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Sunday, April 25, 2010

Job Security


Thai said...

For comments

Dink said...

I'm really surprised the 1st surfer lived. That's a freaking nightmare.

Now the 2nd thing looked kind of fun. I wouldn't want its results covered by national healthcare...

Dink said...

So breaking symmetry...

Maybe if I tell you what my concept of it is, you can correct my errors.

A pattern is identified. Its given a name, boundaries are defined, our minds transfer it into the "Known" category.

There is an unexpected change in the pattern. It doesn't fit in the previous definition, boundaries, etc. So now we take this new pattern, give it a different name, define new boundaries, and transfer this new thing into the "Known" category.

From what I've read there are two possibilities that can result from this unexpected change. Two is nice; makes for easy flow charts and binary systems. But I don't get it. Are the two possibilities 1) stay the same, and 2) change. That seems more like a single branch off a limb instead of a bifurcation.

It fits nice with the "every cell comes from a previous cell" concept. And it fits experientially with knowledge building upon a foundation of previous knowledge.

Dr John said...

I am such a pussy and my life has no meaning according to the tau of Point Break. Some days I must agree.

Thai, what do you mean by "job security"? Are they shooting the banzai pipeline near your ER?

Dr John said...

Live The Tau of Point Break

Thai said...

John, I meant emergency medicine services in general, not my own specifically.

Although after you asked the question, it got me thinking as I used to be heavily involved in recruiting and for some of our facilities it is a major issue.

Board Certified/Board eligible EM physicians really exist in a kind of national labor market. Increasing demand for them in one area would pull supply from my own areas, as well as the resources necessary to pay for my own, etc...

So as I think on it, in an odd way, my answer is "yes", even if demand is distant, it still increases my own demand in a kind of ripple effect- though it might take a while for the ripple to reach me.

Dink, you'll pay whether you like it or not unless current law changes; this is quite independent of the current changes.

As for your thoughts on symmetry breaking: please remember I'm new to this as well.

I tend to think of boundaries themselves as breaking symmetry. Further, it is the breaking of symmetry which creates information (remember how Deb spoke of linguistics in our very DNA, I think she is correct, though using a different vocabulary than most scientists would use today).

Remember, information can be thought of as another form of energy- e.g. conservation laws apply to information just like the do to energy just like they do to everything else, etc...

So in creating information, breaking symmetry creates energy, etc... as they are one and the same at a certain level.

This is an entirely separate issue than things which are known or not know, etc... though in a world where everything is related to everything else, I guess they are related.

So if you are relating the formation of information from breaking symmetry to a system of known information/energy, I guess you could say that some information patterns can be compared against what is known to decide whether they are new or old, etc...

And re: "binary"

I'm not sure but I tend to see this as "yes"

Dr John said...

Is Deb "meurta" on the SRCS? I guess what you say about ER docs is true for psych docs to a certain degree as far as need. I do not see the need for ER docs decreasing but it will be interesting over the next 10-15 years to see where psych goes. I am looking at buying some property in South America where some friends have a few sea side lots. I plan on going back to do a primary care refresher at the hospital I run psych services at down the road. There are almost no doctors on this island my friends tell me. I just want to take care of the natives and get paid in fruit or chickens and have people smile at me and not know how to contact a lawyer.

Thai said...

Nor do I see your services decreasing.

Though I think you will always have trouble straddling this issue of whether you serve the patient or society.

FWIW, every time you see the word "triage" in an Emergency Department, remember that we face exactly the same challenge.

I'm a big fan of Rich's blog. Do you read it as well?

Dr John said...

I have never seen that blog. Thanks

Dr John said...

Wow. I just find myself nodding yes yes yes...

Now tell me Thai. I know you said you voted for Obama. I have not cared for a US president since I was in 6th grade and voted for Nixon in our mock class vote. That was the last time I felt that I was taken in by a chief executive.

Maybe I am over reading your posts but it would not seem to me that you support the current trends in healthcare.Dr Rich in my opinion appears to be spot on in regards to what I am reading so far and how we as physicians appear to be evolving into little more than drones for the state. It is exactly why I am planning my departure and also why I believe there will be a mass exodus of medical talent from the ranks of physicians that few can imagine when this occurs. Every Dr I know around 50 talks of leaving the field.

My first year in practice an elder Heme/Onc physician who took a liking to me after I did a spinal tap on a "psychotic" lady of his with breast CA and dx her with carcinomatous meningitis pulled me aside one day. He said to me "John, medicine should be your mistress". He was not joking. He felt to be good at what we do we needed to be that passionate. He left practice a decade ago taking out a large add in the newspaper telling his pts that managed care and medicare had killed the practice of medicine and the doctor/pt relationship.

Did you see this coming when you cast your vote?

Thai said...

Such a complicated question with so many sub-threads. E.g. what a fractal that one is! ;-)

Remember, in an election, we only get to chose one person. So it becomes a composite "yes" or "no" on all these sub issues and we just have to decide.

Let me say this, I think there is only one system in the end and different ways of perceiving this system. So at some level there is no difference whatsoever between capitalism and communism.

Further collectives (you, I and Dink are part of the collective) are just that, collectives. And no one person or even one group of people is responsible for the behavior of the collective and yet paradoxically we are all individually responsible, if that makes sense?

So it would probably be better to take sub-issue by sub-issue as they are all related, yet they are still all different.

I don't "blame" Obama for the mess which is health care if that is what you are asking me.

And I certainly sympathize with those who dream of universal coverage. Who wouldn't?

But I see there is no free lunch and everyone wants to pretend there is a free lunch.

Dr John said...

Thai you have at times a way of providing an exceptionally erudite response without answering my questions. ahhaha

I will accept that for what it is.

By the way I do not "blame" Obama per say by himself. This has been evolving for many many decades. It is impossible not to see that.

Thai said...

Sorry, it really wasn't a brush aside if that is how you interpreted it.

I guess I see a train wreck happening in medicine "yes" and to be fair I did not fully comprehend when I voted for Obama how much more he would try to spend, though I also did not understand the issue as well as I do today when he was running.

Nor at the time did I understand what a large percentage of the economy government now is.

But I get very nervous about some of this church-state mixing I see from time to time. And while I think people do need to suffer the consequences of their decisions, still to the degree we can I think people should be allowed to live their lives the way they want and I often do not see this in conservative movements.

I guess you could say I'm socially liberal/libertarian and fiscally conservative and permit the reconciliation of the two with the notion that if you want the first personally, you must also be willing to suffer the consequences for your choices.

But I do not think anyone is an island.

Dr John said...

I would describe myself and my beliefs exactly as you have. I was not trying to pin you down just to clarify. Thanks John

Thai said...

John, I just noticed you got your links to work with the Tau of Break Point

Congratulations! :-)

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