Saturday, March 31, 2007

Car Dealerships Rip You Off With The "Four-Square," Here's How To Beat It

Former used car salesman Alan Slone grows a conscience and reveals one of the major strategies dealership use to screw you when buying a new car. At the heart of it all is the "4-square." This is supposed to help you and the dealership come to an agreement, but as you'll see, it's really more akin to three-card monte dealer's deck of cards.

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Fired blogger wins in court!!!

Congrats, Petite Anglaise. Full story here.

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Friday, March 30, 2007

Health Care Renewal: New Data, More Doubts About Pay-for-Performance (P4P)

Health Care Renewal: New Data, More Doubts About Pay-for-Performance (P4P)
This is a great posting. I agree with most of it and have much to say. Students... please read this and understand, why, you have to RISK ADJUST (hear use ALL relevant covariates) and you have to use statistics that lets this data be correctly interpreted. UHC would NOT, I repeat NOT reveal the statistical logistic and linear models they used for their incises, needless to say, I was not invited back. More later... can't resist... i forced them to tell me the R squared and they said like 7-12% and they didn't even use adjusted Rsquare... go figure??

Dr. Peter Rosts' "Question Authority" Blog Soars in Rankings

Look for yourself! Compare the number of linkages your blog has, to his number :)
I looked up this Blog, and found that my number was about 3.5 millionth read blog. His Blog was rated over 29Kth read blog. So that makes my Blog about .008th as LINKED to, as his. Well, this is an outcome that one can track. It has the properties of a good outcome variable: It is objective in its value, that is, number of blogs creating linkages. Second it is not self-report Likert type ratings that depend ENTIRELY on the individuals sampled. Third it is measurable in the same way over time. Thanks Peter, for this good indicator that we can all USE to examine our penetration skills.
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Amazing Google Map direction from New York to Stockholm, Sweden

Check out Google Map's suggestion for how to cross the Atlantic ocean from "Question Authority." Dr. Rost decided to travel from New York to Sweden, and the GOOGLE MAP had him driving or I guess I should say - boating? swimming? across the ocean :)

I added Seattle Washington as a destination, and I was told to swim back and then drive across the country. I just WISH I could do that. I remember this boat/car I saw once... is that what they are talking about?

I hope GOOGLE fixes this BUG soon, it is embarrassing, and very funny.
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Wednesday, March 28, 2007

I was Talking to a Friend Today about Interferon for My Brown Kitties and ....

the above link (pardon my lack of tech skills here) appeared on the best marketing journal I have ever read in the health services realm - (highly recommended reading for any people with open minds about PHARMA). In this post, Jim Edwards describes a new possible PHARMA revenue flow... the animal kingdom... doggie and kitties! Oh boy!

I was speaking with a ND friend of mine and brilliant diagnostician, and we were comparing notes about treating animals. We both agreed that we only treated our pets and our friend's pets when under duress, and ONLY when we thought they were getting sub-par medical treatment OR we thought that the owner's just didn't get the beast.

So, when I saw this post, I it reminded me of my conversation today about me giving my big brown kitties Interferon for their normal kitten flu. I put a tiny bit of interferon into a big saline drip bag and filled a syringe. My boys would come running and get a kitty drink. And amazingly, although perhaps my wishful thinking was also at play, certainly not a RCT, my cats got better very quickly. With a couple of these treatments these PAWS adopted boys never had the flu again for years.

Contrast this with another treatment from another Vet: Antibiotics... bitter horrible amoxi... This treatment was not very accepted by my kitty cats. You first have to wrap the fighting 16 pound cat in a series of towels like a Chinese baby. Then one person pries the mouth open, while the other uses the Kitty PILL SHOOTER and crams the pill down the boy's throat. Then you have to hold his mouth shut, as he shakes his head, and tries to dislodge, what I am sure, is a very bitter pill to swallow... Massage throat.... okay... Unwrap cat... and he goes and spits the pill into the far reaches of the kitchen... under the table... go figure!

The Interferon had a HIGH acceptability quotient to my boys - they liked it, came running; thought it was a kitty treat; and believe it or not, maybe due to the pure hydration, got better. The AMOXY - or better yet, the new designer small range anti biotics for cats and dogs have a very LOW acceptability of treatment quotient: That is, you have to hog-tie them to get them to take it. AND the STRESS from the pill taking experience LOWERS THEIR IMMUNE SYSTEM resulting, in a higher probablity of getting sicker!!!!

The irony is amazing.... Does this sound like... ah... behavioral activation... vs anti-depressants?

Should MDs Use Only Parental Say to Diagnosis Bipolar and ADD in Children

This excellent Clinical Psychology and Psychiatry Posting is a response to a Seattle Weekly Reporter's, Philip Dawdy's, quest for the better understanding of his own Bipolar Disorder and the way psychiatric disorders are diagnosed in children. Clin Psych responds very rationally that all collateral information of importance should be triangulated.

Triangularization in my mind means you check a given data element (ex: distractability) from the client, parent, school, primary care physician, other caregivers, and even in home observation if necessary. Claims of psychiatric symptoms by parents over sensitized by their own children's problems, possibly as a way to avoid thinking about their own role in the somatization of psychiatric pain are often driven by their GOOGLE searches to OVER DIAGNOSIS their kids and try to find the "EASY" way to solve HARD behavioral problems.

As an "old school" behaviorist, I agree with Cheryl's comment that SUPER NANNY has more answers than PHARMA. This, and I apologize in advance for this observation, lack of clearly defined FAMILY RULES is running rampant among our faculty, and results in very severe behavioral problems. I am observing these weekly. I try to set up behavioral contingencies for my "friends" to employ with their kids, but alas, you can lead an MD to water... but can you make them.. ah... drink?

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Climbing out of the Hole: This Has Been the Absolutely Best Day

Sometimes when things are really at rock bottom, you look up that dark dank smelly hole and you actually see light. Not just any light, but spectacular Northern Lights. Here in the very Northwest the day was very special. I think like a database, so I am just gonna list the great things about today. And one day, when I have a friend that will hyper-link and "picturize" my site, then so be it:

1. The weather was incredible, crisp, clear and real walking around an open European type society type weather.
2. My roommate slept too, and she needed sleep, as she is one beautiful Chica... wow.. I wish she would let me put her picture in here.
3. I stayed in my room and was comfortable and didn't go into work until 12 noon. That is a first for me... honestly.. I know... bad.
4. I took a wonderful clean bus ride from virtually in front of my flat to the front of my office building in 12 minutes.
5. I talked to an incredible lady musician on the bus who is very smart and told me a lot of useful information (shout out to all the transit folks who have helped me in the past week).
6. The office space is great. Its beautiful, ergo, bamboo-ed, green and full of the smartest, most laid back folks I have had the honor to work with in a long time.
7. They share my beliefs about PHARMA
8. They want to share my ideas and the ideas of my co-workers back in the USSR .... :)
9. The projects rock - all real large cohort data sets for me to help with. Ones that are way up my alley in terms of my mission and that of my friends.
10. I worked hard and didn't notice the time (nor ate) - good sign
11. Figured out alot of financial stuff - good sign
12. Went to see my favorite boutiques and bought a bag of very cool buttons for my craft projects for only $4
13. Went to the V.L. where I was surprised I was allowed in... another story .... sorry
14. They let me stay for HOCKEY NIGHT!!! very cool... thanks everyone at CC
15. I was told "not to talk" or they will out me.... and they were correct. I needed not to talk.
16. I was only able to market one of the 10 products I brought to give away free - another story
17. Research Girl and I finally connected and she (of great taste) slapped my blog into a color scheme and template that rocks. Please see her great blog on the shout out. She is a blogging V girl.. so be kind and encouraging.
18. A very nice guy shared some very high tech information with me that had me reeling.
19. I took the bus home in less than .5 hr.
20. I sat in the little park and saw great dogs and owners.
21. Dr. Peter Rost showed a Black Kitty to the health - PHARMA bloggers. Thanks :)
22. My friends actually believe that I am smart, not totally sane but smart.
23. My friends think I may have an idea :)

An all around great day. And I am actually sleepy!!

Tuesday, March 27, 2007

Business Majors - Here is a great topic for a Senior Thesis - Free!!

This is an interesting and timely post on a great blog "Question Authority" on blogspot. This guy really knows marketing better than any of your IVY LEAGUE profs. He was the VP of 2 global companies and he is a genius. He is all about helping the consumer and he speaks up against PHARMA. That is my kind of professor! Use to irritate your prof!

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Monday, March 26, 2007

Do You take Human Growth Hormone? If so, Read this Post

This post, courtesy of Dr. Peter Rost supplies us with 2 YouTube clips of individuals speaking about human growth hormone. If anyone should know about HGH it IS Dr. Rost. He was the brave man who laid down his career in order to have Pfizer honestly market HGH to aging adults. Dr. Rost read the medical studies, and found, like we did in the late 80's that HGH didn't do shit. Sorry. All it did in the elderly (65+) was show slight statistically significant results in more hours of sleep and better mood. I believe these results, if statistically analyzed in an empirically valid manner, would show, that ANY efficaciousness of HGH was due to the MEDIATING effects of BEHAVIORAL ACTIVATION.

Activating your MIND and your BODY is the only known way to slow down aging. AND ITS FREE. So jump on the bandwagon folks... try exercise and reading as first line anti-aging treatments, before spending $$$ on shit that just doesn't work.

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HGH !!! The Peter Rost - Anna Nicole Smith Connection

This is a very important story that explains this bizarre connection. Read it yourself, its too strange to be real, but too real not to be strange. Although the intellectual differences between the 2 people, as a different as night and day, they both are tied together by the compount HGH (human growth hormone). What I find interesting, is that, the death of a media icon, a poor very psychiatrically and physically ill woman, could maybe shed light on the misuse of HGH. Look guys, she was shooting so much stuff literally into her butt, that she had very bad infections and scar tissue. I guess she didn't have the laproscopic tummy tie after that.

I watched poor Anna on her 2 seasons on E! I would use some of the episodes as examples of borderline personality disorder, impulsive anger, and of course substance abuse, when teaching residents.

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Sunday, March 25, 2007

EBOY'S New Look is Rockin'

is one of my favorite blogs
I don't know anything about it, except I print out cool pictures and put them on my door at work. They contain lots of interesting words, and it works as litmus test of technology.

Freedom... Freedom of Information, but WHO has any time to really look stuff up?

Here is the blog posting Question Authority with Dr. Peter Rost: Question authority!

which allows you to access information using the freedom of information act - online. If you are inspired to find some information, and put your blog where your mouth is.. hen here YOU go. Click on the link for State or Feds. Good luck!!

Health Care Renewal: More on Financial Entanglements of Physicians and Health Care Academics

Health Care Renewal: More on Financial Entanglements of Physicians and Health Care Academics

This post explains in detail how academic physicians are used by the pharmaceutical companies. In my 27 years of experience in a psychiatry department, I can count on one hand the number of physicians WHO DID NOT TAKE DRUG MONEY. In fact, when one of the NON-taking MDs was leaving, they gave her a whole box of pens from drug companies, because in her 30 years at the hospital, she would not even take a pen!

Here are the forms of money that I have seen - it is not as black and white as it seems:

1. Doctors who sit on best practices committees DO INDEED run studies that use the treatments that they are paid to promote, thru distributing their "research results."

2. Doctors receive poorly "grants" based on single letters of intention to do "research" using their drug of choice. The up side to this is that they hire a staff of young minds who want to enter research and try to earn a living wage.

3. They provide breakfast for the resident diadactics every week for most departments. This is a nice breakfast, but how nice, depends on how much you can actually USE their products.

4. In our single hospital, on a given day, a drug rep is providing a nice lunch for most departments. There are new laws about this, but I still see it happen at least twice a week in our department.

5. Drug companies take MDs to very expensive restaurants, for "CMEs" on their drug of sale.

6. Drug companies pay doctors to give lots of talks. Most of the doctors are only in their offices several days a week. The rest of the days, they are flown around the country to give talks on drug company monies.

7. Drug companies sponsor special speakers, with nice lunches. These are called grand rounds.

8. Drug reps pop up to bring all sorts of sweets for the secretaries that can get them appointments with the doctors.

9. Drug reps give out coffee cards.

10. Drug reps pay for residents to go to conferences.

11. Drug companies hold conferences that appear to be for the consumer and clinicians, but the real point of the conferences is the big halls of drug exhibits and the drug funded "free" luncheons, breakfast buffets and incredible dinners in huge rented facilities that usually involve alot of open bars. Drug companies also host poster sessions, with alot of booze and food and self promotion.

The bottom line is, for years now, ethical doctors have been complaining against this practice and nothing changes at all. Laws are passed by individual institutions, but they seem to dissolve when one follows funding sources for all of the above.

Saturday, March 24, 2007

Big pharma VP blows the whistle ...

Writes a book called "The Whistleblower: Confessions of a Healthcare Hitman" and now is getting a second book out, called "The Wolfpack". It is supposed to be a Grisham type fast moving fiction. Maybe it isn't really fiction, rather the continuing adventures of the wild and crazy doctor crusader. Problem is, Peter Rost, for all his self promotion is one of the bravest men I have ever read. He wants to get the message out anyway he can. The message is very good and important for the improvement of society and health of consumers. It applies across nations and health care systems. People...LISTEN.. this is an EX VP from 2 of the biggest drug companies.

I would say, QUESTION AUTHORITY would be the blog to watch.. from there, you can tap into some of the most accurate, funny, sexy, and very disturbing up to date information about PHARMA, health, and even funny kids pictures.

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Pot is Healthier than Alcohol or Tobacco

Great Digg - Lancet the best British Medical Journal concludes that in terms of dangerousness to ones' self - Alcohol and Tobacco are much worst than Pot - ITS ABOUT TIME!

Someone please forward this to Mark Emery. From the CC, I did not hear one word about this study. One would think that Mark and his brilliant (I mean this not sarcastically) crew, including the sagelike Magic D, and the helpful marketer B would have put out something about this. I also think that PTV should really make a big deal of this article. But who am I to tell others what to do? :)

The important take home message in my mind, is that, for EACH INDIVIDUAL all substances can potentially cause different psychological and physiological impacts. I asked the Sage D to tell me what substances might work for certain psychiatric disorders. His advise- "people are too different to even contemplate RULES about dosing substances such as alcohol, marijuana and nicotine. Remember, to also take into account your PHARMA and therapeutic drugs when you add these other recreational substances.

Great original article! Great posting. Thanks!

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Is Google doing advertising evil with new model? by ZDNet's Donna Bogatin -- Is Google doing advertising evil with new model?

Friday, March 16, 2007

Google promises more privacy

Can this be true? RIGHT ON!

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Advice to Anyone from an "Old Man" (*gasp*) for Rules to Live By - 80% good I Think.. You Decide

1. Don’t pick on the weak. It’s immoral. Don’t antagonize the strong without cause, its stupid.2. Don’t hate women. It’s a waste of time3. Invest in yourself. Material things come to those that have self actualized.4. Get in a fistfight, even if you are going to lose.5. ...

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8 Worst Restaurant Meals - Ruby Tuesday's Watch Out..

This post actually killed my hunger. It includes eight pictures of the "delicious" meals offered up at our most "popular" chain food establishments. Each one, is like 2 days worth of calories, fat and carbs.... eat on!

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Read a Blog without Your Boss Knowing - Great New Tool

This kicks ass, now I don't have to get anxious reading my blogs at work. Thank Peter Rost, for this great little utility.

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Thursday, March 15, 2007

First SHOUT OUT – To my Mother

Thank you so much Mom, for being such a good friend and Mother to me when I was sick. For being so concerned about ME, that you put YOUR personal health at risk. I appreciate your fierce canine-like reactions to the situations that caused/cause me significant stress and anxiety. I know we had a very rocky past, and that we BOTH acted in ways that we now, given what we know now, would have been unacceptable. But one hard core fact has always been true. We love each other!! Mom, This Kitty is for YOU!

Wednesday, March 14, 2007

Walking through Rings of Fire to Providence

It has been a difficult new year for me, and I am so thankful to have a little time to return to this Blog. My original idea was to use this blog to document ideas that I had a priori to having them used in the name of good science. I had to have something that was mine alone, that was relatively independent of my position at the UW. It is for that reason that this post and all other posts are my opinions as a private citizen and not the opinions of any employer, center, institution or charitable organization.

The New Year brought me an increasing stress from a home remodel, family problems and a greatly increased workload with the formation of the Center for Excellence at Harborview Medical Hospital – CHAMMP. Don’t ask me what it stands for, because I can’t remember, but CHAMMP does imply a winner and a loser. It certainly speaks to competition. Other models for Centers like this exist. See CARMHA a similar center at Simon Fraser University in B.C.

I was very sick for the past couple of weeks with a stress induced viral syndrome. This is a tautology of decreased immune functioning due to extreme stress leading to flu symptoms, which in turn cause more stress on the system. Especially when one is too sick to one’s stomach (from anxiety or flu - who knows?) to take one’s medications needed to treat chronic diseases. This illness and the weeks leading up to them were some of the worse of my life. And I am so thankful that I am on the definitive road to healing myself. I had much help along the way. That is why the rest of these posts are shout outs to the people who matter in my life, and those individuals who showed me the way through the rings of fire. I am happy to report that I only see blue skies and northern lights in my future.

When asked by a friend, “what is important in life?” The only answer I could come up with that was fairly parsimonious was: Good quality of Life – QOL. This is a subjective concept. To me it means feeling healthy and pain free; having peace and relaxation and enjoyment on a regular basis; having a home to live in and people you care about; having peace with your family members; a supportive, NICE and ethical work environment, and the ability to use your creativity to follow your passions, no matter where they take you.