Sunday, November 27, 2022

A Day of Thanksgiving 2022

It can be a struggle in a turbulent and violent world to find space to give thanks, but we must try.

I hope that we can commit ourselves to making the world better one day at a time accumulating a series of small acts of kindness.  While each individual action may seem insignificant, if enough of us step up, then the world can change.  A rainbow is the effect of millions of drops of water.

Perhaps, next year there will be more to be thankful for.

Wishing blessings to all.

Sunday, November 20, 2022

Is Medical Marijuana Safe and Effective? We Still Don't Know.

I’ve never subscribed to the caveat to scrub politics and religion from my discourse.  Indeed, you will find these two subjects riddled throughout this blog.  I think we need more dialogue, not less.  I do agree, however, that dialoguing is a skill.  But it’s not brain surgery.  Any of us can become adept practitioners of this seemingly lost art, if we so desire.  It requires listening with an open mind.  It implies that your view on an issue might be modified in the face of a persuasive argument.  And your responses should respond to what has just been said to you indicating that the other side has been heard.

So, now let’s talk some politics.  First, assess your political acumen by answering the following quiz question.

Which of the following issues should not be handled by elected officials?

(a) Tax policy

(b) Zoning ordinances

(c) Which chemotherapy regimen should be permitted for breast cancer patients

(d) Parks and Recreation issues

I realize that this is an extremely difficult question and many readers are probably struggling over it.  Perhaps, you might confer you with your own city council representative for some assistance. 

Well, here in Ohio and elsewhere, elected legislatures are issuing medical directives, as crazy as this sounds.  Would it make sense for elected officials to offer a bill on how best to treat diabetes, heart disease or depression?  (Hint:  No it wouldn’t). 

Politicians are not medical professionals and are wholly unqualified to offer medical advice.

Their ‘medical’ opinions would surely be tainted by political considerations.  If a pharmaceutical company, for example, was in a politician’s district, might this shape the politician’s bill?  (Hint:  It would.)

We already have a group of folks who are trained to render medical advice. Have you heard of the medical profession?

In Ohio, medical marijuana has been legal these past few years.  The state legislature – not doctors or the Food and Drug Administration (FDA) – have decided which medical illnesses are marijuana eligible. Periodically, the list of illnesses lengthens.   I hope that my points earlier in this post have convinced you of the insanity of this absurd process.  Not surprisingly, the quality of medical evidence supporting marijuana’s efficacy for nearly all of the illnesses on the list is very low.  Trust me, if the FDA’s standards of safety and efficacy were applied, the list might be reduced to zero items. (FDA assessment can’t happen now as marijuana is a Schedule 1 controlled drug and is an illegal substance.)

Medical cannabis is not a new remedy.  Medicine bottle from 1937. 

Here's the latest ‘medical news’ from our Ohio politicians.  A bill has passed the Ohio Senate that would permit marijuana use to any individual who can “reasonably be expected to benefit” from its use.  Can we agree that this designation is rather broad and could be applied to any and all medical conditions on the planet?  Let’s see if the Ohio House goes along with this scam.

I'm not against medical marijuana.  But I do think it should be vetted in the same way that all other drugs are.

Remind me, is it still illegal to practice medicine without a license?


Sunday, November 13, 2022

A High Reward Investment with No Risk!

ROI (return on investment) is an investment principle.  If we contemplate an investment – whether money, time or training – we often speculate on what return on our investment we can expect.   What is the ideal ROI?  There is none.  One’s view of a financial ROI depends on the investor’s goals, risk tolerance, financial portfolio and stage of life.   For example, two experienced financial experts might completely disagree on the worth of a particular investment.

What if I offered you an investment that costs nearly nothing but promised a huge yield?  Interested?  Am I sounding like a 2 a.m. telemarketer promising to make you rich on some 'no money down' scheme?

If you follow my advice, you may surely become enriched, but don’t expect that you would enjoy any financial enhancement.  You can decide if it would be worthwhile to include these ‘investments’ in your life’s portfolio. 

Here are some life investments that I think might make our lives better.   I’m certainly not preaching.  I need these in my 'portfolio' as much as anyone.    

Hey buddy, this one's on me!

When you are in line for coffee, buy a cup for the person behind you.  You will be amazed at the payoff.  Both of your days will be better.  Perhaps, this will be the first link in a long chain.

If a driver changes lanes and slides in front of you, even if you feel the driver came across too soon, do not regard him as a traitor to the nation. There is no need to accelerate until you nearly collide with his car while you hurl verbal epithets or gesticulate wildly.  Does the world really need more rage?  Have you ever committed the same offense?  How about a small measure of forbearance?

As you are boarding a plane, help someone to lift his suitcase into the overhead compartment. 

The next time you are poised to raise your voice, consider if the situation truly warrants this.  My guess is that it doesn't.

Tell one of your subordinates at work what he is doing right.

Send a handwritten note to someone you care about.  No reason needed.

Try using this phrase.  "Wow, I've never thought of it that way."

Be gracious and understanding about someone’s error.

Try striking up a real conversation with someone beyond idle small talk. 

Say ‘thank you’ and mean it. 

I would be grateful for any additions to this list.  I thank you for this and trust me, I really mean it.

Sunday, November 6, 2022

Do I Need a New Doctor?

I am a parsimonious practitioner.  While I can’t cite statistics, I strongly suspect that I order fewer laboratory studies, prescribe fewer drugs and order fewer diagnostic tests than do my peers.  Medical minimalism has always been my medical world view.  This can feel a bit lonely at times in a profession that is rife with over-diagnosis and over-treatment.  I am not suggesting that my approach is the only reasonable medical approach, only that it’s the style that I’m most comfortable with. 

All of us should consider the philosophy of the professionals we engage.  And the professionals need to gauge the goals and risk tolerance of those they serve.  These relationships may need to enter into negotiations from time to time in order to agree on which pathway to pursue.

Physicians, judges, law enforcement professionals, teachers and others are not homogenous philosophically.  While folks may (hopefully) agree on the facts, the interpretations may differ.

Consider two different financial planners.  One advocates for a more aggressive portfolio arguing that this has the promise of a greater financial return.  This approach might allow the client to retire earlier or to retire with greater security.  A different advisor has a different approach, perhaps because he sees the world differently or has been molded by certain experiences.  He counsels for a more conservative approach arguing that earning less over time is worth the added security that the investment will remain secure.

Who has the better argument here?  Folks will disagree here and their response will depend upon their own philosophies.  For example, a very cautious investor will likely be partial to the second advisor I cited above.

Balancing One Philosophy Against Another

It’s the same with medical care.  Physicians over time tend to retain patients who share their doctors’ philosophy.  Let's face it, there are many patients who are not satisfied unless the office visit ends with a prescription or a test.  This action validates their reason for the office visit. They likely regard no action as medically inadequate.  Such a patient may not find my restrained medical approach to be compatible with their needs and likely will find doctors who are more comfortable using the medical gas pedal than the brake.  Some of us feel that less is more while others feel that more is more.

Of course, doctors and others need to be somewhat flexible in order to meet the needs of those we serve. And we are.  But being flexible doesn’t mean abandoning one's core principles.  There are limits to how far any of us can or should bend.  If, for example, you are a reluctant investor who is worried about the health and safety of your retirement money, and your advisor wants you to invest it all in cryptocurrency, then perhaps, you need a different advisor.  Similarly, the same principle may apply to your doctor.