- Octopus vs. Shark: guess who wins?
- Pay for performance zinged: Pay for performance is a freight train headed toward American medicine. The Brits have been trying something similar — with not-unexpected poor results. Over at DB’s Medical Rants, DB nails the core problem with these “quality” initiatives, quoting from a British journal: Understanding quality – the British experience
The whole initiative is based on reductive linear reasoning that views the body as a machine and assumes that a standardised treatment will produce an equally standard unit of beneficial outcome. However, any practising clinician knows that the same treatment applied to two people with the same diagnosis can produce very different outcomes. Complexity theory suggests that the body is more usefully regarded as a complex adaptive system, characterised by rich interactions between multiple components that produce unpredictable outcomes. This analogy makes much more sense of clinical experience. Psychological states and social contexts exert measurable effects on the functioning of the body. Standardised treatments ignore all of this.
- Excellent writing: if you find great pleasure in reading superb writers, as I do, you should make Sippican Cottage a regular stop.Try this one out for a taste-test — especially his description of a woodpile at the edge of the woods: Not Even A Concierge Can Save You Now. Gorgeous prose.
- Gagdad Bob has his mojo workin’: The Perpetual War on History
- Five-Second Rule Tested: You know the “five-second rule” – you drop that delectable goody on the floor, and it’s OK to eat if you grab it within 5 seconds. Here’s the scientific evidence on whether or not this is a good idea: Rethinking the Five-Second Rule
- Grateful Dead’s Wall of Sound: In the the early days of the mega-rock bands (Cream, Hendrix, the Dead, Zeppelin, etc), it’s easy to forget that concert sound systems were primitive or non-existent. The Grateful Dead developed a sound system as impressive to see as to hear: An Insider’s Look at the Grateful Dead’s Wall of Sound (HT: Maggie’s Farm)
That’s all for now — have a great week, and God bless.
Hi, Dr. Bob,
Sorry to have been so absent from your presence!
I tried several times and ways to read the article about the five-second rule, and all I can get is sidebars, and nothing listed for November that looks like that topic. I was especially interested, as I think I can still bend over and pick something up within 5 seconds–if the dog isn’t around to beat me to it, that is.
Oh, well.
I’d like to think I could get caught up on all that I’ve missed, here, but that honestly doesn’t look likely. So I hope you and yours are all reasonably well, productive and happy, and, if I don’t get back soon, that you’ll all have a wonderful Christmas.