Author: Ken Goetz

Biden or Trump? Neither! We Need Better Candidates.

Posted on by Ken Goetz

Biden or Trump? Neither! We need better candidates. Our upcoming primary elections must rid us of this pathetic pair of presidential nominees. If you are a regular reader of this blog, you know I’ve harped on this topic a number of times earlier (see here, here, and here), but the situation continues to needle me. And I’m not alone. Most citizens feel the same way I do.

According to a recent CNN poll, President Biden has a job approval of only 39% (see here). And 61% of those polled said they disapproved of his performance. Biden’s negativity seems to be related primarily to our inflationary economy, surging crime, international turmoil, and the uncontrolled influx of illegals at our borders.

Ex-president Trump, Biden’s chief competitor, hardly glitters in comparison. Of those polled, only 42% had a favorable view of Mr. Trump, while 54% expressed an unfavorable one. Trump’s record when president likely plays a role in his low rating, but there is no doubt that his labile personality and revengeful nature contribute to his unpopularity. I have lost count of how many of his former allies he has turned against.

More reasons:

Other crucial factors contribute to the unpopularity of these two. Both are oldsters with diminished brain power. Biden leads in this downward mental race in my opinion, with Trump running not far behind. Both are also vindictive, with Trump, I believe, outdistancing his rival in this category. Both know they are unpopular. So, why don’t they give up their selfish goals, drop out of the race, and benefit us all?

It’s worth recalling that Trump holds the record for presidential impeachments, having collected two (half of the four in U.S. history), but Biden may be closing in. It seems likely he will face impeachment early next year regarding the string of foreign payments made to his son, Hunter, and other members of the Biden family (including himself?).

Legal problems as well:

Trump, of course, is also entangled in plenty of legal problems. According to an October report from The Hill (see here) he is defending himself against a total of 91 criminal charges spread among four state and federal criminal indictments. Separately, he is also a party in more than a half-dozen civil lawsuits.

The legal noise is not as loud for our current president, but he and his family are under investigation by the House Oversight Committee for the millions of dollars collected by Biden family members from foreign countries, most of these proceeds having made their way through shell companies.

Final thoughts:

After skimming lightly over a number of each candidates drawbacks, it’s perhaps not surprising that the same CNN poll mentioned above also reported that neither man is viewed as much of a straight shooter;  just 42% thought Biden is honest and trustworthy while only 33% felt the same way about Trump.

So, after considering the obvious flaws of each candidate, why should we rush as numbly as lemmings toward yet another contest between these two uninspiring individuals? We undoubtedly could identify hundreds of men or women (or even thousands) far better qualified to lead our country through its cauldron of present-day problems. Let us begin the search! Qualified volunteers will be welcomed.

 

Doctor examining patient record

Here’s More About Burned-Out Doctors

Posted on by Ken Goetz

Here’s more about burned-out doctors. After I posted my physician burnout report (see that here), someone sent me the program of the American Conference on Physician Health that was held just days earlier (October 11-13) in Palm Desert, California. (For more resources on doctor burnout click here.)

This was the 7th annual Conference on Physician Health, each one sponsored by the American Medical Association, the Mayo Clinic and Stanford Medicine. These conferences were designed “to inspire organizations throughout the country to seek ways to bring back the joy in medicine for all our physicians.”  (My emphasis.)

I was told that a doctor who attended the most recent conference returned to work and discovered he had 35 patients to see. A prescription for more burnout?

Have these conferences been popular? The digital program of this year’s event indicated, on the cover page, that it was SOLD OUT! And there was a waiting list!

What topics have these conferences covered?

Here’s a sample of some representative titles from this year’s conference. Many focused on instilling well-being in burned-out doctors.

  • Breaking down barriers around emergency medicine physicians seeking mental health care.
  • An innovative medical staff-run approach to the drivers of burnout and joy in work.
  • Association of physician burnout with perceived EHR (electronic health records) work, stress, and potentially actionable factors.
  • Creating a culture of wellness.
  • Drowning in email: the cost of email burden on physician burnout.
  • Heal thyself: leveraging CME education to improve provider wellness behavior.
  • Pebble in my shoe: a program to address micro-annoyances encountered by physicians in the workplace.
  • Significant higher rates of burnout at a tertiary eye care center found after the start of COVID-19.
  • The impact of Sudarshan Kriya Yoga (SKY) breathing on mental health and well-being of physicians: a Canadian experience.
  • The intentional well-being retreat: an evaluation of a wellness retreat for physicians and advanced practice providers.

ALL OF THESE TOPICS (AND MANY MORE) WERE PART OF POSTER PRESENTATIONS ON THE FIRST AFTERNOON OF THE THREE-DAY CONFERENCE. CLEARLY, THIS IS A BIG TOPIC AMONG PHYSICIANS.

Conclusion

Doctor burnout is real. And it obviously is bad for physicians — and for their patients. It is time for governmental and insurance regulators to back off and allow these professional men and women to do their jobs as they know best!

 

 

 

 

 

 

 

 

 

 

 

Medicare advantage changes this interaction.

Is Your Doctor Burned Out? Probably.

Posted on by Ken Goetz

Is your doctor burned out? Probably. According to a recent “Physician Burnout and Wellness” survey conducted by Medical Economics, two out of every three physicians (68%), are feeling burned out. Should you care? As a patient, absolutely. Read on.

“I feel a loss of empathy and compassion for my patients,” said one burned-out doctor.

“Everyone I know wants to leave medicine,” said another. “The paperwork and administrative burden of charting keep us from spending quality time with patients.”

Not the best of news, is it? When you consult with your doctor, you expect that person to be alert and competent, but individuals with burnout, physicians included, often find it difficult to concentrate; they become irritable. They under-perform. A clear and detailed discussion of burnout appears on the Mayo Clinic website, see that by clicking here. Please note: Although I cited the Mayo reference, burnout is NOT a medical diagnosis.

More discouraging quotes

“It makes it hard to fully engage in my practice,” said one doctor. “I’m counting the days until retirement,” said another

How times have changed! When I entered medical school, which admittedly was a very long time ago (late 1950s), medical practice was one of the most prestigious of occupations, right up there with being a justice on the Supreme Court.

And why not? During the first sixty years of the Twentieth Century, physicians had considerable professional autonomy. In that golden age of medicine, doctors controlled their practices. They were independent and provided professional care directly to patients. Physicians performed a meaningful service, and the patient usually paid for that service. If the patient could not pay, the debt usually was written off. Doctors still made good money.  They were highly respected, they usually developed close doctor/patient relationships, and their work was lucrative. Satisfaction among doctors was, not surprisingly, high.

 

Doctor at work

Doctors still are generally well compensated (although there is great variability among specialties), but burnout has replaced satisfaction in many cases. Why? Primarily, I think, because doctors have lost much of their independence. After having undergone four rigorous years of medical school, new M.D. graduates now continue their training in residencies that traditionally last from three to seven years, depending up on the speciality a young physician chooses.

In short, doctors have never been better trained than they are now. They are intimately acquainted with the human body. They know in detail how it functions in both health and disease. Today’s doctors have mastered a variety of medical or surgical skills within the speciality they have chosen. They are exceedingly well-equipped to diagnose and treat whatever ails their patients.  Nevertheless, after all of that preparation, most physicians now work under constraints, and they follow orders from people who know little or nothing about medicine.

As one surgeon wrote, he had “watched as medicine slowly evolved into the domain of technicians, bookkeepers, and clerks.”

Today’s altered environment

In today’s altered environment, most patients do not pay directly for their personal health care (although they may pay partially through a co-pay). Rather, the government (Medicare or Medicaid), or an insurance company, pays the bulk of today’s medical charges. These soulless payers obviously are not grateful recipients of the care, of which they receive none. Insurance companies are in the health game to “make” money and they are eager to limit their payments for such care. The government wants to “save” money, and it also strives to limit payments. So, both government and insurance agencies have set up rules and guidelines as to what they will pay for. Pre-authorization may needed before treatment can begin.

The government and insurance companies clearly now rule the roost. Medical care has transformed into the healthcare industry. Think of all the government employees, insurance employees, hospital employees, and more (basically administrators of one sort or another) who earn their livelihoods today from the “healthcare industry” by providing rules for doctors to follow, and by monitoring how well physicians comply. So, the earnings of this growing crowd of employees have greatly increased the total cost of medical care (as I’ve pointed out earlier, see here, the the New England Journal of Medicine reported that U.S. national health care expenditures increased from 4% of the gross domestic product in 1950 to nearly 18% of GDP in 2019. Now nearly one dollar out of every five spent in the USA now goes to “healthcare,” yet I would argue that this dramatic explosion of healthcare employees has not improved medical care one whit. But, sadly, the rules and regulations cooked up by these administrators are a major cause of physician burnout. (New advances in medical equipment have, of course, also contributed to the dramatic increase in medical costs, but the additional personnel costs are substantial.)

One burned out physician was blunt. “We need less paperwork and regulations.” “We need less busy work,” echoed another. Have you ever wondered whether your doctor enjoys looking at his computer screen while talking with you?

A volcanic shift, government induced

This volcanic shift was initiated decades ago, it seems clear, by the federal government, the same government responsible for the exorbitant costs of today’s college tuitions (see here for my discussion of how the federal government set in motion the explosion in college costs). Government is vital for a free society, but there are areas, in my opinion, where it blunders in and mucks things up.

Medicare, enacted into law in 1965, began the inexorable encroachment on the practice of medicine. As the government began to pay for certain forms of medical care, it also added regulations. Not surprisingly, with government money came government control. An excellent discussion of the depressing changes in medical care over decades may be found in the thoughtful observations of a general surgeon (see that here). This is an excellent review of how governmental interventions “have yielded a cascade of perverse incentives, bureaucratic diktats, and economic pressures that together are forcing doctors to sacrifice their independent professional medical judgment, and their integrity.”

Is your doctor burned out? If so, the details above probably played a role.

 

 

Biden versus Trump: What Can We Do?

Posted on by Ken Goetz

Biden versus Trump: What Can We Do? I’ve written about this problem before (see here and here), but events continue to move in the wrong direction. Will we have the opportunity to vote for a candidate we actually prefer during our next presidential election? Doesn’t look like it. Both Biden and Trump have unfavorable ratings of 55% according to recent polls (see Biden’s here, and Trump’s here) And their approval ratings are hovering between the upper 30s to low 40s. Nevertheless, unless a miracle occurs, those two tainted individuals are headed toward an undesirable slug fest in 2024. WHAT CAN WE DO?

First, try to recall a time when two more unpalatable candidates vied for our presidency. Admittedly, there have been some colossal duds in the past, but I submit that never before have our choices been so bleak. Both Biden and Trump are imbued with scary traits. I’ll consider here just two of each candidate’s many drawbacks.

Personal attributes

Mr. Biden:

People talk about his age. A recent Wall Street Journal poll found that 73% of voters think him too old to run for president. Some 60% say he isn’t mentally capable. I’m most concerned about his mental acuity, which is in shreds. Even partisan Democrats must have noticed the endless indications of the man’s dotage. One telling recent blooper occurred at a private campaign event, in which Biden told a story about why he chose to run. Minutes later he told the same story again, almost word for word, as verified by a transcript of the speech later published by the White House. Think about that. An aware person may repeat a word, but not an entire story after just telling it. In short, Mr. Biden’s mental status is dismal, and far below the level necessary to adequately perform duties of the presidency.

Mr. Trump:

Although he is just three years younger than Biden, fewer people focus on his age. His brash, vindictive personality weighs him down far more than his age. Try to recall all the former friends and associates that Trump has turned his vengeance on. It would take some doing to log all the bodies strewn in his wake. Accordingly, it seems likely that the former president, if he were to move back into the White House, would spend much of his time settling what he considers old grievances. Moreover, it was obvious that Mr. Trump did little to dignify the presidency while he occupied the White House, and it is difficult to imagine his behavior would improve if he were reelected. In short, Mr. Trump’s aggressive and vindictive personality likely would inflame the already-divisive Washington climate and thereby hinder his performance as president. 

Legal difficulties

Mr. Trump:

1) The former president is immersed in a swamp of legal problems. He faces charges that legal experts say portends a dangerous road ahead for him.

2) In Washington federal court, he is charged with conspiring to defraud the U.S. by preventing Congress from certifying Biden’s victory over Trump and thus depriving voters of their right to a fair election.

3) A Georgia grand jury has issued an indictment accusing him of efforts to overturn his 2020 election loss to Democrat Joe Biden.

4) A federal court in Miami has charged him with unlawfully keeping classified national security documents when he left office in 2021 and lying to officials who sought to recover them.

5) A New York grand jury indicted him for allegedly falsifying business records in connection with a hush-money payment (allegedly using campaign funds) to a porn star before the 2016 presidential election.

6) A New York attorney has  sued Trump and his family business, the Trump Organization, in September 2022 for alleged fraud by him and his family.

Mr. Trump has pleaded not guilty to all of the above charges. Each of them, it should be noted, carries possible prison sentences. Stay tuned.

Mr. Biden:

1) House Republicans have started an impeachment inquiry of the current president, this concerning whether Mr. Biden collaborated with his son, Hunter, in enriching the son, other family members, and the president himself.

2) I don’t pretend to know fact from fiction here, but one point seems self-evident, that being that Hunter Biden has neither the knowledge nor the expertise to have earned (without help) the millions of dollars he collected from foreign sources. As has been widely reported, a sizeable amount of circumstantial evidence suggests his father, while vice president, was linked to Hunter’s earnings. I’m not alone. Some 61% of those in a recent poll (see here) believe that Mr. Biden had some level of involvement in Hunter’s business dealings — and 42% think that he acted illegally (there has been no proof of wrongdoing by the president). 

3) According to Business Insider, subpoenaed bank records reveal that the Biden family created over 20 shell companies (companies through which they reportedly received about $20 million in payments from foreign sources). Bankrate.com defines a shell company, or shell corporation as an entity that typically lacks active business operations or employees. Shell companies can have many possible uses, from serving as vehicles to raise funds to facilitating corporate mergers, but they may also be used by individuals and companies to evade taxes, launder money and hide the identities of their owners.

4) It also has been reported that a total of nine Biden family members received unexplained wire transfers from foreign businesses. Even two of Biden’s grandchildren received payments. It’s unclear which grandchildren received payments, but most of them are in their early twenties with no personal or business ties to Ukraine, Russia, or China.

5) An IRS whistle blower, Joseph Ziegler, who works in the agency’s International Tax and Financial Crime section, said in his opening statement before Congress that he was the lead IRS case agent on the investigation and that the IRS had recommended both felony and misdemeanor charges against the president’s son.  That recommendation was ignored. “I have a reason to believe that there was gross mismanagement present throughout this investigation,” Ziegler said.

6) According to Hunter Biden’s former associates, the Vice President joined Hunter in telephone conversations with the foreign representatives who provided money to Hunter.

Mr Biden denies that he was in any way connected to his son’s businesses. The investigation continues. Stay tuned.

Final thoughts

I’ll end where I began. Biden versus Trump: What can we do? Well, we can raise a fuss, and many of us can raise many fusses. If that fails, we can individually assess the multiple drawbacks of each of these sorry candidates. Once that is decided, we then can vote against the one considered to be the worst. By doing that, We the People of the United States, will form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, just as the preamble to our Constitution proclaims.

If you agree that a Biden – Trump ticket is not what our country needs, please consider forwarding this post to others, and urge them to do the same. Who knows? Perhaps we can make a difference.

 

Does a Striking Football Player let his Teammates Down?

Posted on by Ken Goetz

Does a striking football player let his teammates down? That question came up recently, and I’ve taken a crack at answering it. To come up with a reasonable answer, I’ve tried to imagine that I’m a valuable player on an outstanding professional football team, the reigning Super Bowl champion, no less, and I’ve further assumed I’m making something like a cool $20 million a year as a defensive tackle. (I almost broke my noggin with those ridiculous assumptions, but I tried to be creative.) I made one final assumption: I’m now in the last year of a 4-year contract worth $80 million, so I’ve been in the bucks for a while.

It was even more difficult for me  to assume that I’m not happy with that $20 million bundle of chicken feed. But I pretended I was unhappy. Why? Because another defensive tackle on another team, probably the best tackle in the league, is making more than I am.

Continuing my little game, I filled in more blanks. I have not reported to camp for pre-season drills. I have not shown up for any team practices, and I have not been with the team for any of its pre-season games. And I won’t be playing in the opening game against the Detroit Lions tonight, on September 7.

Now I’m trying to imagine how my teammates might feel about all of this.

As many of you realized, I was pretending to be a character in what is a real-life situation. Chris Jones of the Kansas City Chiefs is in the position I imagined I was in, and he seems to be firmly entrenched (see here). Naturally, I don’t know what motives are directing Jones’s behavior, but I’m convinced he’s off base when he talks about how his teammates, those hoping to return to the Super Bowl this season, feel about his prolonged absence.

When Jones was asked whether he might be letting his teammates down, he responded, “How have I let them down? It’s just like when you’re at your job, and you ask for an extension — you ask for a raise.”

 “Who are you letting down for asking your boss for a raise?” he continued.

Well, I’ve thought about that question. Here are a couple of things for you to consider, Mr. Jones. When asking the boss for a raise, please consider that one usually doesn’t quit working while asking for more money. Beyond that, if the person asking for a raise is involved in a vital team project, wouldn’t that person’s absence be hurting other members of his team?

To be more specific, Mr. Jones, your teammates on the Kansas Chiefs are vying for another trip to the Super Bowl, and a weakness in their defensive line could lead to the loss of one or more games that might otherwise be won if you were playing. Such unfortunate losses would reduce the Chiefs’s seasonal record and possibly prevent your teammates from reaching their goal this year.

So, Mr. Jones, please understand that your prolonged absence is indeed letting your teammates on the Kansas City Chiefs down, and, of course, letting all Chiefs fans down as well. Would you please negotiate the extension of your contract with those considerations in mind? Please consider your teammates and fans.

Addendum September 8, 2023

Some of you likely know that Chris Jones sat in a private box high above Arrowhead Stadium last night as the Kansas City Chiefs lost, 21 to 20, to the Detroit Lions. I wonder whether Mr. Jones saw any Chiefs player wave up at him during the game, as if to say, “We’re with you as you hold out for more money, Chris. You’re looking all cool and relaxed up there, Man, while we’re working our butts off.  We know you’re making more money than most of us down here are, and we sure could use your help, Brother. But no worries. We’ve got your back.”

Do you think anything close to that happened?

Lose Weight and Become Healthier for $1,350/Month (or Free)

Posted on by Ken Goetz

Lose weight and become healthier for $1,350/month? Yep, you can do it, at least according to the preliminary results reported yesterday by Novo Nordisk on its drug, Wegovy, a drug that sets users back over a grand per month (Novo Nordisk funded the research study that has not yet been peer reviewed or published). Or maybe you can lose weight and become healthier for free. See below.

I’ll put on my medical hat now, as I occasionally do (see here). The reported results are hardly a surprise. It’s been known for years that so-called glucagon-like peptides-1 (Wegovy is a GLP-1 drug) reduce the risk of cardiovascular disease in diabetic patients.

Reducing Obesity

Beyond that, GLP-1 drugs have been in the news lately because they reduce weight in obese patients. So, since it is well accepted that obesity is a risk factor for cardiovascular disease, it’s hardly surprising that the Novo Nordisk study found its participants who received weekly injections of Wegovy had fewer heart attacks and strokes than the participants who received placebo injections.

What is new in this study is the population studied. Participants were all 45 years or older, and overweight (body mass index of at least 27), but they did not have diabetes. The key finding? The people receiving Wegovy had a 20% reduction in major adverse cardiovascular events (heart attacks, strokes, and cardiovascular deaths), this coming from a population of over seventeen thousand subjects studied since 2018. So, assuming the data stand up when reviewed by peers, the results are convincing.

Press Release

I checked out the press release (you can see it here), and there is no mention of weight changes in any of the subjects, but almost surely those receiving Wegovy lost substantial weight.

The active compound in Wegovy is semaglutide (2.4 mg in each weekly injection). Semaglutide is also the active ingredient in Ozempic, a name that, if you watch any television, you’re familiar with, the drug that is now touted as a weight reduction wonder.

How do they work?

How do GLP-1 drugs work? They mimic the action of a hormone called glucagon-like peptide-1. As blood sugar levels rise after a meal, these drugs stimulate the production of insulin, which in turn lowers blood sugar levels. These drugs also curb hunger. The mechanism isn’t totally worked out, but they slow the movement of food out of the stomach into the intestines, giving the sensation of feeling full longer. Thus one eats less.

Plan B

Since evidence suggests that GLP-1 drugs lower a person’s weight by reducing caloric intake, here’s an alternate plan for you to consider. Rather than laying out some hefty dollars for Wegovy or Ozempic, or any of the GLP-1 drugs, why not consider the possibility of toughening your resolve and sticking to any of the weight-losing diets available? Lower your caloric intake and you will achieve the same happy results without laying out a boatload of cash. In short, lose weight and become healthier for free. Not only that, but you’ll avoid the side effects of Wegovy and Ozempic, the most common being nausea, vomiting, and diarrhea.

 

Oppenheimer, the Movie: A Blogger’s Review

Posted on by Ken Goetz
Oppenheimer, the Movie: A Blogger’s Review. Be forewarned! This is not a typical movie critic’s review (i.e., the refined opinion of someone who sees endless films weekly and thus is well attuned to the thunderous volumes and computer-generated enactments of most present-day movies. Rather, I offer a very brief opinion from the perspective of a guy with interest in J. Robert Oppenheimer, not to mention the continuing threat of nuclear war, a topic I’ve written about here before (see here).
 
I saw the movie yesterday. Thankfully I had heard the sound is LOUD, so I took along a pair of spongy ear plugs, my best decision of the day. Theaters tend to amp up the sound of everything these days, and Oppenheimer, clearly no exception, rumbles along at prodigious decibel levels most of the time. I popped in my plugs the moment the film started and kept them in for all but a couple of scenes when dialogue had dropped to almost the sound of normal characters talking.
 
Three story lines
The movie has essentially three story lines: 1) the rush to develop a nuclear bomb, with Oppenheimer placed in charge of the Los Alamos Laboratory that actually designed the bombs (to me the most interesting part of the story), 2) Oppenheimer’s background as a leftest and Communist sympathizer (which prompted the director to insert a couple of Oppenheimer’s intimate encounters, including one truly ridiculous clip when the physicist is suddenly shown in naked coitus with another women ([thanks to the supposed imagination of his wife]) as he is sitting at a table being interrogated about his political past by a partisan committee. Go figure!  3) the power politics of that time, with various characters struggling for position. One might possibly include here the philosophical and moral implications of devising nuclear weapons capable of destroying hordes of human lives.
 
Each of these story lines is chopped up and scattered through the three-hour film. The part dealing with the bomb’s development was for the most part handled well, but someone not familiar with particle physics, or some of the scientists portrayed, such as Niels Bohr, Werner Heisenberg, and Edward Teller, probably would have trouble following some of the developments clearly. My main objection to this part of the film was the frequent screening of nothing but wavy lines and speeding particles, these accompanied by intensifying noises, but not advancing the story one jot. Perhaps the director thought jaws would drop in awe at the colorful whoopdeedo. Mine didn’t, but I grimaced after the second, third, and following arrivals of the increasingly benumbing  light show.
 
Wrap up
The thread of the second story line was handled, I thought, reasonably well, but the third one was overly long. Poor Oppenheimer was grilled by the malevolent committee for what seemed hours. This after the point was made clearly within a couple of minutes! Why numb the mind while making a simple point?
 
That’s it. One man’s opinion.  Some critics loved it.  See here  and here. Final reminder: If you decide to see Oppenheimer, consider taking along ear plugs.
 
 

 

 

 

Should Artificial Intelligence be your Doctor? A Warning

Posted on by Ken Goetz

Should artificial intelligence be your doctor? A warning for you. As I’ve mentioned here recently, AI is an amazing animal. As a “Chatbot,” AI can respond like a human with seemingly infinite knowledge. But to me AI is something of a murky creature facing an undefined future. Despite its eloquence, AI, in its ChatGPT form, is not infrequently wrong (see here, and here). If you would like a more detailed analysis of ChatGPT’s potential errors, a summary can be found here.

Earlier this month (6 July 2023) the Journal of the American Medical Association published online a series of articles on the risks and potential benefits of AI in health care. Below is an excerpt from the opening of one of the JAMA articles (AI Chatbots, Health Privacy, and Challenges to HIPAA Compliance). The article is largely free of medspeak, and the first three paragraphs telegraph the major theme of the article.

From JAMA

 As health care becomes more expensive and difficult to access, people turn to websites and smartphone apps for medical advice. These resources increasingly feature artificial intelligence (AI)–powered chatbots such as Google’s Bard and OpenAI’s ChatGPT.

Chatbots rely on large language models (LLMs), which are the next generation of internet search products. These tools have rekindled enthusiasm for AI-powered health care. Chatbot answers to health care questions often compare favorably to those of other medical resources. Moreover, chatbots can save time by taking on repetitive tasks that contribute to clinician burnout. However, the technology can cause significant harm. Large language models make frequent mistakes, tend to reflect the biases of their training data, and can manipulate people. In one instance, a user reportedly died by suicide after the software urged him to harm himself.

We are only beginning to understand the risks, including how chatbots threaten privacy. This Viewpoint examines the privacy concerns raised by medical uses of LLMs. We conclude that chatbots cannot comply with the Health Insurance Portability and Accountability Act (HIPAA) in any meaningful way despite industry assurances. Even if they could, it would not matter because HIPAA is outdated and inadequate to address AI-related privacy concerns. Consequently, novel legal and ethical approaches are warranted, and patients and clinicians should use these products cautiously. (My emphasis)

Food for thought

Should Artificial Intelligence be your Doctor? The advice you receive may be erroneous, even dangerous. And your privacy may be compromised. I suggest you weigh the potential consequences carefully.

 

Two Odes to the Heart, by Artificial Intelligence

Posted on by Ken Goetz

Here are two odes to the heart written by that rapidly emerging poet (and soon to be anointed Poet Laureate of the World), Artificial Intelligence, or, as it prefers to be known by its common designation, AI. Each ode, AI might tell you modestly, was composed in a flash and printed out completely within a few seconds. As I posted here earlier, AI is mind-bending and thoroughly amazing, but at times astonishingly wrong (see here).

How did AI come to write the odes? I simply asked it by using ChatGPT on OpenAI.com (see here). Here is the exact prompt I gave ChatGPT to tell it what I wanted it to do:

Please write an ode to the heart, using rhyming poetry and praising this amazing organ for whatever factors you choose, but being sure to include its reliability, its muscular strength, it’s steadfast and rhythmic beating throughout an entire lifetime, and even include how it also functions as an endocrine gland. Please deal with these factors in whatever sequence you think is best. Perhaps you could end the poem with a stanza focusing on the heart’s popular association with love, composing that with a manner to make the reader smile.

And voila! An entire Ode to the Heart appeared on the monitor of my PC in an instant. I’ve pasted it below and added #1 to the title, because I greedily asked AI for a second ode. Please check out ode #1, and then I’ll comment on it.

 

Ode to the Heart #1

Oh, heart! O wondrous, beating core,
Reliable guardian at life’s door.
With strength of muscle pure and true,
Your rhythmic dance, a lifetime through.

From birth to dusk, you tirelessly beat,
A metronome of life’s vibrant feat.
Unyielding drum, a steadfast tune,
In sync with cycles, sun and moon.

A marvel that withstands the years,
Through joys and sorrows, hopes and fears,
Your faithful throb, an endless song,
A melody that keeps us strong.

Not just a pump, but more, you see,
An endocrine gland, or heart, you be!
You weave emotions into life’s art,
Releasing love, joy’s counterpart.

As hormones surge, enchanting dance,
In symphony, we find romance.
Your ventricles and chambers kind,
Unite two souls, true love to bind.

But let’s not forget, in every jest,
To treasure you, dear heart, with zest.
For though in love’s embrace you play,
You’re more than just emotions’ display.

Through valleys low and mountains tall,
You’re the anchor that keeps us all.
Reliable heart, so strong and true,
This ode to you, forever due.

And in this ode, we find our grace,
In beating hearts, we all embrace.
So let this twist bring forth a smile,
For hearts in live, go the extra mile.

Beyond romance and tender woo,
Our hearts unite, old and new.
From friendship’s bond to kinship’s art,
Love’s not just for a single heart.

For every heartbeat plays its part,
Together, love, we will impart.
In unison, let’s joyous be,
One heart, one love, eternally.

What do you think? For a poem written as fast as greased lightening, I think it’s not bad. Why did I ask ChatGPT to focus on the heart? Well, back in my working days I spent significant time investigating the heart, how its rate and strength of contraction are controlled, and, when Canadian scientists discovered somewhat surprisingly that the heart is also an endocrine organ, I studied what its hormone actually does. Despite what AI implies, when the heart’s hormone surges, it has nothing to do with romance. This hormone’s role is in regulating the circulatory system, not our reproductive system. That shouldn’t be a surprise.

So Ode #1 demonstrates one of AI’s glaring weaknesses. Although AI is unbelievably fast, and amazing in so many ways, it also can make colossal mistakes. Facts are not always one of its strong points. Still, if I were a poet, I think my knees would be shaking. Writers in general probably should be worried. I’m told that a novel written totally by AI was published recently.

As mentioned above, I went to the ChatGPT well again for a second dip, and just as fast came another Ode to the Heart. What do you think of this one? Again AI seems to “think,” if that’s the right word, that the heart’s hormone has a role in passion.

 

Ode to the Heart #2

Oh, wondrous heart, a marvel strong and true,
A rhythmic symphony, your beats construe,
Reliable and steadfast through the years,
A tireless guardian, allaying fears.

Within your chambers, muscular might,
You pump the crimson flow both day and night,
With every thump, a life’s journey sustains,
Enduring, unyielding, your love remains.

A marvel of design, with love entwined,
From birth to twilight years, a friend so kind,
In every pulse, a tale of life’s embrace,
A steady metronome, never to erase.

Oh, heart, you’re not just known for strength and grace,
A dual role you play, a hidden space,
An endocrine gland, you secret hormones share,
Emotions stirred, affection’s tender flare.

Through joy and sorrow, love’s enduring art,
You beat in time with every longing heart,
And when we find a love to call our own,
You flutter, dance, a rhythm all your own.

So, here’s to you, dear heart, for all you do,
For love, for strength, for life’s journey so true,
With every thump, you make us smile anew,
A symbol of love’s beat, forever and for you.

 

There you have it, a second ode to the heart, courtesy of AI. Does this one strike you as better than the first one above, or not? And now a more important question, I think. Can you imagine any danger that Artificial Intelligence might pose? Is it possible that this uncanny, and rapidly improving technique could be a danger? Is it possible that humans may lose their position on top of the food chain?

 

 

 

 

 

The Likely (and depressing) Biden-Trump Race

Posted on by Ken Goetz

Here’s an update on the likely (and depressing) Biden-Trump race. Prepare yourself. It’s not pretty.

The first primaries are just more than six months away, the first GOP debate is next month, and yet the only thing to be sure of is that clear and consistent majorities of Republicans, Democrats and independents don’t want the choice they’re likely to get, a race between Joe Biden and Donald Trump. So wrote Peggy Noonan in today’s weekend Wall Street Journal (July 8-9, 2023, see her article here).

As I indicated in my previous post, both men would do the country a huge favor by dropping out of the race (see that post here). In that essay I zeroed in on the contents inside their respective skulls, touching on Biden’s declining mind and Trump’s grating behavior when he was in office.

Biden’s mental acuity

I didn’t elaborate much beyond that, thinking it would be unkind to mention that Biden apparently wasn’t the sharpest knife in the drawer even when he was younger, for example when he was in law school. Although he once claimed he had graduated in the top half of his law school class, when he released his law school records, they revealed that he had graduated 76th in his class of 85 at Syracuse University College of Law.

And his years of decline are evident to practically everyone. As NBC News correspondent Jonathan Allen phrased it 2021: Age is catching up to Biden in the White House, adding his decline is alarming. He went on to highlight numerous instances of Biden’s gaffes and verbal slip-ups, incidents that have become even more common.

Trump’s erratic behavior

Nor did I elaborate on some of Trump’s more egregious behavior while he was our president, or after he left the office. Plenty has been said about his conduct. As The Guardian’s Richard Wolffe said in an op-ed a few years ago, It is important to recognize that Trump’s language is toxic, incendiary, and dangerous. It tears at the fabric of the republic.

Trump’s bizarre behavior has far-reaching effects, although he seems oblivious of them, or refuses to care about the consequences. Here’s how Peggy Noonan expressed the repercussions of his aggressive demeanor. His special superpower is that he is the only Republican who will unite and rally the Democratic base and drive independents away. He keeps the Biden coalition together.

Course of action?

So what might we concerned citizens do to derail the likely (and depressing) Biden-Trump race? What powers do we have? No matter which side of the political aisle we occupy, surely we can find better candidates than these two  ____________  (fill in the blank with the noun you think best describes them). If you are a party activist, or simply someone who thinks the person serving as our president should be alert, competent, and diplomatically tactful, express yourself.  Let’s demand someone better than our two (whatever you called them) who are bumbling along in the depressing Biden-Trump race.

Food for thought

Here’s a final tidbit from Peggy Noonan: If either party were daring and serious about history, it would shake off its front-runner and increase its chances of winning in 2024.