Unfortunately, it's never that black and white.
Like you said... hard choices, and it's important to be right, because you're taking away someone's livelihood and reputation, right along with their license. It's tough to strike that delicate balance between patient safety, and due process for revocation. I empathize with your situation, because if I were a patient, I'd sure as hell want to know who the bad doctors are. Unfortunately, sometimes those of us who practice with them don't even know (particularly if we're in a different specialty), until it's too late.
I'm truly sorry, but I cannot live up to that ideal, much as I would like to.
I've made mistakes when treating patients... I've even watched treatments that I've prescribed kill patients (look up the complication rate for thrombolytic treatment for strokes, you'll see what I mean). I then had to face their family, and explain to them that the medicine they were gambling on to cure their relative's stroke had, in fact, caused her death. Bad outcome? Yes. Do you think I should be sued?
I would like nothing more than to be right all the time. Sometimes I just don't have the information I need (I work in the ER, and often have to go on little to NO information), and the patient suffers as a result. When a guy having a heart attack lies to me about his cocaine use, some of the drugs I'd normally use to treat his heart attack can harm, even kill him. What am I supposed to do? An attorney can go to court and argue that if I'd waited for his medical records to arrive, I would have seen the drug abuse in his old chart... but I have to treat RIGHT NOW, or I run the risk of breaching the 30 minute door-to-drug standard of care, and I can get sued for THAT. Hard choices.
I don't mind being between the devil and the deep blue sea... I signed up for that. What I cannot do is be perfect, or always have a perfect outcome.
The good news is this: most people understand... which is part of the reason that doctors prevail in 80-90% of all malpractice suits. Juries often "get it," despite the depredations of the personal injury bar.
you are absolutely correct... there are bad docs out there.
The question becomes this: What do we do? Are you going to "profile" all doctors because a few are bad? Do you justify punitive actions against the whole group because of a few bad apples? Of course not... to say that good doctors "deserve" the collateral lawsuits is not justifiable.
Doctors do police themselves to a degree... ask for the yearly minutes of any state's medical board, and look at the number of licenses they suspend/sanction/revoke every year; there's pages and pages of them. Usually, they are for gross breach of the standard of care, drug abuse, inappropriate relationships with patients, etc. I get those minutes sent to me every year, and sometimes I just shake my head at the stupid behavior that people jeapordize their career over... but there's often more to the story in even those cases. I've seen some cases in those minutes that I had personal knowledge of, and the punishments were totally undeserved (while others were richly deserved)... the system is far from perfect.
The reality is this: unless the care is unbelievably substandard, it's hard to justify taking somebody's license.
What more do you want us to do? If you are going to try to take away somebody's medical license that they've worked 12 years for, you'd better have some pretty solid proof. I can't go around in public saying what a "horrible" doctor somebody is (because one patient I referred to them had a bad result)... I'd get sued for slander... particularly if I didn't have a truckload of cases, complications, deaths, M&M minutes, etc to back it up. It takes a while to build up the kind of evidence that taking away a license requires, particularly if the care is only a little below par, but still objectively reasonable. So much of medicine is a judgement call that it can be pretty hard to simply point a finger and say "Bad! Bad doctor!."
Yes, I realize it's not good for the patients that a "bad" doctor continues to practice while they gather data about his care... but there is little alternative. You protect patients, but you also have to protect the doctor from character assassination and slander.
Yes there are bad doctors... but they are few... and are far outnumbered by the honest, hard-working, give-a-damn doctors.
This is the kind of maddening garbage that makes people sound the trumpet for tort reform... and rightfully so.
I'd like to see some kind of penalty for filing frivolous/nuisance/totally-without-merit suits, preferably a monetary penalty (jail time might be going just a wee bit too far... though it would be very satisfying).
This should really go for all types of torts, including medical malpractice (disclaimer: I am a physician). I have multiple colleagues who have been sued, and NOT ONE of these suits had real merit, or were for any sort of egregious breach in the standard of care. How do I know? I've looked at the charts and thought "I wouldn't have done anything different." I could never testify against any of these physicians, because what they did was objectively medically reasonable. Now, they all won their cases, but some were very close... frighteningly close.
You always play the odds in medicine... and sometimes you lose. Every surgical procedure has a certain complication rate, no matter what you do. Every disease has a certain mortality rate, no matter what you do. The medical reality is that "sh*t happens," and it inevitably happens to a certain percentage of patients. It sucks to be in that small percentage, but attorneys and "hired gun" expert witnesses attempt to pin it on the doctor. The scariest thing of all is that you can lose everything you've ever worked for, just because "sh*t happens."
Tort reform is a good thing... trick is, you have to do it while not taking away the poor man's keys to the court room. Even so, if the poor man files a nonsense suit, he should find himself even poorer.
If only someone had taught him to keep his finger off the trigger...
To be fair, I'm certain a gun enthusiast like ESR knows better; still, it sucks to have your lapse in gun safety photographed and spread across the internet.
Slashdot Mirror
though I can't recall the last time I actually used a .gif file (I think it was for a website that I coded a few years back... clipart or some such)
OK... now can we do the same thing for some of the AV codecs?
Oh my... That's hilarious (I thought you were kidding).
I'll bet his LDS constituents would love to know that link is on his website.
Wonder when that domain was bought and pr0n-ified...
it's called the "captain of the ship" doctrine in legal terms. It dates back to english common law and the era where many were slave owners... a slave owner could be held liable for the actions of a slave that he owned.
It's what allows me to be sued if someone (including one of my nurses or another doctor treating their patient in the ER) does something inappropriate in my department. Even if it's not my patient, theoretically EVERY patient in the ER is my patient, since I'm the ranking doc in charge of the department.
It sucks, and it's vicarious liability, but it does happen (though some modern courts have started to rein this nonsense in)
Same thing with medicare fraud... if my billing company commits fraud (they bill in my name), guess who goes down? I do. The medicare and medicade regulations are extremely convoluted, and get changed very frequently... if my billing company doesn't keep track, and they bill wrong, they may get flagged as a potential fraud. The pressure to get successful prosecutions of fraudsters is VERY high, and agents go after doctors relentlessly... and the doctor takes the fall, even if someone else is doing their billing.
It's outrageous that you can be held to account for the actions of others, particularly if you don't understand their job, lack the expertise to oversee them, and don't directly control how they do business... but that's our legal system. It's not right, but it can and does happen.
So yes, I'd say if it's good enough for me, it's good enough for the good Senator Hatch.
My DSL experience has thus far trounced my cable experience soundly.
My current Cox cable barely gives me 3-400kpbs download speeds (based on driver and iso downloads), whereas my ex-DSL provider (Ameritech) gave me a solid 700-800kbps down. Online gaming pings are roughly equivalent. I can't explain the difference, because the costs are very comparable.
My DSL provider also didn't have a problem with me running servers, and the service was greater than 99% available... outages counted on one hand, and never more than a few hours in length.
Now don't get me wrong... dealing with Ameritech can be like a root canal sans anethesia (3 tries to get the installation right), but once it was set up, it ran like a champ.
You could use the principle behind LIDAR (police radar using laser rather than radar) if you wanted a good estimate of speed and distance.
The mechanism by which it measures your speed is a bit different, but it would give you the same data. Lidar sends out a thousands of pulses, and measures the time it takes for the backscatter from the laser to return, rather than relying on the doppler effect (or red shift, in the case of the visible portion of the EM spectrum). This method is more accurate (and thus preferred) by most police agencies.
However, that doesn't answer some of the other questions that have been raised: how does the car know what it's firing at? How does it know whether the object it's tracking is in your lane, or across the median on a long sweeping turn?
That aside, I totally agree with your sentiment regarding letting the computer have control over the vehicle (ie. tapping the brakes for me). Until they can design a system that's better than a NASCAR driver (and the computer controlled car successfully completes the race, no accidents, no skids), I'd much rather rely on my own driving skills and assessment of the road conditions.
It sounds like a neat idea... NO WAY I'd trust my family's life to it... call me a Luddite on this one if you want.
man... slip me some of what you smoked today.
Bush has been eating a big shit sandwich ever since he took office. Unfortunately, much of it is batting cleanup from Clinton's presidency, but that's the way of things. Many problems get dropped into the lap of the subsequent leader, and it happened with Clinton too... but let's give credit where credit is due.
The Economy: already failing when bush took office. inherited from Clinton.
Corporate Scandals: Ongoing when Clinton was in office (part of that artificial economic boom)... the companies simply got caught under Bush's watch. This is one albatross that can be worn by a bunch of people, not just by, or even primarily by, bush.
September 11: Terrorist problem completely neglected under Clinton... inherited by bush (and will be inherited by presidents after bush... these people have been hitting us for a decade, and will continue to do so, at least until we find them and put a bullet into every one of their fanatacism-filled heads). As far as being the "worse" leader in time of crisis, I disagree... he's simply decided to wade in and do the dirty work that other presidents didn't have the stomach for... I'd count that as a plus.
As far as his previous substance abuse problem, if he's dealt with it, does it make him any less of a man? You're awfully judgemental... no problems/mistakes in your past? If he falls off the wagon, or recidivates again and again, I'd probably throw him out faster than you would.
By the way, Clinton didn't just "get a blow job." He's used women like shake and bake bags his entire life, committed perjury when confronted about it in court... this guy subjected our country to the humiliation of seeing his semen spewed onto the dress of some intern, and subsequently sent to the FBI crime lab.
Bush has his flaws, just like all of use do... but let's at least give credit where it's due. Many of these problems were NOT of his making.
Here's the relevant section:
*SNIP*
"I do not look up any patents on principle because (a) it's a horrible waste of time and (b) I don't want to know."
"The fact is technical people are better off not looking at patents. If you don't know what they cover and where they are, you won't be knowingly infringing on them," Mr. Torvalds wrote in the e-mail message last August.
In an e-mail interview earlier this month, Mr. Torvalds explained that his was a candid view in the murky, complex realm of software patents these days.
"Hey, one of the advantages of not personally being involved in any of the commercial Linux players is that I can be honest," Mr. Torvalds wrote. "In fact, openness pretty much requires it â" there is no corporate speak here. Ask any lawyer in a tech company (off the record, so that he can be honest too), and he'll tell you that engineers should absolutely not try to look up other people's patents. It's not their job, and you don't want them tainted."
What's so terrible about that? Why would you bias yourself (and waste a LOT of time) by poring over someone's code before writing your own? You may subconsciously emulate what they've done, and taint any originality you might have started with.
Same thing goes for other disciplines. In medicine, one should talk to the patient first, THEN read their medical records... you want an honest gestalt, unbiased by somebody else's interpretation of signs and symptoms. Isn't that what a second opinion is supposed to be?
This sounds to me like the old "better to beg forgiveness than ask permission" philosophy. Big whoop... give linus a break, SCO.
here's a website I found in the UK that gives a very detailed explanation.
Wrap your brain around this.
I tried to digest all of it...
Now my head hurts.
COFDM?
My understanding of these matters is limited, but the description on their website makes it sound like they are using a sort of spread-spectrum scheme.
They claim signal quality equal to FM... but I suppose that depends on how much data redundancy they have across their frequency range. They claim to be able to reconstruct missing or corrupted sections of data... is there some error checking built into this as well?
Thanks... but you know what's funny? I feel the same way about most other slashdot posters (referring to training and experience).
I should point out that I have no formal computer science training, apart from being a self-taught computer geek since the TRS-80 days, so I often find myself in awe of the coding/hacking/mathematical skills of many slashgeeks. This is one forum where I very seldom find myself able to speak authoritatively about the issues at hand... so I end up lurking instead of posting. When I can, however, I try to lend something to the discussion.
I'm a physician... my training and board-certification are in emergency medicine, hence my experience with critically-ill people. Everyone dies sometime, and to be perfectly honest with you, I'm not sure that we have as much to say about it as we think we do...
/. (Davak UID#526912 is an internal medicine specialist)... there's also a smattering of paramedics and EMTs who also post here from time to time.
But anyway, I'm not the only doc who posts on
That's one of the things I love about slashdot, penis birds and goatse.cx trolls aside.
I echo your sentiment about the legroom... though that in itself might not prevent DVT. In fact, I could see it increasing your risk (more comfortable seat = you stay in it longer = more venous stasis). The way help avoid a DVT is to unbuckle your seatbelt, and move about the cabin... You have to walk a bit, maybe do some knee bends (pretend you're looking for something under your seat if you're concerned about other passengers looking at you funny). I would even consider taking an asprin before a long trip. That single asprin (avg dose 325mg) will "thin" your blood by inhibiting your platelets... irreversibly, I might add. Don't worry... you'll replace those platelets with normal ones over time, assuming you take no more asprin, but it will take you a week or so. Ever wonder why surgeons ask you to stop taking asprin for two weeks before any elective surgery? That's why.
DVTs come from a couple of factors; venous stasis (blood pooling in your veins) is only one. The others are injury (getting kicked in the leg), and any sort of hypercoagulable state... ie. your blood clots more readily than normal. This last category is large, and includes pregnancy, birth control pills, smoking, cancer, genetic problems, etc, etc.
I took one trip that lasted almost 30 hours (20 hours+ of pure flying time)... inbetween sleeping and eating, I got up and walked the length of the airplane any number of times. Not only does it let you get the kinks out and stretch, but it also helps prevent DVTs, and their lethal sequela, the feared pulmonary embolus (PE).
A big PE (so-called "saddle embolus") will turn you out like a light. A large enough clot blocks your blood flow to the lungs, effectively dropping your cardiac output to zero. That, as you might imagine, is rapidly fatal... so rapidly fatal in fact that I've had people have huge PE's right in front of me and die, right there... nothing we could do for them (diagnosis made on autopsy). PEs are one of the major contributors in sudden death cases, though that's gotten a bit better with proper diagnosis and treatment.
While PEs are a problem, they used to be a bigger problem. Years ago, if you broke a hip, you were on bedrest for 6-8 weeks until it healed (these days, whenever possible, aggressive surgical repair and early ambulation are the rule). In retrospect, the bed rest was a bad idea; those folks were dying left and right of pulmonary emboli... thank god for medical progress.
I didn't know that solar power was too weak beyond the mars orbit to power anything; I would have thought it stronger than that.
Our thick atmosphere filters out so much radiation... I would have thought the vacuum of deep space would have allowed solar power to be more effective at a much greater distance than that.
The most common "low voltage" electrical injuries are some kind of cardiac arrhythmia. The 60-cycle current that is the standard in the United States is just right to cause your heart to fibrillate at fairly low amperages. Presumably this is where the old "don't let the current go across your heart" expression comes from.
Once your heart is fibrillating, you rapidly lose consciousness, and are in cardiac arrest... just like the 70yo cardiac patient who collapses in your local Wal-Mart. You have about ten minutes to get defibrillated, or receive some kind of CPR before your odds of any kind of recovery are slim-to-none. The sooner you get defibrillated, the better (odds of survival go down roughly 10% per minute of unresuscitated cardiac arrest). What you require is direct-current defibrillation via your nearest AED, or friendly neighborhood EMS agency.
Now let's talk about high-voltage injury, which can be a bit different. High voltage injuries often cause burns at the entrance and exit site; not unexpected. However, electricity follows the path of least resistance, so any muscle belly inbetween the contact points (full of ions and such to conduct the jolt) is potentially the current's path. Problem is, high voltage will often literally "cook" that muscle belly, causing wholesale cell death and tissue necrosis... a BIG problem if it goes unrecognized.
Once that dead muscle starts to break down, it releases its component proteins into the bloodstream... myoglobin, CPK etc, a condition called rhabdomyolysis. Those proteins circulate until they reach the kidneys, and that's where the secondary problem begins.
The kidneys use their Glomeruli to "filter" the blood, and they do it well under normal circumstances. However, when this avalanche of excess protein hits them, the nephrons clog up, causing ATN (acute tubular necrosis), and renal failure. Unfortunately for you, you are now a dialysis paiient. Your kidneys may recover eventually, so you won't necessarily be a 3x/wk dialysis patient forever... but if this ever happens, I promise you you'll never want to repeat the experience.
There is a way to mitigate this, of course, and it's as simple as recognizing the high voltage injury, and keeping the person's kidneys running at full bore. Yep. That means running massive quantities of fluids into your veins, and watching it come right out of your foley catheter... with diuretic assistance, if necessary (diuretics are drugs that make you urinate).
Massively-high-voltage injuries, like lightning strikes, are another animal entirely. These injuries are less well-understood (probably due to the difficulty in replicating the phenomenon for study).
All of these injuries are bad, and I'd highly recommend avoiding them all... otherwise, you may find yourself in the ER with a guy like me standing over you... truly a horrifying experience.
Outstanding.
Wowbagger, I've read a number of your posts, and I must say I've learned something from virtually every one (what my meager Ham-Radio-driven electronics knowledge enables me to understand.)
Your electronic expertise is a welcome addition to this forum, and I, for one, appreciate it.
My mod points are at your service, sir.
If a jury has two or more strong personality types the jury could be split or whipsawed by these two playing off each other
An excellent point... one I hadn't considered. I realize a jury is theoretically a team that has to work together to reach a verdict. I always wonder, however, about the value of that one insightful, perhaps personality-dominant juror, ALA "12 Angry Men" (one of my favorite Henry Fonda movies).
And I suppose that leads into the reason why police officers are excluded, and once you put it as you did, it does make sense. Most LEOs are accustomed to persuading/ordering people into compliance, primarily with their verbal skills (arguably the most power weapon the officer has). Also, I can see other jurors defering to the officer, based on his/her courtroom experience and mantle of authority. From your point of view, I can see where you'd want the jury to be listening to you, rather than listening to the cop on the jury... so, point taken.
Also, it is widely regarded that criminal law experience leaves the officer with a cautious or questioning view of their fellow man
So a cynical streak disqualifies as well. That's one I would not have guessed... but you know what's funny? That disqualification leaves out almost anybody who works in emergency services (an ER staffer who doesn't develop a least one cynical bone in their body usually doesn't last long). We are so accustomed to being lied to, assaulted, vomited on, scammed out of drugs, and variously used/abused by our more antisocial patients, that one quickly develops a very keen nose for mendacity.
Interesting. Thanks for your replies; I've learned something today.
Much appreciated, counselor.
First, let me say that I appreciate your comments, and hope my own have not come across as any kind of rant.
You are correct, and I misspoke; a jury is not technically "selected." However, I do stand by my comments regarding attorney attempts to mold their jury (I would also put venue changes in this same category). I certainly understand why they do it... nobody wants to argue their case to a hostile jury... I just wish the process had a little less gamesmanship.
You would also be correct about my law enforcement background making me unlikely to be a juror... personally, I've never known a police officer who survived jury selection, particularly in a criminal case. However, my jury selection experiences were before I was a cop (and they told us we'd been booted by preemptory challenge... we asked). Also, I can't think of anything particularly "strong" about my own personality, apart from the usual geekish non-conformist/iconoclastic streak. Of course, a psychiatrist would say one's "objective" opinion of one's own personality is anything but, considering all of the typical ego defenses we all employ... but I digress.
You've piqued my curiosity, however... the concept that personality traits are incompatible with jury service... That's really quite an interesting point. Setting aside the usual antisocials, what personality types make poor jurors? Clearly, your knowledge and experience in this setting exceeds my own, so I conceed that I may be missing a blindingly obvious point, though it's not obvious to me.
Also, perhaps you can offer some additional enlightenment. I can understand why a defense attorney would not want a police officer to serve on a jury in a criminal case... but why would that hold in a civil case? Is it there some recognized antipathy that police officers hold for lawyers or defendants? There must be a basis for the "cause" that's used to strike a police officer from a civil jury... what is it?
I'm sorry, but I do not agree.
Are juries good enough to decide who lives and who dies? I'd say it depends on who's on it. Death penalty opponents would point to a host of errors in jurys' judgements...
I used to be a police officer, and I've been tapped for jury duty a few times. Guess what... every time, I (along with others) was thrown off the jury via preemptory challenge. Those of us in the "thrown off" groups noticed something; all of us were very well-educated, at least undergraduate or graduate degree, and were of various races. Comparing notes further regarding the other jury selectees we had met, we were probably the best-educated people in the pool. Coincidence? Maybe... or maybe the attorneys wanted a particular kind of jury... one they could lead and mold? I have my suspicions about the jury selection process, confirmed by conversations I've had with attorneys. Jury selection is an art and a game... and anyone with any legal background knows it. Are juries good enough? I guess it depends; what are your jury-selection goals? A black jury? A white jury? A dumb jury? A conservative jury? A rural jury?
Tort reform is not about denying access... nobody is asking for tort abolition. Reform is about weeding out the suits that have no merit, and limiting astronomical jury awards that have no basis in reality. I know one surgeon who was sued for 150 million... It's sticky to put a value on a life... but how do you justify that? 150 million?
Being a trial lawyer, I don't expect you to agree... but to deny that there's a problem, and to say that it's all about the $$$ is a little simplistic. As you well know, most docs make out better financially if they settle. Less time in court, less hassle, less stress, less time away from your practice... So why don't they? It's simple; it's not about the money for docs... it's about standing up for what you did, particularly when you did your best. It's about reputation and professional pride. Settling is like admitting your did something wrong, and that's exactly how every hosptital, HMO, and insurance carrier will view it.
Maybe it's about the $$$ for the attorney... but for the doctor it's about far more. Scoff if you want, but not everyone is motivated by money.
good question... I'll try to answer it, but I'll have to plead ignorance on what the hospitals pay for malpractice, because I honestly have no idea.
Malpractice insurance is very regional, and depends almost entirely on what state you practice in (Bad states include Florida, West Virginia, and others). It also depends on amount of coverage, and type of coverage (occurrence, versus "Claims-made"). Without getting into too much detail, my malpractice insurance as an ER doc is 35,000+ per year for average coverage, with no suits in my past. OB/GYNs have it even worse... some of them pay 100,000+ per year.
100,000K seems like a lot of money (and it is), but believe it or not, they're the lucky ones; some specialists, like neurosurgeons, can't even GET insurance. They have to "go bare" and try like hell to protect their assets, such that if they are sued, they don't end up broke and without a license... (kind of a kick in the teeth after 15 years of training).
I honestly don't know how much it would decrease the cost of medical care. So much of the cost of medical care is out of the control of physicians, and hidden from consumers, that it's extremely difficult to get accurate figures.
I always ask people if they are paying less for their healthcare than they used to, and they inevitably say they are paying more. And yet, physican incomes have actually dropped in recent years. Not kept pace with inflation, not stayed even... dropped. Where did the difference go? Some would say newer/more-expensive treatments, others would say treating the uninsured... I think part of the answer is administrative overhead. More HMO employees, more office staff to file claims, more people to refile those same claims after the insurance company's routine first denial (lather, rinse, repeat). Larger salaries for HMO CEOs... there's an enormous middleman in the health care industry, and I'm not sure malpractice savings wouldn't get added into the bottom line and reappear as a stock dividend.
Yikes... now I'm starting to sound like some of slashdot's anti-corporate anarchists.
I think tort reform would save substantial cash, not only in premiums, but in defensive medicine costs. I know some docs that do a CT scan on every headache, just so they don't get sued for missing that 1-in-a-million 18yo stroke victim, or the early brain tumor. It's horrendously expensive to practice medicine that way. Even so, I understand why they do it... it only takes one weird case to get scared. I've seen people walk into my ER with normal neurological exams, only slightly sleepy, with half their skull full of blood. Scary thing is, by most standards, you could easily justify not scanning that person... (I'm damned glad I did the scan). and that's just one example. I try not to practice defensively, but it can be hard when the patient threatens to sue you before you even find out their name, or they are on the phone with their lawyer from their ER bed (both true stories).
Does that sort of answer your question? I think it would help, and it would go well beyond simple premium savings.
I understand your position, and I agree that bad doctors need to be removed from practice. The devil, as they say, is in the details.
The state medical board is a panel of physicians, and they judge the fitness of their fellow physicians. I think this is the way to go... only another physician would have the necessary expertise. Police officers in use of force cases are judged by the standard of a "reasonable police officer," and I think a similar standard should be applied to physicians.
M&M is brutal, and I've been to my share of them. I believe that only in a closed forum can doctors be absolutely frank about their opinions, and help prevent future errors. If it were otherwise, those opinions could be used against them, or their colleagues in a malpractice suit. Two surgeons can strongly disagree, AND both be advocating medically reasonable treatment. Can you IMAGINE what trial attorneys would pay for a seat at some of those conferences?
I am careful about judging my fellow physicians, as I would want them to be with me, were I to make an honest mistake. I've seen some truly horrifying honest mistakes, but I believe they were truly that... honest. If I thought otherwise, if I thought a doctor was truly a lethal danger to his patients, I'd take their license myself. Unfortunately, it's never that black and white.
Like you said... hard choices, and it's important to be right, because you're taking away someone's livelihood and reputation, right along with their license. It's tough to strike that delicate balance between patient safety, and due process for revocation. I empathize with your situation, because if I were a patient, I'd sure as hell want to know who the bad doctors are. Unfortunately, sometimes those of us who practice with them don't even know (particularly if we're in a different specialty), until it's too late.
I'm truly sorry, but I cannot live up to that ideal, much as I would like to.
I've made mistakes when treating patients... I've even watched treatments that I've prescribed kill patients (look up the complication rate for thrombolytic treatment for strokes, you'll see what I mean). I then had to face their family, and explain to them that the medicine they were gambling on to cure their relative's stroke had, in fact, caused her death. Bad outcome? Yes. Do you think I should be sued?
I would like nothing more than to be right all the time. Sometimes I just don't have the information I need (I work in the ER, and often have to go on little to NO information), and the patient suffers as a result. When a guy having a heart attack lies to me about his cocaine use, some of the drugs I'd normally use to treat his heart attack can harm, even kill him. What am I supposed to do? An attorney can go to court and argue that if I'd waited for his medical records to arrive, I would have seen the drug abuse in his old chart... but I have to treat RIGHT NOW, or I run the risk of breaching the 30 minute door-to-drug standard of care, and I can get sued for THAT. Hard choices.
I don't mind being between the devil and the deep blue sea... I signed up for that. What I cannot do is be perfect, or always have a perfect outcome.
The good news is this: most people understand... which is part of the reason that doctors prevail in 80-90% of all malpractice suits. Juries often "get it," despite the depredations of the personal injury bar.
you are absolutely correct... there are bad docs out there.
The question becomes this: What do we do? Are you going to "profile" all doctors because a few are bad? Do you justify punitive actions against the whole group because of a few bad apples? Of course not... to say that good doctors "deserve" the collateral lawsuits is not justifiable.
Doctors do police themselves to a degree... ask for the yearly minutes of any state's medical board, and look at the number of licenses they suspend/sanction/revoke every year; there's pages and pages of them. Usually, they are for gross breach of the standard of care, drug abuse, inappropriate relationships with patients, etc. I get those minutes sent to me every year, and sometimes I just shake my head at the stupid behavior that people jeapordize their career over... but there's often more to the story in even those cases. I've seen some cases in those minutes that I had personal knowledge of, and the punishments were totally undeserved (while others were richly deserved)... the system is far from perfect.
The reality is this: unless the care is unbelievably substandard, it's hard to justify taking somebody's license.
What more do you want us to do? If you are going to try to take away somebody's medical license that they've worked 12 years for, you'd better have some pretty solid proof. I can't go around in public saying what a "horrible" doctor somebody is (because one patient I referred to them had a bad result)... I'd get sued for slander... particularly if I didn't have a truckload of cases, complications, deaths, M&M minutes, etc to back it up. It takes a while to build up the kind of evidence that taking away a license requires, particularly if the care is only a little below par, but still objectively reasonable. So much of medicine is a judgement call that it can be pretty hard to simply point a finger and say "Bad! Bad doctor!."
Yes, I realize it's not good for the patients that a "bad" doctor continues to practice while they gather data about his care... but there is little alternative. You protect patients, but you also have to protect the doctor from character assassination and slander.
Yes there are bad doctors... but they are few... and are far outnumbered by the honest, hard-working, give-a-damn doctors.
This is the kind of maddening garbage that makes people sound the trumpet for tort reform... and rightfully so.
I'd like to see some kind of penalty for filing frivolous/nuisance/totally-without-merit suits, preferably a monetary penalty (jail time might be going just a wee bit too far... though it would be very satisfying).
This should really go for all types of torts, including medical malpractice (disclaimer: I am a physician). I have multiple colleagues who have been sued, and NOT ONE of these suits had real merit, or were for any sort of egregious breach in the standard of care. How do I know? I've looked at the charts and thought "I wouldn't have done anything different." I could never testify against any of these physicians, because what they did was objectively medically reasonable. Now, they all won their cases, but some were very close... frighteningly close.
You always play the odds in medicine... and sometimes you lose. Every surgical procedure has a certain complication rate, no matter what you do. Every disease has a certain mortality rate, no matter what you do. The medical reality is that "sh*t happens," and it inevitably happens to a certain percentage of patients. It sucks to be in that small percentage, but attorneys and "hired gun" expert witnesses attempt to pin it on the doctor. The scariest thing of all is that you can lose everything you've ever worked for, just because "sh*t happens."
Tort reform is a good thing... trick is, you have to do it while not taking away the poor man's keys to the court room. Even so, if the poor man files a nonsense suit, he should find himself even poorer.
Seems fair to me...
If only someone had taught him to keep his finger off the trigger...
To be fair, I'm certain a gun enthusiast like ESR knows better; still, it sucks to have your lapse in gun safety photographed and spread across the internet.
I'm sorry, that's next door... it's the getting hit on the head lessons in here.