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Saturday, May 11, 2013

Weekend Potpourri

A psychiatrist recently opined in print that the increase in Attention Deficit Hyperactivity Disorder (ADHD) diagnosis is due to drug marketing. As more treatments are developed the pharmaceutical companies press prescription-writers to prescribe more treatment – with their own drug de jour, of course.

Don’t miss this critical diagnosis (ADHD) in your practice.” Physicians are well aware of the legal climate they face. Lawyers will try to punish them severely for diagnostic errors, thus, “well, it’s better to err on the side of caution, so let’s call Michael Junior ‘hyperactive’ and give him some drug X.”

We are looking at kids who exhibit: difficulty concentrating in (second grade) class, prefer activity over reading or study, and sometimes find it difficult to remain in their seats for an entire class. This is an example of the medical “experts” defining being human as a condition that can be treated. It sounds like a normal seven-year-old boy. It describes ADHD “symptoms” needed to support that diagnosis.

Whether its grief, inability to sit still in class, upset about losing a job, or some other normal human condition, the pharmaceutical industry has a treatment for it. And a price.

Back in the day

Maybe we need to go back to a farming, or to a hunter-gatherer existence. They didn't define living as a treatable condition back then. They didn't define protecting one’s family from predators (human or otherwise) as “a need to have terrorist weapons at home,” either.

Gaslighting from DC

And, speaking of “dangerous weapons.” Some of the reassurances coming from Washington D.C. and from Sacramento illustrate an influence technique called “gaslighting.”

According to Wikipedia, Gaslighting is a form of mental abuse in which false information is presented with the intent of making a victim doubt his or her own memory, perception, and sanity. The term originated in a play centered on turning the gas lighting down and denying that the house is darker. This made the spouse think she was going crazy as she saw the lighting change while her husband denied seeing any change. He “gaslighted” his wife.

Our State and National leaders assure us that any perception we have of ongoing abuse of power by politicians is just a figment of our imagination. It’s just that we are a little crazy. If we shoot guns for a hobby then we’re definitely insane and need help. (Presumably we need to be confined and treated or medicated with medicines that drive some patients to suicide or murder.)

Home-brew gaslighting

A form of gaslighting is used in Costa Mesa by naysayers as they point out how nefarious the Mayor or the Council majority is. After several have announced their opinions of the “dastardly three” it’s easy for a rational spectator to wonder. “If they’re all convinced of something that sounds so evil, well, maybe I’m missing something. Maybe I’m the crazy one.

Please be reassured; it is the speakers who are “confused, very confused.”  

Lose their credibility when they talk

When the speakers make unsubstantiated accusations and apply labels and assign hidden motives, they get attention. But when the naysayers return to the speakers’ lectern, as they certainly will, they seem less credible. They pay for their unsupported blathering with their credibility.

Statistics don't lie, but

Sometimes statistics can be excerpted to “prove” a point. For example, D.C. recently saw celebrities and serious-faced officials stating that “police favored gun registration.” Police should know, right?

In March an organization of police officers – rank and file officers – conducted one of the most comprehensive surveys of working police officers ever conducted. The result? Overwhelmingly the officers agreed that gun registration and gun control would have negligible effects on crime. The guns registered and controlled weren't involved in crime, for the most part. And the law-abiding gun owners weren't involved in crime.

The statistics cited by the celebrities and Senator Feinstein? A group of Chiefs of Police were meeting with federal officials to seek grants. They agreed with the “official position” in order to get money for their departments. Makes you feel are warm and protected, doesn't it?

If you see something what do you do?

Department of Homeland Security (DHS), the government organization buying up bullets by the billions and fully-automatic rifles in lots of hundreds of thousands wants you to know their slogan. “If you see something, say something.”

Considering the Kitty Genovese affair in New York, that seems like good advice. Considering the time lapse between calling police and getting help in many areas (15 minutes to 40 minutes), it might not be helpful advice. Perhaps it should be re-stated as, “If you see something, call and do something.”

That’s not to say try to perform like a cop when you are a civilian, not at all. But four or five people yelling at the rapist might have made a big difference for Ms. Genovese.

Raise minimum wage to . . .?

And, what should we expect when we raise the minimum wage? Better living conditions for workers?  Reduced poverty?

According to the US Bureau of Labor Statistics, 70% of minimum wages go to teenagers, college students, and secondary earners who are not from poor households. If the idea is to reduce poverty, it’s a weak effort. Only 30% of the increase goes to the poor, and a substantial number of jobs are lost as marginally-profitable companies give up and close.

Medical care rationing by cost-effectiveness

All current treatments for castration-resistant prostate cancer “exceed the generally accepted criteria for cost effectiveness," according to the American Urological Association.[1] That is, they are costly, and alternatives must be found. Do they work better or worse than each other? That isn't mentioned.

This isn't exactly care rationing by “death panels.” But it illustrates what that physicians group, and possibly others, thinks is important in planning care for a cancer victim. We’ll see more about the “cost effectiveness of medical care alternatives” in the future.

Coming soon 

Tomorrow, we’ll clean out the mailbox, and next week we’ll get back to Costa Mesa stuff, such as meetings of governmental bodies and the charter.

[1] Pollard M, et al "Cost-effectiveness analysis of the current treatment paradigm for metastatic castration-resistant prostate cancer" AUA 2013; Abstract 128.

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