[FRIAM] money is a delusion

[Marcus Daniels]

Wife had a GP she really liked in Los Alamos. Also trained in India and had to redo resisdency here to keep practicing. It was her favorite GP, ever, and she is very particular. Was very collaborative with specialists and was willing to communicate daily by e-mail. When I first met her (the GP), I asked her a question about why something should be the case. She thought it shouldn’t be but then Googled it right in front of me to learn that it was true. I liked her immediately. I don’t know that this had anything to do with her training, it might just have been that my wife was a more interesting technical case than the constant flow of Type 2 diabetes cases that came through her door. 

From: Friam <friam-bounces at redfish.com> on behalf of glen <gepropella at gmail.com>
Date: Thursday, April 17, 2025 at 6:51 AM
To: friam at redfish.com <friam at redfish.com>
Subject: Re: [FRIAM] money is a delusion 

I guess we could make the same argument with physicians: "act like a physician, not a business".

https://www.statnews.com/2025/04/15/ai-scribes-artificial-intelligence-medicine-note-writing-physician-patient-relationship/ <https://www.statnews.com/2025/04/15/ai-scribes-artificial-intelligence-medicine-note-writing-physician-patient-relationship/>

I guess I'd prefer "act like a witch, not a doctor". My GP back in Oregon was a great example of a *general* practitioner. Granted, I had insurance. But he rarely recommended specialists. He'd cut pieces off me right there in his office, tolerated my rants against acupuncture pamphlets, etc. But! He was originally trained in India. I only have a couple of experiences. But it wouldn't surprise me if Global South doctors act more like physicians than US trained doctors, in general. Actually, I've seen studies that show the average visit with a physician in Scandinavia is ~1 hour, whereas the average in the US is more like ~15 min. So, maybe it's not the Global South, but the rest of the world versus the US?

And it's not quite fair to blame the humans. The hospital and clinic systems, coerced by insurance/payers, captures them in their ion traps. Even the less-than-greedy ones are subliminally encouraged to escape into a specialty. If we think university accreditation is resource hungry, take a look at the firey hoops hospitals jump through: https://pmc.ncbi.nlm.nih.gov/articles/PMC8011742/ <https://pmc.ncbi.nlm.nih.gov/articles/PMC8011742/>

Stupid bureaucracy.

On 4/15/25 1:11 PM, Santafe wrote:
> Turns out Masha Gessen wrote a kind of nice piece in the NYT a few days ago, which came to me on a different list.
> 14gessen-videoSixteenByNineJumbo1600-v2.jpg
> Opinion | This Is How Universities Can Escape Trump’s Trap, if They Dare <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html>>
> nytimes.com <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html>>
> 
> <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html <https://www.nytimes.com/2025/04/14/opinion/trump-higher-education.html>>
> 
> To the extent that it has been done, it’s proper to say it is a strategy. I think the resulting education will end up being rather more restrictive than what I had hoped for from a full educational program, and probably focused heavily on civics. Math could be possible, in the sense that that can be taught “behind the hedges”. Medical research, not so much. But, one does what one can do.
> 
> It’s an interesting question what is the proper balance of criticism and understanding to give the businessmen who run universities, and who have Darwin-wise managed to eliminate almost any other model from the ecosystem. It’s not total criticism, in the sense that there is sheer mechanics that they do contribute to solving, without which the broad set of functions I want don’t get done. But the sense that they don’t take seriously what it means to live under a fascist regime where dissidence is the _only_ alternative to collaboration — there is no more neutrality — does seem to be a deserved criticism of their responses so far.


-- 
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