Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Tuesday, July 26, 2011

Minnesota Madness

There was a time when, asked by people where I came from, I used to look away and mumble Mason City, Iowa. I would then quickly point out that it was the home of Meredith Willson, who wrote “Music Man” and hoped that that gave me some increased stature in the eyes of the asker. Today, if I can trust the papers and the commentary on the news stations, coming from the heartland carries with it a badge of honor.

Two serious Presidential candidates are from Minnesota and one, from Iowa recently picked up his hat from the ring. The pluck of Iowans coping with floods is passed through the internet as a symbol of strength, determination and independence. But the true pride, the backbone of the distinction comes from the Governors, and Wisconsin, where I am presently vacationing and Minnesota are examples of why.

I asked my brother-in-law, who used to be in the Wisconsin Assembly to explain to me, why. After all, they had five recall elections just last week.

Dave said, while the elections were a disappointment to the Republican Party, and by inference to Governor Walker, the good news was in the one election expected to be the most closely contested, only 18% of the electorate showed up and almost half of those voted Republican. Hardly a definitive sign that the Governor will be recalled in 2012.

Of course the reason for the recalls was the battle a few months ago to break the teacher’s union. If you remember the entire Democratic side of the Assembly mysteriously disappeared when a vote was needed to decide if the state could financially support the existing contracts. Ultimately the bill was passed without Democratic support and a court challenge, which originally said the bill was unconstitutional, was reversed on appeal. Read this article:

And in Minnesota, government closed for two weeks.

What is important about that is that in at least seven states the Governors have taken a stand that they are going to have to face the budget crisis of their states. Many have rebelled against the trickle down financial responsibility that passed costs for Medicaid and other entitlements from 50% of something affordable to a budget-crunching, staggering, unaffordable burden. Many passed part of the burden down to the Counties. In California that started another rebellion. Where will it end?

There are clear signs that the public is ready for compromise beyond what the politicians have stomach for. If in fact the public response at the polls in 2012 may well see the pubic demanding a more compromise-related government, the results may see a more central-directed electorate. I have had a party affiliation for half a century and have financially supported candidates personally and though various PACs. I have no appetite for that support at this time, and I do not feel I am alone.

To watch a state fall to its knees for two weeks is sobering. To watch an assembly abrogate its responsibilities by leaving caucus for two weeks is inexcusable. To watch a nation skirt to the brink of financial default is appalling. Government and politics are twins, joined at the hip, but politics has seized the breast and threatens the survival of its twin.

Next post I’ll lighten up and tell you why pork barrels have become a new buzz word.

Saturday, July 23, 2011

Engineers, Actuaries, and a Member of the Family

My Hygienist was complaining that it is very difficult for her to get agreement on almost anything from her husband. Not that he is contrary. More that he is an Engineer. As such, he is always in search of a solution, often before there is a problem. What should they have for supper? He pauses and seems to weigh what is in the refrigerator, what they had most recently, what is the time of preparation? When what his wife was prepared to do was give him the two choices she had in mind. What she ends up doing is making her own selection while he is still contemplating the problem.

I found this true working as I have over the years with IT people and with Actuaries. For the most part I think I have some agreement that these people fall into a general class of People Who Watch Their Shoes. They find it distracting to make eye contact. Time has beaten them down from being the first to engage in conversation. They are bright, often a wealth of knowledge and experience, but are difficult to figure out.

I have a theory that in the classical chicken-egg story, that their personality draws them to their chosen occupation.

My sister was an Architectural Engineer. My father was always fascinated over what drew her to compete as one of only three women in a five-year curriculum. I on the other hand was sure that anyone who lined all their shoes up in a row to polish them every Saturday must have a different mindset than I. My father felt she was living in a world he would never comprehend. I was sure of it. He once asked her, “What do you see when you look through that telescope thing on stilts?” My sister explained that there was a man somewhere down there with a stick and it was very important to learn things about the stick and where the man was

I explained my theory (and my prospective Blog) to a friend who is a teacher. He reflected and then told me that he could tell who, in the teacher community, came from an engineering background. “They teach differently;” he said. “All facts and reasons and analysis instead of discovery.” In his mind this seemed to be a negative.

In my field, Dentistry, I have always been amazed at the variety of the personalities who turn to the field as a profession. Everyone, including me, seems to have some sort of passion for an avocation beyond the profession they have chosen. In my case, when I was graduating from high school, with no thought of what I wanted to do with my life, my mother took me to Ames, Iowa for a two-day battery of tests to determine my “aptitude”. In the interview following the tests, the conclusion was that I could be anything that I wanted to be, although I seemed to have an inclination toward the creative fields…like advertising.

I could have been one of the Mad Men (I graduated high school in the mid-fifties).

My father became a strong influence as I began to flunk out of my creative curricula, primarily because he had encouraged me to include subjects like Physics (under James Van Allen), chemistry, biology (made a great frog), and other subjects that tested me and prepared me for my eventual career. He took away my check book and car, sent me to a Catholic boy’s school in Minnesota where his brother was the Bishop and probably single-handedly propelled me in a year into dental school. Thank you, Dad.

So, although I don’t look at my shoes, I am reflective of the analytical side of things. I am guilty of solving my wife’s problems before she tells me they are problems, and of finishing her sentences before she does. I think my Purgatory will be having to listen to every sentence I never let the speaker finish.

Where do you fit into the “personality chose my profession”?

I may take a vacation break from my Blog for a week, but if not, research that I am doing visiting Wisconsin will prepare me for a piece on the “Minnesota Meltdown”. Stay tuned.

Tuesday, July 19, 2011

Coin of the Realm

If I needed one more reason why I think it is a mistake for the Federal government to take over our health care system, it was provided by a story on NPR last week.

The gist of the story was a government idea that we could save a lot of money if we stopped printing dollar bills and forced the use of a dollar coin. This was not a new concept as Susan B. Anthony and Sacagawea could testify if they were still around. The twist was that they would put an incentive into the purchase: They would allow purchase by credit card.

The unintended consequence of this well-meaning effort was the focus of the story, which introduced a new term: Airline Hacker. But first a little background.

The treasury prints millions of dollar bills a week and sadly they have a life expectancy of little more than a year. A coin however, especially now that there is no requirement that a coin have any precious metal content, can be minted cheaply and stay in circulation virtually forever. We find Roman coins on sunken ships all the time. A dollar coin has other advantages. Parking meters, for instance. The new Los Angeles meters only take quarters and dollar coins. Oh, and credit cards. And with most of them only giving 15 minutes or less for a quarter using a dollar coin makes sense.

But the public has never taken to the dollar coin. Too close in size to a quarter. Too bulky to routinely have ten or more on your person. When the government made a decision to have a substitute coin for the bulky (and expensive) silver dollar, they never quite came up with a popular substitute. Hence the incentive to get the coin into circulation by demand rather than by default (a on time race tracks and other gambling sites paid off in coins).

But what has happened is that sales never achieved the desired result. Purchase was for $250 minimum, with shipment to your residence (not a bank). But what quickly became the game was to purchase with a credit card that gave points redeemable for miles. The recipient would then march the coins to the bank and redeem them for bills. The banks accumulated literally millions of coins but were forced to put more bills into circulation while the coins stayed in their vaults.

Not only was the plan ineffective, it resulted in the printing of more bills than would have been required for normal commerce.

It doesn’t require much of a stretch to draw a healthcare analogy. More tests, more unnecessary care. More entitlements. Hmm!

If you want to do your part with the coin circulation, or if you want to become an airline hacker, the site to purchase coins is: .

Next post I’ll explain why a friend has a problem with her husband.

Saturday, July 16, 2011

The Royals

The newlyweds visited Southern California last week and the papers were full of the news of their activities, which prompted me to ask a friend, “Why do we need royalty in the 21st century?” NPR had just reported that the Royal Family costs the British taxpayers $13 million a year. They seemed to feel this was an extravagance, especially when the Dutch get their Royal Family for only $3 million.

What does either of them get as a return on that investment?

It turns out that they get quite a bit, at least the Brits do.

But before we explore that, we should reflect on the differences between Great Britain and their constitutional Monarchy and what we are seeing in the Middle East: in Tunisia, Egypt, Libya, Bahrain, Yemen and Syria, where there have been major uprisings since the first of the year.

In 1215 with the Magna Carta, the British were given a major concession. The king no longer had absolute power. In exchange, the free people would defer to kingly judgment on matters that were considered in the king’s realm: matters of war and peace, of taxation to support the public good, of relations with other nations. The king also was allowed a measure of pomp and circumstance to maintain a regal posture.

To date, this has worked out quite well, and the $13 million a year seems to be an acceptable cost to support the arrangement.

In the above-mentioned countries however, the monarchy maintains absolute power, and what the people perceive as compensation to the royals is more than they are willing to give. Add to that the unrest over religion and the combination becomes very volatile.

There is unrest even in some countries where you might not expect it, like Monaco. Monaco is a little strange because it is so small. The population is only about 50,000, a number small enough so that the forty-two year old king has invited the entire population to his forthcoming wedding. It has become a refuge for many multi-millionaire sports celebrities because its taxes are significantly less than in their native-born countries. But there is a huge disparity between the life-style afforded by the wealthy and the general populace. And that leads to unrest.

Unrest that manifests itself in demands for rights: like the Saudi women, who want to drive as well as demands for girl’s education and sexual freedom.

Lost in this conflict are such things as an almost universal desire for little girls to dream of being a Princess and finding a Prince, of living vicariously the life of a Princess Diane, of wearing the Crown Jewels and riding in a horse-drawn carriage, and the study of all the regal history with queens incarcerated and kings dethroned.

Which may explain that most of the 1.2 billion tourists who visited Great Britain in 2008 put on their bucket list visits to Kensington Palace, the Tower of London, the changing of the guards, a visit to see those Crown Jewels and Buckingham Palace.

Those tourists, and the money they spend, explain why it is unlikely we will see the demise of British Royalty any time in the near future. And, as she described her visit to England, was what my friend explained to me.

In Tuesday’s post I think I’ll explore a recent government action or inaction: printing money, and why it is particularly relevant today.

Saturday, July 9, 2011

Baghdad by the Bay ®

“Did you hear what they are thinking of banning in San Francisco?” commented my wife. “Not really. I heard they were thinking of doing a similar policy to the Chinese with pets instead of children. Limiting each family to one.”

Turns out it was even a little weirder. The City Council, or some activist group readying something for the City Council, was going to forbid the purchase and entrapment of goldfish.

Not that I am a bleeding heart prepared to go on a hunger fast for the rights of goldfish or for the rights of children to own and learn about them, but I feel there is a limit to what and how laws and regulations should affect our lives. And I think the chronicler of what the residents call The City, Herb Caen, would agree with me.

I grew up in my adult life with Herb Caen, who at that time and until his death wrote a daily column for the San Francisco Chronicle. It was Caen, early in that adult life who coined the term “beatnik” and several other descriptives for those who gathered in his city for the 1967 “Summer of Love”, a year I visited my sister in her North Beach apartment.

And it was Caen who I followed daily when I was attached to various Navy posts in the Bay Area from the late 60’s to the mid 70’s. His column made my day: How were we dealing with the SF pigeon crisis? What was going on between Hunter Thompson and the Mitchell Brothers? And what about the Embarcadero?

Caen died in 1997 from lung cancer, the same malady that claimed my sister at age 65. Caen was a more respectable 81. Writing until almost the day he died. My sister also was productive until close to her time. And that is one of the two messages of this post.

Message number one: Grab the environment of where you are at. As I write this I am listening to one of my favorite performers, Garrison Keeler, who is in Cincinnati. He is talking and parodying, “Cincinnati Chili”. I can truthfully say I have had Cincinnati Chile at the Mother Lode and it is delicious. Strange, but delicious. And part of the enjoyment came from my brother-in-law telling me that to ask for variations is to ask for TROUBLE!

Message two: While San Francisco may well want to be the bellwether (checked the spelling) for change, the fact that they were among the first to promote universal health care for residents of The City (a dismal failure) and for fining the use of plastic bags at time of purchase have not been totally successful. It seems to me that so many of the “ideas” that spring from the SF residents are quickly ignited and not so well thought out.

Maybe it was the earthquake.

Although the earthquake didn’t happen until 1906 and the gold rush was in the 1850’s the relevance of San Francisco was based a lot on it being the seventh largest city in the U.S. at the time.

When I discovered it, it was number one: in sleaze, think Carol Doda; in art, think Ferlinghetti, and coffee shops; in druggies, think Timothy Leary. Bottom line, it had a fringe reputation.

And it still does. Although my local SoCal environs can take blame for cancelling an elephant presence at a 4th of July parade because the company that handles the elephants may have been under suspicion for a film “Water for Elephants”, San Fran can field opinions on not allowing plastic bags, while still allowing unlicensed street vendors and artists.

Point of the post? San Francisco is a fascinating city, one I visit at least twice a year. I regularly travel down Lombard Street, eat at one of the more than 1,000 restaurants, smell the bay and glory in the clear sky. If you haven’t become a regular, please join my crowd.

On Tuesday, I think I may lighten up. We have had a visit from The Royals. Why should we have a monarchy in the 21st century?

Tuesday, July 5, 2011

A Tendency to Gamble

A long, long time ago I went to a dental meeting and came back with what I thought was a novel idea. The speaker suggested that we as dentists had lost the feeling of responsibility for our services. He lamented that, since we no longer did our own laboratory work, the casting, waxing, firing, etc. that went into our restorations, we found it too easy to blame shortcomings on the work of other, nameless people.

We were only a part of the problem.

He asked that we look at the plastic utensil that we were stirring our coffee with, or cutting our fruit. Asked that we check out what was printed on the handle and then check with our neighbor as to what was on theirs. Sure enough, on each handle there was a number. And it was different on each plastic utensil.

Those numbers are put there so some Quality Control person will know who is responsible if a piece is incorrect or flawed.

“Would you put your number on your crown?” he asked. It was a sobering moment.

When I got home I could hardly wait to share my story with my family, and indeed I did. My younger son, aged seven or eight at the time, said, “I knew that. That’s the game we play at (elementary) school. The guy who has the highest total on his knives, spoons and forks, wins the quarters.”.

Competition, not quality control.

At the time I remember two conclusions: first, gambling starts pretty early, and second, competition will find a game where size and skill do not always dictate the conclusion and winner.

I am amazed at the popularity of the reality shows, in particular those like Idol and Voices, where virtual unknowns can compete (and win) against huge odds. Not that the winners have no talent. But it seems that they also might have more popularity, more personality, more blind luck, which allows them an edge on the competition.

In researching for this post, I checked some plastic utensils to see if they still have numbers. The brand I checked (Solo) does in fact have identifying numbers, but in my limited sample it seemed that they had the same number on each fork in the package (037) or knife in the package (8). Perhaps the QC factor has been forgotten for a simple identifier (country of origin?).

That same gambling child now carries the nickname, “Mr. QC”, given him by his fellow teachers because he is the one who always notices the picture, crooked on the wall, or the clock, two minutes slow. Perhaps he learned attention to detail checking to see if he had strong numbers on his knife and fork. He went on from second grade to be very competitive, in tennis, wrestling, soccer, gymnastics, and almost any other sport he tried. And he still gambles, with Blackjack being both his favorite and his nemesis.

I don’t know if his early sojourn into comparing knives and forks had any effect on either of those traits, but I like to think it might have affected both.

For my part, I have taken responsibility for my own dentistry through the decades of practice and, I like to think, have taken responsibility for many things I have affected in the fields of dentistry, public health, and the insurance industry. My latest effort, and one I might conclude I have become the “First Follower” for is developing “reason codes” for dental procedures so we can tell why we do what we do, and if what we do makes a positive difference.

The group I am following is called COHRI , a Consortium for Oral Health Related Informatics, which is rapidly gaining momentum to establish standard codes for why dental services are performed.

I invite any of you who have interest in this topic to come on board as what my friend Sonia Marsh calls “Second and Third Followers”, making a crowd that gets attention. You can get more information on this at my website:

This weekend’s post is likely to dwell on recent antics in one of my favorite cities, San Francisco.

Saturday, July 2, 2011

By the Time I Get to Phoenix

There is a story that goes: Man to Psychiatrist, “Every time I hear the name Tom Jones, my head fills with music. Is that normal?” To which the Psychiatrist answers, “It’s not unusual…”

Earlier this week I posted a teaser on my blog that referenced the “late” Glen Campbell. Research for today’s post very quickly corrected me. The news a week ago or so was that Glen Campbell announced himself, that he was diagnosed about six months ago with Alzheimer’s, a not uncommon diagnosis for someone 85 years old. He also said in the announcement that he intended to make one final tour while he was still able.

Mary and I often listen to music at suppertime, often show tunes. I find myself finishing the score over the next several days, in the shower, while driving, or other times when I’m alone. Recently that has included “The Music Man”, “How to Succeed in Business Without Really Trying” (we have tickets in November to see Daniel Radcliffe in NYC), and for some unknown reason “West Side Story”.

I also can’t get “By the Time I Get to Phoenix” out of my mind.

Not too surprising in that, although he is older than I am, Glen Campbell's career really began in the mid 1950’s; about the time I became aware of music (Buddy Holly died in 1959 about 25 miles from my home). By the time of Holly’s death, Campbell had staked out a career in LA as a studio musician and had filled in on Beach Boy Tours for Brian Wilson.

He also had established himself as a cross-over artist, taking his country hit, “Gentle on My Mind” to the pop charts. He would repeat this in both directions with other Jimmy Webb hits: “Wichita Lineman” and “Galveston”. About that same time he would have, what many in the business call, his “prolonged trip to instant fame”. He was given a chance to be the summer replacement for “The Smothers Brothers Show”. He was such a success that he was given his own show, “The Glen Campbell Goodtime Hour”.

That show was an instant success, largely due to the fact that Campbell was so well connected with stars of the time: Willie Nelson, Linda Ronstadt, Johnny Cash, Waylon Jennings, Roger Miller, Merle Haggard and even one of his friends from studio days, Leon Russell. But it was his genuine warmth and likability that carried the show. He seemed humble and almost anxious to share the spotlight. He introduced us to such future stars as Anne Murray, Mel Tillis and Jerry Reed, who were regulars on the show.

When the show ran its course, he stayed prominent in the industry, writing and singing the title song for the first “True Grit”, performing on several other television shows, working movies for Clint Eastwood and others, and generally staying current, or leading current styles. His biggest hit came in the late 1970’s when he recorded a cover of Larry Weiss’s song, “Rhinestone Cowboy”.

Although he has recently chosen to make only sporadic appearances, his influence remains phenomenal, with the greatest of that being the ability to perform music which appeals across genres.

For me, the reason I can’t get “By the Time…” out of my head is because it evokes so many memories over so many years: from college dances to movies that were special. Listening in my head to the music triggers dozens of visual images. What a gift, for a performer to be able to do that!

Am I alone, or is this something that you also notice?

Tuesday I think I am going to share with you how a seven year-old taught me why we are inclined to gamble.