I’d bet if you took a survey in the US, you’d find most people are pretty happy with their current health care provider(s). Let’s face it, most people aren’t sick, and even when they do get sick, their own immune systems can fix most anything on its own. For most other ailments a visit to a primary care physician can easily diagnose and prescribe the necessary action to resolve the matter quickly.

So why do we even try to rate health care providers? I for one have never been a fan of health care provider ratings, because it can’t be done reliably. Health care is not an exact science. It is an art [of sorts], and trying to apply statistical measures to it are at best suspect.

Even trying to track the things that could be measured objectively, such as in patient infection rates, readmissions, etc. can’t be relied upon, because in a for-profit health care system, absent of regulation (like in the US), the incentive is to skew the data to produce positive results. And you sure can’t rely on data supplied by patients either, because most people aren’t knowledgeable enough about medicine, and are subject to personal prejudices.

Still that doesn’t stop people from trying. There’s a new website being developed by a multiple myeloma survivor, attempting to present data comparing survival rates of multiple myeloma patients by doctors, hospitals and regions in order to quantify the best in each category.

Despite the well intentioned efforts I’m sure this person has, I can’t help but ask myself why bother?

Certainly this information might be useful, but like I outlined above, you just can’t rely on the integrity of the data, especially, as in this case, when the data is being supplied directly by the doctors and hospitals being rated.

And even if you could rationalize the integrity of the data in this instance, the number of variables that exist [and not included] are endless, and difficult, if not impossible, to quantify.

For example, how far along has the disease progressed in a particular patient? How do we know if the health care providers, with the worst survival rates, weren’t just being inundated with the worst and most difficult cases? Identifying those health care providers as poor performers would not only be doing a disservice to the health care providers, but also to the patients who might steer clear of them.

And how do you quantify the aggressiveness of a disease? One thing I’ve learned throughout all this is, while there may only be one disease, there are numerous variants of each, some aggressive, and some not so agressive. Even if the doctors and hospitals were able to run all the tests necessary to categorize the aggressiveness of a disease (a cost which incidentally would be exorbitant), one has to keep in mind we are all different, and in any number of cases, those with poor prognostic indicators can perform extremely well, while those with good prognostic indicators can perform poorly.

Then there’s age to consider. How do you factor that into account? Are all 60 year olds in the same physical condition?

Just look at Joe Paterno. He died extremely quick after we first learned of his diagnosis. Do we really think he wasn’t receiving the best care? Should the hospital and doctor be penalized for that?

While I applaud the effort, simply because anything that keeps cancer survivors occupied, and not constantly worrying about their fate, has to be beneficial, I would be extremely skeptical of any of the ratings provided by this website, or any similar ones.

Posting on how to be better, more informed and proactive patients (one of the original goals of this blog), in my opinion, would be time better spent.

The only way to be sure we’re receiving the best possible care is to be knowledgeable of our disease. We’re not all blessed with being able to see a hematologist/oncologist that focuses solely on our particular disease, so asking the right questions, and supplying your doctor(s) with up to date information is absolutely vital.

Doctors are only human. They see many patients, all presenting differently. It would be naive to think any hematologist/oncologists has the ability to keep up with all the advances in the treatment of the myriad of cancers they deal with on a daily basis.

Staying informed and helping your doctor by supplying him/her with the latest information regarding your disease is something I have found every doctor I have had contact with to be very grateful for.

All you really need to know is, a proactive patient is a good patient, and the one who will likely survive the longest!

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For starters, I hate people who refuse to get a flu shot, or other vaccinations for that matter. Some people think they are a conspiracy to make us sick. Others just think they don’t work. That’s one reason I stopped working. Two people in the office didn’t believe they worked. Despite all the evidence to the contrary, they think they can get the flu from a flu shot. And this is despite the fact they always got the flu (and still came to work).

I get one ever year even though most medical experts don’t believe they work on the immune compromised. Mostly I depend on others getting their flu shot to protect me. Fortunately I managed to avoid the flu this past season, and I’m hoping for the same again this flu season.

So everyone PLEASE get your flu shot! If not for yourself, then for me. :)

I also hate riding my bike in the rain. That happened yesterday, and I was not a happy camper. It wasn’t raining when I started out, and I didn’t think it was supposed to rain (although it did look pretty ominous), but somewhere along the road, I got soaked. The worst part is your shoes and feet getting soaking wet, not to mention the cold. I will admit though, the hot shower did feel pretty good afterwards.

Facebook is another thing I am learning to dislike more and more everyday. It occupies too much of some peoples time. I especially hate the re-post requests, i.e. repost if you are or know of someone with cancer, if you know someone in the military etc. and the invites to different events or whatever. If I’m interested in something, I’m sure I’ll find out about it some other way. But mostly I just don’t need to know what my friends and relatives are doing every single minute of every single day.

And finally, I hate people who think supply side economics works. (OK, You didn’t think I let you get away without at least one political rant for the day.)

I believe in demand side economics. If people want/need something bad enough [take drugs for instance], businesses [drug dealers] will pop up to supply that demand, regardless of the impediments [taxes, regulations, police] put in their way.

You can make all the widgets you want, I’m not going to buy them no matter how little they cost. (Remember the Edsel?)

But make something I need, or even just want, I will buy it regardless of the cost, that is assuming I have enough money to buy it.

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Are you as perturbed about junk mail as me? It seems that’s all I get any more in the mail. I would even include it as another one of those pet peeves of mine.

I especially hate it when my credit card companies sends me checks to use instead of my credit card, which I have to waste time shredding. And what’s the point of that anyways? The reason I have a credit card is so I don’t have to use checks.

Well, if you are as aggravated as me about junk mail, then have I got a plan. It’s actually not my plan. I got it from a friend, but that doesn’t make it any less of a good idea.

Now, whenever I get an offer for something in the mail, instead of throwing it directly in the trash, I take any documents which don’t contain my name, and return them to that company in the prepaid envelope.

Obviously this won’t work if there’s not a prepaid envelope included. I’m not about to waste any money doing this, but it seems quite a bit of junk mail does include a prepaid envelope.

While this approach likely won’t end junk mail, hopefully it will create enough extra work for the companies, and make their dealing with it as annoying as it is for me having to deal with their unwanted junk.

Plus, if I can get a movement going here, maybe we can finally eliminate junk mail.

And when you really think about it, why do we even need mail delivery. If it meant eliminating all the unwanted mail, I’d be all for getting rid of daily mail delivery. I can’t think of anything that can’t be paid online, or received via email or by UPS, Fedex etc. And think how much money our cities, counties and states could saved if they stopped sending billing notifications through the mail, and used e-mail instead.

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But then I cried!

Proposition 20, removes elected representatives from the process of establishing congressional districts and transfers that authority to the recently-authorized 14-member redistricting commission comprised of Democrats, Republicans, and representatives of neither party.

Not necessarily a bad idea, but Proposition 27 eliminates the [recently-authorized] 14-member redistricting commission and consolidates the authority for establishing state Assembly, Senate and Board of Equalization districts with elected representatives who draw congressional districts.

That is just getting ridiculous! What happens if both propositions pass?

What California really needs is a proposition to end all propositions, or if we don’t want elected representatives to run the state, then how about a proposition to disband the legislature, and put everything up for a vote of the people [letting the special interests run the state]?

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Oct 232010
 

Since it’s raining today, I didn’t have much to do [I couldn't ride my bike], so I thought I’d complain about some of the little things that bug me. I know I’m not supposed to sweat the little things, which I don’t [for the most part], but these are so minuscule, I figure they don’t really count.

One of my biggest complaints are walnuts, or any kind of nuts, in chocolate chip cookies. Nuts have no business in chocolate chip cookies. Chocolate chip cookies are sweet. They’re a dessert, and nuts provide an unwanted texture, and flavor that takes away from that. Nuts don’t belong in chocolate chip cookies.

And come to think about it, nuts don’t belong in brownies either, but I don’t usually eat brownies (I don’t particularly like them), so I don’t really care. Still they don’t belong. They’re OK in Snickers, but that’s about it.

Another complaint is with people who buy [or rent] a convertible, and then drive around in it with the top down, and all the windows rolled up. Rolling up the windows takes away from the aesthetics and clean lines of the convertible. It’s just ridiculous! If you want a convertible, either ride with all the windows rolled down, when the top is down, or just leave the top up and use the damn air conditioning.

I personally don’t like convertibles for exactly the reason people do that. It’s too freakin’ windy, and it can get cold (depending on where you live), when you ride in one with the top and windows down. So what’s the point? It just bugs me.

Then there are those people at the gym, who after using equipment, fail to return the weights to their proper storage places. I’m not a very big guy, so removing a 45 lb plate so I can replace it with a 2.5, 5 or 10 lb plate, is not something I relish doing. Hey, I could drop that heavy weight on my toe or foot, and then how would you feel? What’s the big deal? You put the plates on, so take them off. It’s just common courtesy.

Oh, and I can’t forget the few people who find it necessary to do stretches, and/or other exercises right in front of some piece of equipment they’re not even using, when there’s plenty of open space elsewhere for them to do just that. I hate asking people if they’re using this equipment, when I know full well they’re not. IMO, that’s a stupid question.

Could you guess I went to the gym today?

Those are just 3, or 4 (depending on how you’re counting), pet peeves that immediately come to mind. They’re not something I get overly worked up about, but they do bug me some. Still, if those were my only problems, I would be a very happy camper.

Unfortunately that’s not the case. I’ve got tons of others, some of which I’ve blogged on before, i.e. alternative medicines/treatments, the US health care system, work, etc. but they have more to do with a perceived general overall stupidity of far too many (IMO) Americans displayed in their everyday business and private lives, so I won’t get into that today.

Mostly I was just upset because it was raining today, and I didn’t get to ride my bike. I just needed to vent. :)

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I haven’t been very philosophical in a great awhile, but a recent conversation with one of my wine drinking buddies has compelled me to do so now.

We were discussing a recent 60 Minutes segment about people choosing to walk away from their mortgages, and allowing their homes to fall into foreclosure, because the value of their homes had fallen well below the amount they currently owed, despite the fact, in many cases, they could still afford the monthly mortgage payment.

The conversation got a little heated, when I said I could understand the reasoning behind the decision. It’s purely a financial one. Why continue to pay [and pay] for something that’s no longer worth what you paid for it, or even what you owe? Why keep throwing good money after bad, especially when it’s cheaper to just stop paying? There has to be a time when it’s best to just cut your losses and run [so to speak].

But my buddy felt, if you could afford it, you were morally obligated to continue making the payments. If you entered into a contract, you were obligated to fulfill that obligation regardless of the financial implications. He likened it to borrowing money from a friend to purchase a car, but later found out the car was defective. Would you then refuse to pay your friend back, he asked?

First off, I don’t see there being any moral considerations when making financial decisions, and how can you compare a house worth several hundred thousand dollars with a car worth a few thousand dollars?

And how can you compare a friend to a bank, especially a bank that understands the risks involved in lending money for a home loan? Why else would they retain title to the home, until the borrower paid it off?

Incidentally, I would pay back my friend no matter what the cost!

I was then reminded of the controversy surrounding the decision by John Edwards to continue seeking the Democratic Presidential nomination, in 2008, after his wife was diagnosed with cancer. There was a lot of name calling, and people condemning Edward’s decision to continue the campaign, and not giving up everything to stand by his wife’s side while she fought her disease, all the while professing to know the moral thing to do, and how they would have reacted in the same situation.

Well, it’s the same for both cases.

In this case, my friend is retired, living on a nice pension (with health insurance), in a very comfortable home worth over a million dollars, with very little if any mortgage. How can he possibly think he knows what he would do if his house was worth half what he owed.

My point is he can’t. Nobody can know. And we definitely shouldn’t be passing judgment. Until you’ve walked in the shoes of someone faced with a tough decision or in a no win situation, there is no way anyone can ever know how they will react.

Not only is it naive to think otherwise, it’s down right arrogant.

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