TED Community » jeffrey friesen

More About Me

I'm passionate about

Music, the arts, people, medicine, children, cooking, teaching, the environment, chocolate, Canada, and my wife. Always my wife.

An idea worth spreading

Corporate welfare must end. People are more important than maximizing profits. The current environment, especially in the USA, of placing corporate profits ahead of everything and everyone will destroy the middle class, and that, friends, will be the end of egalitarianism. Having said that I wholly support policy that benefits and succors small business; the benefits of which would stay in our communities and with our citizens.

Talk to me about

Music, inspiration, natural medicine, gourmet food, alternative energy, organic gardening, CSA's, building techniques, systems analysis.

People don't know that I'm good at

Writing and poetry. I never share that part of my life with others.

My TED Story

I found this site totally by accident and love it. I have sent a link to every friend I have. It exemplifies the highest ideals of the internet; that we inspire, inform, and support each other. Kudos to TED.

Comments

• TEDCred score: +25.30 TEDCred reflects your contribution to the TED community.

• A reply on Conversation: What if medical schools cultivated the art of healing along with knowledge acquisition.

  Feb 11 2012: I agree with you in most ways in your OP. I do think that too many docs run the recipe card for a particular set of symptoms, matching them to the prescription they know. They do this because of the seriously flawed time constraints forced upon them by the insurance reimbursement system. Many doctors who have never practiced outside the USA don't even realize that there is another way.
  
  A friend of mine is a doc in Canada and he spends about 20 to 30 minutes with each patient. His nurse handles his entire days insurance billing in less than a half hour at the end of each day online. He works 35 hours per week and never deals with insurance dorks overriding him or not paying him. He knows a year ahead of time what his reimbursement rate is, and if that isn't good he and his professional organization is able to negotiate changes. Best of all he has plenty of time for CE and keeping up with journals.
  
  Compare that to the USA where docs also see pts for about 35 hours per week and spend the rest of the time in paperwork, plus the also support some of the 3 insurance billing specialists employed for every doctor in the USA.
  
  I do agree with Linda that the only people who heal are patients. At best docs help them on that journey.

• A reply on Conversation: What if medical schools cultivated the art of healing along with knowledge acquisition.

  Feb 10 2012: Linda,
  
  The problem as I see it in focusing that diagnostic process to disease management rather than patient management, that you tend to get systems analysis.
  
  Pt:"Gee doc, I have symptom X, Y, and Z. What should I do?"
  
  Doc: "I don't deal with X and Z, but here is a prescription for Y and a referral to Dr. A for symptom X and Dr. D for symptom Z.
  
  The problem here is that too many physicians are not given the time nor tools to make those connections, and if we aren't going to have the doctors do that work, who do you suggest when you say that we shouldn't have the docs doing everything.
  
  BTW - at our clinic our docs spend an average of 20 to 30 minutes with every pt follow-up appt. and sometimes over an hour with each new pt. intake. They get a thorough history and work up of subjective and objective data. By giving that time to the pt, they are able to miss fewer things and work up a functional understanding of that pts. case. There is a reason that we are where pts come when no one else is helping.
  
  Again, I don't blame the docs who are mired in the insurance paradigm. FYI - we do not bill insurance (national average of insurance billing specialists to doctors, 3:1 - in Canada that ratio is 1:7 - yikes!!!) and as a result of lowering that significant amount of overhead and wasted medical specialist time, we are able to lower our costs to pts while still maintain a healthy profit margin to attract good docs.
  
  The insurance (broken) system time is done. Let's stick a fork in it.
  
  Could you explain your second last sentence more? I'm not sure what you are talking about.

• A reply on Conversation: What if medical schools cultivated the art of healing along with knowledge acquisition.

  Feb 10 2012: linda - whoops. Mea Culpa.
  
  I didn't check the link and transposed in my grey cells with another concept. Sorry about that. Age can be a mofo.
  
  Having said that I would say that yes, PBL is taught in all medical schools, but an alarming number of doctors don't seem to be using it much post graduation. We see WAY too many patients who come to us after seeing another doc who is practicing recipe card medicine: they take the symptoms, mix them together and follow the recipe to find an answer and if it doesn't work, well, it must be because the patients wasn't compliant (or some other excuse).
  
  I don't blame docs however. It is difficult, if one is mired in insurance based practices to move beyond the box the insurance company is willing to pay for without causing the doc to spend hours arguing with an uneducated no-think-em about necessary. After a while it just becomes easier to do what you know will be reimbursed, cash the check and walk away. Anything else is punished.

• A comment on Conversation: Why do we need violence to transfer power?

  Feb 10 2012: Good point. I wasn't thought of the less tangible forms of violence. Thus, sticks and stones may break my bones, but dammit, words can really hurt...
  
  I also think that social isolation can be very cruel. There was a girl in my junior high who had been ostracized by all the girls in the school and then eventually most of the boys. I have always felt bad about participating in that even in a small way. When I think about it now, I feel deep shame for my actions (lack of action and backbone) back then and I have vowed to make sure it doesn't happen to anyone I see or know about on my watch. At least that is the ideal, one which I fall short of.
  
  That said, I feel that men and women bring different thoughts, experiences and wisdom to the table. We would do well to use that combined wisdom, experience and knowledge to our advantage rather than continuing to ignore 50% of our potential because someone else has secondary sexual characteristics that we don't share.
  
  To use an example from my SWAT background. When not reacting to emergency situations (which were, thankfully, less often than they could have been) I worked with non SWAT officers. There was one female officer who was a genius of spotting concealed weapons at the distance of about 1 city block. It was uncanny. She just knew based on a number of subtle clues such as stance, gait, and the way they presented themselves and how their clothes were hanging on them. Damned if I could get even close to that level.
  
  Another female officer was very good at defusing situations using words. And I can tell you that not all of the male officers were even half as good as that. It is always better to never have to use violence.
  
  During the Yukon Gold Rush the entire territory was policed by a few NWMP "mounties" lead by a man called Sam Steele. Rumor has it that he is the foundation of the "one riot, one mountie" ideal. He kept the peace during chaos without backup. We should all be so good at our jobs.
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  A reply on Conversation: Why do we need violence to transfer power?

  Feb 9 2012: Linda - I can tell you for a fact that there are plenty of men who don't fight to prove a point, show their honor, or even win the fight fair and square. I used to be on a SWAT team and I've worked with SAS, marines, etc.
  
  And any fight is about walking away alive. There are some men who are much more vicious than any female I have ever met. Sure, one can always find the exceptions to the rule, but when you are taking the genders as statistical classes, I would be much more likely to turn my back on a woman than a man.
  
  Having said that we are all humans and that means we all have good points and not so good points in all of us.
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  A reply on Conversation: Why do we need violence to transfer power?

  Feb 9 2012: Rhona - My tongue was firmly in cheek in my previous comment.
  
  I agree that equality is the key to harmony. The best advice I ever received was on my wedding day "Just smile and agree and you'll be happy. If you are determined to have your say then become content with being unhappy." It's worked well for me for 20 years.
  
  Misogyny never made sense to me. The philosophy of cutting out half of the energy, spirit and innovation of the human race seems like bad management.
  
  Cheerio.
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  A reply on Conversation: Why do we need violence to transfer power?

  Feb 2 2012: I would go a step further. Given that men have been largely in charge for the past few millennia, we should put women in complete charge for a similar length of time.
  
  There is no possible way that they could cock it up as bad as men have. What's the worst that could happen. Russia will make a cutting comment about America and then America won't talk to Russia for a full week?
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  A reply on Talk: Erica Frenkel: The universal anesthesia machine

  Feb 2 2012: But then how could you patent a device and market the heck out of it?
  
  Waddarya? A commie?

• A reply on Talk: Erica Frenkel: The universal anesthesia machine

  Feb 2 2012: Yah - what Kevin said.
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  A reply on Conversation: What if medical schools cultivated the art of healing along with knowledge acquisition.

  Feb 2 2012: Wow. 200 hours and they get to work as an acupuncturist? Zoinks. That is very little. We have an associate clinician on our staff who has over 2000 hours of oriental medicine coursework and practicums before she even worked a day at that job. Add to that 20 years experience and you have someone who can contribute significantly to pt outcomes. I'm not sure someone with only 200 hours could cut it.