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This one turned out so so great. The quilting was done by a local quilter and she did such a good job doing all of that free hand! It gives this simple pattern so much personality.
This quilt was a mixture of prints (I blogged about the quilt top here) and the back was pieced from a few large pieces I had leftover of the Good Life collection from Robert Kaufman. That fabric is the perfect shade of green.
I stuck this on my son's bed to see how it looks…and it fit! Well good enough anyways…it could probably use one more row at the bottom. Unfortunately it only got to sit there a minute before it was packed and shipped away…which is OK since little boys + white quilts don't mix and match so well.
Anyways…I love this quilt. But I love this quilt more:
Leave it up to the Fat Quarter Shop to make me want to start all over and make another one….dag nabbit.

subset: commoncrawl


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Norfolk, Connecticut Bed & Breakfasts - This lovingly restored, Gilded Age Victorian is a Norfolk tradition, owned and hosted by Dean and Jean Marie Johnson. Nestled in the scenic Litchfield Hills of Northwest Connecticut, is a short - 5 minute walk to Yale's Summer Chamber Music Festival.
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Westport, Connecticut Fishing Trips - Saltwater Fly Fishing & Light Tackle Fishing. Fish the Islands and coastline of Western, CT with one of the area's most experienced guides. Chase Stripers, Blues & more. Sailing from Westport,CT,(1 hour form NYC)fishing is only minutes from our dock.
Norwalk, Connecticut Sailing & Yacht Charters - We are a privately owned and operated yacht charter offering the most unique experience. We are Long Island Sound's Premier Private Yacht Charter. Our number one goal is customer satisfaction.
Dayville, Connecticut Horseback Riding - Come spend the day at the farm. Horseback riding offered for the whole family or any individual. We have horses for all ages and sizes. Riding is by appointment only so call today.
Westbrook, Connecticut Sailing & Yacht Charters - Offering sailing charters on the Sound in Connecticut. Hourly, sunset, pop the question cruises, lessons. Make some memories! Great for a special event or celebration or just to watch a unique sunset.
New London, Connecticut Scenic Cruises & Boat Tours - For over 40 years the schooner Mystic Whaler has guided 1,000's of travelers through the unspoiled waters and ports of Southern New England and the Chesapeake Bay. Come sailing with our experienced crew and enjoy the best windjammer vacations.
Westbrook, Connecticut Bed & Breakfasts - A rare find! This Sea Captain's manor, one block from the beach, radiates New England charm. Uniquely furnished guestrooms and simply elegant gathering rooms provide the perfect settings as travelers and friends have discovered for over 100 years
Branford, Connecticut Vacation Rentals - Halfway between New York and Boston this is a three season seaside cottage with private beach for a couple or small family one week minimum. Bask in the sun on the beach, or curl up with a book in th...
Niantic, Connecticut Bed & Breakfasts - Beautiful Waterfront B&B near Mystic. 16 rooms w/waterviews, private bath, a/c and cable tv, some with balcony & fireplace. Breakfast included. Kayaks & beach passes. Near Mystic, Casinos, wineries & more
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Do you need a relaxing getaway or a change of scenery? Plan a vacation to the scenic and historic Northeastern state of Connecticut. Swim in the Atlantic Ocean, see the natural wonders of the Appalachian Trail or head to the capitol city of Hartford. If you are looking for a beach vacation, Connecticut offers a variety of different shoreline options. You can tour the Thimble Islands on a cruise ship or go sailing in the Connecticut River. Be sure to check out Hammonasset Beach State Park, a great spot to spend the day or camp overnight. If you are planning a family vacation, plan to stop at Quassy Amusement Park, which offers fun for the whole family! Another great option is the Action Wildlife Foundation, where you can check out wild animals from all over the world.
There are tons of festivals, from floral exhibits to folk art, happening year round in Connecticut. Looking for a romantic excursion? Go hot air ballooning during the day and stay at a romantic bed and breakfast at night. Are you a golfer? Connecticut has several golf courses, including the beautiful, sprawling, public Lyman Orchards Golf Club in Middlefield. Sports fan? Check out a UCONN Huskies game or go skiing and snowboarding in the winter months at Mohawk Mountain. If you are looking for a more cultural experience, catch a Broadway show or go to the Wadsworth Atheneum Museum of Art in Hartford! Maybe you're a literary buff? Check out the Mark Twain house also located in Hartford, which is dedicated to preserving Twain's literary legacy.
Connecticut has something to offer all types of travelers. Let RealAdventures help you plan your next trip to Connecticut today!
Jeanine Kutil
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Secure a seat inside the sprawling MidFlorida Credit Union Amphitheatre and enjoy the breeze as some of the hottest artists come to town. Read through details regarding the venue as you prepare to see 5 Seconds of Summer on Saturday, September 12, 2015.
MidFlorida Credit Union Amphitheatre Seating Information
Reserved seating is completely under the awning, while the lawn is open to the elements without a roof. Sections 1-3 make up the front of the amphitheater, although the front sections are often turned into a general admission pit for some shows. Sections 4-7 are just behind the general admission pit, followed by sections 8-10 and VIP boxes. Sections 11-17 make up the back of the venue, followed by the general admission lawn.
MidFlorida Credit Union Amphitheatre General Information
Smoking will be permitted in the lawn and plaza areas, but not throughout the pavilion seating. No coolers, glass, metal, or soft drinks will be allowed into the MidFlorida Credit Union Amphitheatre, and all bags will be subject to a search before they can be admitted into the venue. Personal cameras will be admitted to the venue, but no flash photography, cameras with removable lenses, or video or audio recording will be allowed. All guests can bring a one gallon, clear plastic bag of food, as well as one sealed bottle of water per person. Chairs that are less than nine inches from the ground will be permitted for those with lawn seats, along with blankets, a one-gallon collapsible cooler, and tote umbrellas. If you choose not to bring your own lawn chair, the MidFlorida Credit Union Amphitheatre has chair rentals for a small fee. All shows will be held rain or shine.
MidFlorida Credit Union Amphitheatre Parking Information
Parking is located onsite at the MidFlorida Credit Union Amphitheatre, and the parking fee is included in the price of your 5 Seconds of Summer tickets. However, premier parking may be purchased for an additional cost. Tailgating is permitted in the lots.
MidFlorida Credit Union Amphitheatre Gate Times
The MidFlorida Credit Union Amphitheatre generally opens two hours before acts take the stage. The parking lot will also be open for tailgating in most cases, but guests are encouraged to check in advance of seeing 5 Seconds of Summer.
MidFlorida Credit Union Amphitheatre Accessibility
The MidFlorida Credit Union Amphitheatre does its best to accommodate those in need of special access. Accessible seating is available throughout the venue and you can check with the event staff for help with any questions or special accommodations prior to the event.
available, priced from $
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Implementing Buddha into an exterior decor is a desire for many seeking tranquility and relaxation in their garden space. If you are creating an outdoor space that you will use for meditation or relaxation purposes, a Buddhist garden is an excellent way to do so. But if you want to create a Buddhist garden, follow the tips from the experts, as there is a way to do a Buddhist garden the Buddhist way.
A large Buddha statue or the addition of the religious outdoor statues of your choice are standard elements if you desire to bring the religious and harmonious balance you seek into any outdoor decor. But this is not enough, you will want to use authentic Buddhist principles to accomplish this goal.
Elements of a Zen Buddhist garden include a quiet place for sitting, numerous paths for walking meditation, and a body of water such as outdoor garden water fountains or a running pond. A place for feeding birds, fish, and other animals is also conducive to respecting the harmony and balance in nature, a key principle in Zen Buddhism.
These are simple Buddhist principles that you can easily incorporate into any outdoor living space. When you add these basic elements, you combine the harmony and balance of nature with the inner peace you wish to seek.


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By BEN CARVER
My dad says that I wasnŌĆÖt noticing the massive amounts of litter all over town until I got elected.
He may be right.
Maybe it took getting into local office, for me to open my eyes and notice all of the trash littering our roadways in Starkville and Oktibbeha County.
It also became more noticeable after I spent a considerable amount of time last year in Maryland and Pennsylvania. You just donŌĆÖt see as much litter on the roadways in Northern states. I had some gentlemen explain to me that they heard we are called the ŌĆ£Dirty SouthŌĆØ because of this.
Maybe it took me looking for ways to improve our great city, and litter control can be one of the easiest ways to improve our appearance to visitors and to help increase our quality of life here in Starkville.
The aim of this short article is simply to raise awareness of the growing problem.
I dare you to open your eyes and start counting the pieces of trash that you pass to work each day.
Too often, people are seen throwing entire bags of food and paper products out of the window of their vehicle. This causes the trash to collect on the roadways, and our private and public mowing services to have to clean up after litterers.
Another major contributor is trash flying out of the back of pickup trucks. I drive a pickup truck myself, and I check the back of it daily and take any trash out of it the bed before I leave the house. If everyone would get their trash out of the back of their trucks, less would be on our roadways.
Also, I also challenge you to ride down Old West Point Road and look at the amounts of trash on the way to the County Dump.
Please contact your local county supervisor and urge them to work on getting Old West Point Road cleaned back up. They did not create this problem, but I believe that it needs to be cleaned up. Contractors and individuals that are hauling debris and trash to the dump should be required to tarp the contents of their trailers.
Like most situations, peopleŌĆÖs first reaction is for the government to come to everyoneŌĆÖs aid and help alleviate the problem; but, litter is the peopleŌĆÖs problem and is caused by the people.
I say it is time that we try to educate everyone in the town on keeping our appearances up.
Hopefully, your eyes will be opened and talks will begin to educate more people on not littering.
There is such an easy solution to an easy problem to fix: donŌĆÖt litter in the first place, and we wouldnŌĆÖt have to waste taxpayer dollars cleaning up roads in town and the county.
More importantly, our town and county will be more beautiful and pleasant to the eye.


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Moderators: Tonyblack, Jason, Toothy
Tonyblack wrote:I did get one that said as you bought Barack Obama's biography, you might enjoy Mitt Romney's one. There was a post script saying: "Please, please buy one! We have a warehouse full of them and no one will buy them even when we try and flog them at 32c!"*
*This last bit may not be true.
The one broke in the first week. Total waste of money, time and energy. These stools are not fit for purpose
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Super Katana Low Cut Collar
The Super Katana Low Cut Collar features our IPF Approved Super Collar. It's wider, heavier, cut lower, and tied into the sleeve base seams for greatly improved performance. The lower cut neck reduces likelihood of the shirt riding up and putting pressure on the neck while the increased width and thickness of the collar acts as an energy band to create more resistance and store more energy than regular Katana's. The Super Katana w/ Low Cut Collar comes in both arched (A/S) and flat (S/S) bench styles and is backed by an unmatched guarantee that's as tough as you are: 2 years on blowout plus an 18 month "No Run" Guarantee! We just don't look for the best powerlifting materials and support systems in the world, we create them! This shirt is for Elite Lifters ONLY!


text: I have a wireless keyboard/mouse combo with a small usb receiver. I know KVM's exist, but is there a simpler usb switch, that has one or more inputs and two outputs? I'm using a desktop PC, and at the same time trying out various linux distros on a little netbook beside me. I'd like to use my wireless keyboard/mouse receiver on both without switching usb ports every time.


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Here, in our terribly fabulous little world, you will find a gorgeous
collection of handmade or hand chosen gifts,
toys, creative kits, decor and accesories
from around the globe.
We are all about kids making and doing, rather than spectating. We want them off the couch, exploring and creating, questioning and building, pretending, playing and learning.
Thanks so much for visiting - we think you'll really love it here.
proud mama of 3 boys, shopaholic & director
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Our Entrepreneurs
Pamela Chavez
Impact metric77% growth in revenue since engagement
"I saw an opportunity to become a global supplier of biotech products."
- Country
- Chile
- Industry
- Prof. Services
- Employees
- 26
- Year selected
- 2010
- Website
Company Snapshot
Aguamarina offers laboratory services to local copper mines and it develops prototypes for environmentally-responsible products that increase the efficiency of copper extraction. Its goal is to be the leader in the development of biotechnological processes and services for large mines in Chile and abroad. With the copper industry representing 45% of Chile's exports, Aguamarina is situated in an exciting market and is led by Pamela Chavez-Crooker, an unconventional role model who is one of the few marine biology post doctorates in Chile.
Home to the largest known copper reserve in the world, Chile produces over a third of the world's annual copper output, which accounts for almost half of the country's exports. As Chilean miners push to increase production and take advantage of higher prices caused by fast-growing Chinese consumption, Dr. Pamela Chavez-Crooker is in a prime position. Pamela runs Aguamarina, a biotech research and development company that offers services for the mining and aquaculture industries. Based in Antofagasta, the largest city in northern Chile, Aguamarina offers laboratory services to local mines and develops prototypes for environmentally-responsible products that increase the efficiency of copper extraction.
Born and raised in Antofagasta, the center of Chile's mineral region, Pamela always knew she wanted to be a scientist. She studied Aquaculture Engineering at the University of Antofagasta. After graduating, Pamela undertook research projects and became an Associate Professor for the University. Later she accepted the prestigious Mombusho Scholarship from the Japanese Ministry of Education and received her Masters of Science in Aquatic Microbiology and Ph.D. in Molecular Marine Microbiology from the University of Kyoto, Japan. Shortly thereafter, Pamela completed her post-doc fellowship in Cell Physiology of Marine Invertebrates at the University of Hawaii, Manoa.
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Mask (Kavat)
Worn during spectacular night dances, this helmet mask represents a leaf spirit, one of the many bush spirits depicted by kavat bark-cloth masks.
The mask is formed by stretching bark cloth over a thin cane frame. The pigments that decorate these masks have general symbolic associations: red with masculinity, reminiscent of the flames through which the mask dances at night; black with femininity, the soot of cooking fires, and fertile earth; and white with the spirit world.
- Culture: Central Baining (Uramot or Kairak Subgroup)
- Medium: Bark cloth, pigment, cane
- Place Made: Gazelle Peninsula, East New Britain Province, Papua New Guinea
- Dates: late 19th or early 20th century
- Dimensions: 50 x 11 x 29 in. (127 x 27.9 x 73.7 cm) (show scale)
- Collections:Arts of the Pacific Islands
- Museum Location: This item is not on view
- Accession Number: 1994.142
- Credit Line: Gift of Thomas and Katherine Brush
- Rights Statement: Creative Commons-BY
- Caption: Central Baining (Uramot or Kairak Subgroup). Mask (Kavat), late 19th or early 20th century. Bark cloth, pigment, cane, 50 x 11 x 29 in. (127 x 27.9 x 73.7 cm). Brooklyn Museum, Gift of Thomas and Katherine Brush, 1994.142. Creative Commons-BY
- Image:
- Catalogue Description: White, red, and black painted designs on bark cloth over a wooden frame. Circular opening in lower back of mask.
- Record Completeness: Best (83%)


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Agoraphobia Center - Atlanta, GA
Atlanta Psychiatrist Doctors for Agoraphobia
Type of Physician: Psychiatrist
What is a Psychiatrist?
A certification by the Board of Psychiatry & Neurology; practitioners are skilled in the prevention, diagnosis and treatment of mental, addictive and emotional disorders. He or she is trained to understand the biological, psychological and social components of illness and is qualified to order diagnostic laboratory tests and to prescribe medications, as well as to evaluate and treat psychological and interpersonal problems. The psychiatrist is also prepared to intervene with individuals and families who are coping with stress, crises, and other problems in living.
Specialty: Psychiatry
Common Name:
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Georgia Rehabilitation Outreach
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Institute For Higher Living
Peachtree Psychiatric Profssnls
William Jay Klopstock MD
Atlanta, Georgia
Considered a top business city and transportation hub, Atlanta is the world headquarters of The Coca-Cola Company, AT&T Mobility, and Delta Air Lines. The surrounding area contains additional corporate headquarters, including Home Depot and UPS. Hartsfield-Jackson Atlanta International Airport, which is located seven miles south of downtown Atlanta, is the world's busiest airport and the only major airport to serve the city.
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- Arlen Meyers, MD, MBA
- Aurora, CO
- United States
This conversation is closed.
Are the ethics of healthcare compatable with the ethics of business?
Healthcare providers need to be profitable to serve patients. But, the interests of the patient are primary over the interest of profits. Are the two co-exist?
Is physician entrepreneurship a contradiction in terms?
Jan 22 2014: i'm not aware of different ethics for different fields. i think ethics is ethics, let it be business, healthcare, friendship, father and son relationship, whatever.
Jan 22 2014: Would be the way to practice some peace in our mad society. We think in the same direction, Kriszian.
Thank you :)
However, people still need to agree upon some basic ethics that would be workable….
Jan 22 2014: surely in some cases, but we also don't have to in other cases. we need to agree on how to use a river, many people affected. we don't have to agree on what i eat, it is my decision.
but certainly, it is time for us to discuss what is ethical. and to get to somewhere, i suggest dropping such silly notions that "business ethics vs healthcare ethics". we need to focus on the individual. deciding questions like "what level of inflation is the best" is next to impossible to do. we always have to go down to the individual, and judge actions. if an action, in itself, is ethical, or acceptable, we should not condemn it because it goes against some high level principles. if principles disallow otherwise commonsensically ethical behavior, the principle is defective, and should be discarded. we are bad at judging principles. we are good at judging individual actions. (okay, maybe not good, but better.)
i kinda like this talk: http://new.ted.com/talks/barry_schwartz_using_our_practical_wisdom
Jan 23 2014: You've said it - "we need to focus on the individual."
It's a very forgotten approach/thinking - in our "robotic" society of industrial games. I just published my long post. Please read it and let me know what you think, if you have a few minutes.Jan 22 2014: Do patients have any ethical responsibility to optimize scarce healthcare resources in any of this? Or, are they just lemmings being led to slaughter by greedy capitalists and physician entrepreneurs who take advantage of unknowing prey?
Feb 4 2014: Hi Dr. Meyers,
Thank you for your insightful, timely, and highly relevant questions. These are the questions I'm asking myself as a patient or consumer of healthcare. Most of the time, I feel just like a lemming as you mentioned.
What can we do about this?
Feb 11 2014: Stay healthy!Feb 9 2014: Arlen, We are talking about a salad which is comprised of apples and oranges. First the apples: The Hippocratic Oath binds the doctor to provide care to the best of his ability swearing to medical honesty. The oranges: The cost of doing business. The realities are that medical practice is very expensive ... in terms of education, facilities, equipment, personnel, insurance, and all of the other "costs".
So as the salad cannot be made with out each of the two ingredients nor can the physician serve his patients without the necessities of "doing business".
Laws passed that says a hospital must treat all who request services have cost the medical profession dearly. As the federal government has refused to protect our boarders the illegals have found that they can go to emergency rooms and get treatment with no means or cares about payment ... this means that there are approximately 11 million who can get "free" care. The private practice also has dead files that must be absorbed ... insurance companies deny claims or seriously reduce the payment for treatment ... Now there is Obamacare which has the force of law to question and deny medical opinions. Oops, I forgot it is a TAX that can question medical opinion. ACA can also set payment limits which would further reduce the income of the doctor. All of this to obtain a goal that both Hillary and Obama proclaimed ... sole source providers. Socialism in action. Worked so well in all of the other third world countries why not do it here .... As Nancy Polosi stated ... First lets pass it and then examine it .... That happened and in the light of day the problems are glaring and damning.
I looked up ethics: ethics, also called moral philosophy, the discipline concerned with what is morally good and bad, right and wrong. ... A person is either ethical or not .... by having two professions or ten the answer remains the same ... good or bad .. right or wrong.
I wish you well.
Feb 9 2014: Illegal immigrants represent about 2 % of ER visits
Feb 9 2014: I just did a quick search and cannot find anything which substantiates your statement that 2% of ER visits are illegal immigrants Arlen. Could you please provide a link to where you got that information? ThanksFeb 9 2014: Out of the 2000 characters I wrote you only heard about illegal immigrates ....
Sorry to have wasted your time .... Bob.Feb 9 2014: We should be celebrating physician entrepreneurship. I don't mean price gouging or ripping off patients. I mean adding patient defined value through the deployment of innovation.
We need to eliminate the unintended barriers and give patients the tools they need to be better patient customers...transparent outcomes and prices, an incentive to spend carefully, better ways to partner and communicate with care teams, etc.
Medicine is no lonter a doctor taking care of a patient. It's a care team taking care of a patient's team or community.
Feb 9 2014: I wholeheartedly agree Arlen, that the practice of medicine can be a "team" endeavor. I consider the medical professionals involved with my health care as a team, and I am the captain of the team.
In order to be on a team, we each have to do our part. We can "give patients the tools they need....", and if a person does not know how to use those tools, they are the same as they are without the tools. In order to communicate with care teams, a person needs to have information about their own body/mind functions, and that seems like something some folks don't want to explore.
Linda Waters
Jan 18 2014: We've had the experience of choosing between not-for-profit (which I believe is total BS) and non-profit hospice care for a family member. There is a myth that capitalism improves everything. We saw how the not-for-profit sparingly doled out services. For what? Presumably to preserve the salaries of the providers not to preserve resources for the community. If we can, we'll choose a non-profit hospice every time. To me, there is something immoral about profiting from dying. (PS - I believe the same for funerals so I am glad my family member chose cremation.) To me, the problem lies with sustainability. The high salaries of hospital administrators, health care insurance administrators, equipment manufacturers, etc. cannot be sustained. There is no real competition. Its more like a cartel between providers.
- +4
Feb 7 2014: Ethics is a wrong concept in healthcare. If we have to spend million dollar to save a baby that will need life time of care? What will be ethical choice? To let baby die?
- +3
We need to set a parameter on what society can afford and what individual can afford. Business is there to bring innovation and efficiency to the table and then have clarity on their operation and charges. If they are unfair they will go our of business. It will be value judgment call on the part of society.
Society need to be trained so that at some point "NO" is acceptable even if it means death. There are competing choices on efficient spending of resources
Feb 7 2014: This has already been addressed by the 4 pillars of ethics: autonomy; beneficence; non-maleficence; and social justice.
Justice is the pillar that ensures the extent to which resources are utilised are in keeping with the ability of society to sustainably and easily repeat the exercise without burdening the system on the whole. The scenario you describe is only possible in a private healthcare system where individual resources of parents can 'command' the system to unethical depths.
Feb 7 2014: Sumesh:
Thank you.
My impression is that it happens with Government support at child birth and end of the life in Medicare all the time. I am not sure what will happen in Obama care. Issue is unresolved. 20 % of hospitalization consumes 80 % of resources. Society has not resolved when death is acceptable.May be I am wrong.
Feb 7 2014: I'm not sure where you get the 20% 80% relationship from, but I don't agree with it.
Medicine has resolved when death is acceptable. The details are available if you search for EOL care and protocols (end of life care). Futility is a specific and defined term and specific criteria must be met.
The field of medicine is quite clear on many issues that society claims it needs clarity on.
Sadly it is commerce that comes in and creates confusion by inciting greed and inequality.Feb 3 2014: "The etymology of 'business' stems from the state of being busy, and implies commercially viable and profitable work." Wikipedia
Heathcare is one form of business. In fact, it is one of the most profitable businesses. People who work for clinics and hospitals, i.e. healthcare admininstrators, doctors, nurses, and medical technicians are some of the best compensated workers and their positions are some of the most stable. People get sick and need healthcare all the time. Healthcare business is not seasonal, unlike some other types of businesses.
Ethics, good business practices, and good customer service are expected regardless of the type of service or business. These are even more critical in the business of healthcare, where some cases are a matter of life and death.
Good medicine and good business practices are compatible. To succeed in healthcare business, one has to practice good medicine and good customer service, including not gouging your patients just because you can.
MD and MBA should not be contradiction in terms.
Feb 6 2014: And how do you achieve that when the human is a biological creature driven not only by compassion and altruism but also by instinctive physical desires, emotion, lust, anger, greed etc.
Sadly we will never be rid of these qualities and they will always invade the 'busy' venues we interact in.
This is alright when life is upheld, but when you could lose your life, or suffer interminably then I refuse to accept your syllogistic simplification of medicine. Medicine was a field DEVELOPED by compassionate and altruistic minds to actively perform the duty of helping our fellow humans without discriminating between economic classes.
It Transcends all other form of commercial activity to allow itself the stature of being business that is not the slave of commerce.
It is ok for a trader to refuse you processed food since it is possible for you to grow your own. Therefore payment for staple food may be contentiously regarded as acceptable. But if you are in severe pain, or you have been knocked by a bus and cannot breathe, then to insist on payment first is beyond inhuman.Feb 7 2014: I agree Rodrigo, that health care is a business, and like all businesses, it depends on how it is managed. So I agree that good medicine and good business practices are compatible
You say...
"Ethics, good business practices, and good customer service are expected regardless of the type of service or business. These are even more critical in the business of healthcare, where some cases are a matter of life and death."
If the business part of health care is not managed well, it often contributes to compromising the health of the customer. If the "managers" of health care are simply looking at the bottom line and profit, they may not be aware that the profits may be at the cost of the care they are providing.
We had a good example of this locally years ago with the big teaching medical facility in the area. It was once on the top ten in the country for good care. The board of directors were apparently looking primarily at the bottom line profit. They decided to redecorate the lobby, at the cost of a couple million dollars, and at the same time, they were decreasing the nursing staff by about 300 nurses. A lot of people, including myself were appalled at this, and it certainly was not the only poor decision the directors made, but it was a very public one.
I had a relative and friends who were patients in the facility at the time, and it was VERY clear that there was a shortage of nurses, as the construction for the new lobby was happening. As I said, there were a lot of other very poor decisions, and finally, there was so much public outcry, most of the members of the board of directors were terminated. There was a legal matter with the chair of the board as well, regarding money he accepted from contractors.
On the other side, my doctor and her husband have a small practice in a small town and don't make a lot of money, while providing health care to a small community. I would say that an organization like doctors without borders is in this category as well.
Feb 7 2014: Thanks for your insightful testimony, Colleen. We need a peaceful revolution or, at least, constructive evolution in healthcare, education, and public administration.Jan 24 2014: Business and healthcare have compatible ethics only to the extent that there exists a positive correlation between healthy workers and profitable businesses.Feb 17 2014: i disagree with the first sentence: healthcare providers do not need to be profitable to serve patients. They only need to make payroll and cover expenses.
Medical care should not be a profit focused activity. It is unethical to make a profit off of sick and dying people. People who do this are vultures not doctors.
It seems to me the biggest problem is that insurance creates huge pools of money which allows healthcare providers to charge extremely high prices. Prices are completely out of control.
The only solution is to eliminate the huge pool of money, i.e. get rid of insurance plans and go to cash based payments only. That would limit usage and lower prices.
However under the new ACA more people are required to have it.
This will cause prices increase since more money will be available.
I'm in favor of private physician practice and for eliminating the AMA which controls the number of physicians thus keeping salaries extremely high.
One problem in the U.S. is the wolves are in charge of guarding the sheep.
Lamb Lamb
Feb 9 2014: Thanks:
- +1
1. All professional people were on time for you!
2. sharing your Story.
3. It is very nice to meet you at the TED conversation".
Best Wishes for You, every day that will be peaceful and content. Colleen.
Feb 9 2014: Thank you very much Lamb Lamb......I appreciate you and wish you every day peace and contentment:>)
John Walker
Feb 9 2014: Until the medical and health professions (and any parasitic "hangers-on" including politicians and regulators) have a profitable incentive to provide wellness and disease prevention services, they will keep on being motivated to have the patient return for more sales. Where is the incentive to teach "self-responsibility" to keep the patient away from the doctor?
- +1
Business schools teach that an existing customer is more profitable than finding a new one. So in the sickness industry (not health), it is better to have a sick customer remain a sick customer and return for regular checkups and prescriptions. There is no incentive for anyone who makes a living from the diseased and sick to do themselves out of a job. The system that bows to the power of the big players is the reason why the medical system itself is now the largest killer, and the various "wars" (eg "war against cancer") will continue to be a farce. The World Economic Forum in 2011 stated that most western health systems will be bankrupt by 2030. They also stated that most non-communicable diseases are lifestyle related (nutrition, exercise, etc).
Until there is a change of consciousness and a leveling of the playing field so that we start to focus on lifestyle wellness factors (including funding scientific research into these areas), the problem will continue to grow. You do not need to go back far in history to find examples of how some people kept healthy without pharmaceutical or medical interventions. Our biological systems genetically evolved from hunter-gatherers. They have not had time to adapt to the onslaught of toxins from excess consumption, modern food systems, industrial chemicals and pharmaceutical drugs.
There are some parts of the world where natural plant medicines and alternative practices exist and are used in parallel with modern medicine (eg plant medicines from the Amazon, dry fasting in Russia, nutrition).
Feb 9 2014: Good points John....."self-responsibility"! I agree that there is not much incentive to learn better ways of taking care of ourselves, when drugs are readily available to "fix" our discomfort!
I agree that a change of consciousness is needed with individuals and health care providers, and the challenge seems to be to encourage folks to be aware of the mind/body connections, how they work, and how we can keep ourselves more healthy. I strongly agree with you that it is good practice to use all available resources, and that requires KNOWING and LEARNING about all available resources and how they work with our body/mind.
Henry Neu
Feb 6 2014: Doctors are people like you and I. Not saints. The organizations they work with are run by people. Not saints. Their reputations are determined by the experience of the local people not bureaucrats in Washington. With private health care you can choose to tell all of your friends of this organization`s shortcomings and never go there again You can seek legal redress for any wrongs against you through the courts. These options would be lost for you under government health plans..
- +1
Feb 6 2014: would be? they are already lost.Jan 25 2014: This question asks about ethics and not morals, and while they are both concerned with right vs wrong, ethics relate to formal rules provided by an official body of people, whereas morals refer to an individual's beliefs. In responding to this question, I think we should be clear as to whether we are thinking about morals or ethics.
When hospitals dump its poor patients onto the streets early to save money (see http://www.alternet.org/news-amp-politics/ca-sues-nv-dumping-mental-patients and also http://www.latimes.com/local/lanow/la-me-ln-patient-dumping-skid-row-20140103,0,7977084.story), that clearly shows the incompatibility between healthcare and business ethics.
The Hippocratic oath is one of the first and most famous formalizations of healthcare ethics. It says very clearly, "Do no harm." It says that unconditionally. Not "Do no harm if you can help it." If you're dumping patients on the street, you are doing harm.
Sidetrack: I just read one translation of the original Hippocratic oath - fascinating! Here's the first paragraph - wow, how far is this from reality today?!
"To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art — if they desire to learn it — without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else."
[From "The Hippocratic Oath" by Ludwig Edelstein]Jan 23 2014: At least most businesses know when they are pricing themselves out of the market. Almost everyone is already saying that healthcare is going to bankrupt America, yet, it seems no one from the industry is listening. Health insurance and healthcare costs have been out of control for a long time now. Insurance is intended to make people feel secure in the event of serious or long-term illness but, instead, it has put a lot of us to bankuptcy and misery. These days, it seems ethics and healthcare have become contradiction in terms.
Hello, is there anyone listening ... someone who truly cares?
Jan 23 2014: Here is a hope when a few intelligent individuals are already changing their OWN routine in practicing - independently from the systems.
Krisztián Pintér shows this link - it's very encouraging
http://www.youtube.com/watch?v=L9s6l9srzDUJan 23 2014: Our healthcare systems appear as grotesque and ugly as any social circus may ultimately become.
Presently some goodhearted teachers and doctors cannot change existing systems because they are already insiders, Servants, and must obey their mindless, controversial rules.
We are missing basic ETHICS in all schools as well, demonstrating unethical methods in teaching. Schools are Taming students to think as conventional units to get them prepared to serve large systems, industries, institutions and dogmatic religious institutions. This popular sort of "education" commonly create natural resistance among some young students, especially most talented. Some of the students might become dangerously desperate, fighting agains the systems later on .
Unfortunately they have no idea that there are some wiser, more peaceful ways.
I must say that All Large Systems/industries, and everyone who serves them, as well as many of us, who are involved as victims are already Unethical in every way, even towards our own selves.
My goal in writing this very post is to suggest how we might change this nightmarish industrial "culture".
I'd like to engage someone in this thinking.
Well, perhaps it would be impossible to change or fight against gigantic systems - this might be costly, time-consuming and even bloody. I honestly do not see any need to do so!!
My main thought - we have to invent and practice new Independent Small Systems which would be purposely designed to serve real individuals with their individual needs. It would be a more natural approach, beneficial economically, educationally and health-wise.
These small systems can be designed after the idea of a Sustainable innovative community, for instance, we can build them as small enchanting villages, with gardens, a small bakery, restaurant, library and perhaps a club/theater. Can a school or a hospital be built after an enchanting resort, while offering meaningful New jobs and traditions?
Jan 23 2014: quick response, maybe more later: http://www.youtube.com/watch?v=L9s6l9srzDU
Jan 23 2014: Thank you for showing the link - this doctor is a peaceful revolutionary - great beginning! She was born with wonderful intuition, kindness and sense of ethics.
Carl Dalton
Jan 23 2014: Hi Vera
- +1
Regarding: "There are no truly thoughtful ethics possible until Both sides are ethical."
Can't say I agree, as I have always maintained my own ethics, regardless of others determination to sidetrack them.
As to "Never treat others as you would like to be treated yourself - unless they agree to it first - because what "works" for you may be damaging for others"
I could not agree more; and as to the Golden rule of ethics, I have always felt that perhaps it should have been stated differently, which now given "your version", would seem to work well together
"Do for others, that which you would want them to do for you"
"Never treat others as you would like to be treated yourself - unless they agree to it first - because what "works" for you may be damaging for others"
However my own feeling has always been; "Do not do unto others, that which you would not have them do unto you".
And it follows; "If others undeservedly do unto you, that which you have not, and would not do unto them, it is not acceptable behaviour.
Cheers Carl
Tobias Blech
Jan 22 2014: Hi Vera,
- +1
the ethics of those 2 fields were only compatible in historical China where doctors were assigned certain areas and they got paid for those people that were not (!!!) ill.
In modern systems a healthy person does not bring any income. Successful practitioners thereby would become at one point bankrupt and that has to be avoided by any means.
Like a friend of mine in Copenhagen had a business selling herbs (Urte was his surname which actually means 'herb' in Danish). One day we got told that he went on a 'trip' and left while his shop got sold by a lawyer. I have never seen him again. Though this doesn't proof anything, one gets into thoughts about it especially if one hears similar stories from other friends.
Jan 23 2014: This is a very ill-some "healthcare" situation in which we are all involved, more or less. Here, in the USA, that "healthcare" system and its pretentious "humane philosophy" appears as grotesque and ugly as any social circus may ultimately become.
Why do Medical institutions and their doctors honestly Love to keep their patients ALIVE, and its is important for them to look so "helpful and humane" to their patients ? They do this for the wrong, unethical, reason.
You have answered this painful question boldly - if patients are gone, die too soon, or get really well , it'll be no work, and no income for those healthcare systems.
Therefore, medications/procedures do Not Help us Get really Well - the main purpose is simple - to Keep us Alive as long as possible, absolutely addicted to pricy medications. While we live in misery and pain, we are not getting much of a clarity - we feed a bunch of systems simply by staying Sick!
Thank you, Tobias.
Tobias Blech
Jan 23 2014: Hi Vera,
- +1
here in Germany it's not different. Doctors are helpful. But what they are doing is patchwork and this has to be recognized. They are very good at patching somebody up, but they don't handle the cause of it. This is needed if somebody e.g. has a car accident or something like it so he doesn't die before the cause can be handled. But then they also prevent the cause to be handled.
I forgot to mention in my earlier post that this friend had managed to cure a case of Aids and couldn't keep his mouth shut. Though he insisted on his 'treatment' not to know what his customer's problem is. He only recognized on symptoms what the body is missing and sold that to the person. But then this customer came back and told her success, that she through all medicine from the doctors away and only took what he gave her.
There are few people that still belief after all these years and money spent 'on research' that cancer is not curable, but Aids is still hot business.
Jan 23 2014: Tobias, Very grateful for sharing with your your stories.Jan 22 2014: There are no truly thoughtful ethics possible until Both sides are ethical.
In this respect I'd like to suggest to Replace the Old Golden Rule with this New one
"Never treat others as you would like to be treated yourself - unless they agree to it first - because what "works" for you may be damaging for others"
Mike Colera
Jan 20 2014: I don't think so, I am not a doctor, but I have come to know a few. So a doctor to practice medicine as an individual has to have help to provide those services... Clerks, nurses, others, there are offices spaces, equipment and supplies, utility expenses, insurances, school loans, taxes... the list goes on. So, the doctor needs to know what his costs are to provide services and therefore his charges to patients to meet those costs. Then he has to be in some sort of price range with other doctors. This same process is as it is with all business.
- +1
There is no question of ethics.
If a doctor or any business man fails to give service for value received, he will soon be out of business.Jan 19 2014: Here in Europe health is considered so important that the goverment of most countries are responsible of taking care of all their citizens, not only of those who are wealthy.
Heath is not a business and never will be. Is a human condition previous to the economy.
So YES: medical entrepreneurship is a nonsense.
Jan 19 2014: That has been my experiance as well. We moved from Holland to Canada and seeing the difference, I call it the medical industry.
In my opinion it is only the government that can set and maintain/enforce the rules.
Most European governments are socialistic, which means people come first and have to be protected against companies. I don't know about other countries, but in Holland there are hardly any unions and practically never any strikes.
Well, i'm talking about the situation of 30 years ago..Jan 18 2014: Without the funding from business and tax payers, health care would be hard to have at all, because it is very costly to preform the treatment that is needed, and it require that you have at least some profit. It would be amazing, if money wasn't the thing that runs everything, and it would create less conflict through out the world, but as it is greed is the root of everything in this world, and if money was were not the root of it something else would be.
David Levine
Jan 18 2014: Physician entrepreneurship by itself is not a bad thing. Abuse of it is such as physicians over utilizing their own labs, diagnostics, etc,. If a physician group owns a hospital who cares if they make the profit versus a big company?
- +1
The big companies are really the issue - the boards and investors of these companies make far more than the physicians.
Here is the financial statement from HCA
I would bet their BOD (all 20 plus) are all millionaires. VERY FEW of the physicians I work with are, even after 20 years of practice.Jan 18 2014: Excellent Topic. I look forward to the thoughts that will out. I suspect we may find our demons are very much alive and well and wish us well as we proceed with the business of evolving.
What I currently think is that we would like to live in a world where ideals reign supreme, but frontal lobe thinking is so very energy consuming that once we stop 'envisaging' and resume 'living', we suddenly feel these primitive competitive, survival urges taking control of our billing software, management strategies, course attendances, and perk-related medical purchasing patterns.
Every now and then Professor Frontal Lobe gets a little jolt from a good night's rest and resolves to mend his wicked ways, but watching cognitively challenged bling-decorated unreconstructed homo sapiens drive past you in wickedly expensive sports cars somehow results in an instant frontal lobotomy and .... kerrchinggg!
Financially, we currently require far less as a profession than we generally earn. I feel it is only natural to see oneself as a human being first and behave as nature intended. To do this unrepentantly requires us to extend the same courtesy to everyone else. This is not a good recipe for the maintenance and growth of a civilised society. The problem is it needs to be addressed in all professions at all levels, and I understand, despite taking exception to, societies vilification of doctors.
It is imperative we push ahead the humane agenda, insisting on fair and equitable healthcare sans the standard supermarket business model. But we must not just engage in the increasing practice of humane and fair healthcare delivery, but also actively protest at other sectors that fly under the radar yet remain sickeningly unethical due to the focus being on doctors.
I refer to hospital and managed healthcare business-persons, politicians, pharmaceutical companies, subscription journals, academic researchers, etc.Feb 17 2014: Quite simply cutting to the chase
Is it wrong or right, to profiteer off the sick and dying, yes or no
And putting aside all excuses and academic arguments, that is a matter of conscience; which quite clearly as the massive profits of the health Corporations serve to define, they do not possessFeb 17 2014: The ethics of human being always are differs from human to human which means human ethics in health care or in business will be changed from one to another this will lead the concept of "Health Care For Patients" or "Business Of Health Care" are carried by human "Doctors, Nurses, ... and so on" will not be compatible in every and each case, so we are going to something like "Standards" to try to measure "The Ethics" scale between the business and the service.Feb 17 2014: /
Physician entrepreneurship is a contradiction of ethics orientations, not terms. Fairness or ethics for each has a different center of gravity even though ethics for each is basically the same thing: ethics, seeking to do the good, is about doing no harm and finding a healthy thriving outcome for patients for physicians, and at the same time in business it is doing the prime good of growing your business, profit margin, market share without unfairly disallowing others to be financially successful as well. A good business person does no harm as part of being a good person but that directive does not take center stage as a constant center of focus. If the patient is under my knife I am likely to be acutely aware of every choice in the light of possible harm. If I am removed from the patient, as a pharmaceutical business person, I may see opportunities to do good without seeing possible harm as clearly.
Profitability may accompany but does not correlate with nor cause quality of care.
good questionFeb 16 2014: Given current industry I don't think that there is an industry wide way to make this happen. Why is it that insurance companies get far different rates for medical services than someone with cash? I have seen multiple examples of people getting the short end of the stick when they are not covered while health insurance companies are getting price breaks all over the place. I understand the business aspect of this model and am intrigued by the cash flow but in an industry where compassion and humanity should be priority number one the profit margins seem to win out.Feb 11 2014: Larry alludes to the difficulty in making the hard decisions needed to reform healthcare, whether private vs. public or corporate vs. entrepreneur. Defining the terms clearly demonstrates the impractically of expecting morality to dominate decisions regarding the allocation of any scarce resource.
Our system's failure to keep costs competitive with other developed countries is the result of politically savvy 'haves' demanding Cadillac coverage even though it forced the cost of providing treatment for to large group of uninsured to spiral out of control. If we admit resources consumed must be more important than morality of allocation of service, tough rules must be agree upon ......... and enforced.Feb 11 2014: I simply do not favor ethics as defined in an association of healthcare and business. Business sense of what is right and wrong seem to change as a matter of convenience. The goals of healthcare and business do not run parallel but you got to have a business presence in healthcare. I would favor physician entrepreneurship on a sound foundation of integrity clearly defined.
eth·ic noun ˈe-thik
: rules of behavior based on ideas about what is morally good and bad
ethics : an area of study that deals with ideas about what is good and bad behavior : a branch of philosophy dealing with what is morally right or wrong: a belief that something is very important
Full Definition of ETHIC
1 plural but sing or plural in constr : the discipline dealing with what is good and bad and with moral duty and obligation
2a : a set of moral principles : a theory or system of moral values —often used in plural but singular or plural in construction
b plural but sing or plural in constr : the principles of conduct governing an individual or a group
c : a guiding philosophy
d : a consciousness of moral importance
3 plural : a set of moral issues or aspects (as rightness)
in·teg·ri·ty noun in-ˈte-grə-tē
: the quality of being honest and fair
: the state of being complete or whole
Full Definition of INTEGRITY
1: firm adherence to a code of especially moral or artistic values : incorruptibility
2: an unimpaired condition : soundness
3: the quality or state of being complete or undivided : completenessFeb 10 2014: Does any healthcare program around the world deny joint replacement based on age or obesity etc.?Feb 10 2014: Does any health care program limit the availability of artificial joints based on age?Feb 10 2014: Do countries offering 'socialized medicine' use the all too frequent 'wait' for availability of an expensive procedure to reduce the number of operations and thus total cost to the 'system'? This would seem a logical way to avoid the 'unethical' decision mentioned by Henry. This would be more difficult to rationalize when expensive drugs are 'available'.
Feb 10 2014: Wait times vary from system to system including the VAFeb 10 2014: The ethics of health care and the ethics of business have a considerable overlap. If a physician knows a patient can be returned to functionality by a very expensive procedure but also knows that there are thousands of others who also need this procedure and the money isn1 there what should he ethically do? Should he tell the patient "We could help you but we don`t have the money." or would that be unethical. The ethics of health providers is necessarily very cruel at times. The money necessary to help that patient might well be enough to send several young people to college.
Business ethics present a much less critical problem.Feb 10 2014: Thanks Colleen, I have come to the conclusion (at age 63) that there has been virtually nothing in my life in terms of illness or disease that couldn't have been mostly fixed with fasting, good nutrition and exercise. And that includes knowing that I have a genetic predisposition to obesity, heart disease, diabetes and inflammatory diseases like arthritis. I admit that I have not had any broken bones or been in a serious life-threatening accident. But even if I had, I now believe that regular fasting (especially dry fasting) - like a hunter gatherer would have naturally done - rather than normal medical treatment would have accelerated the recovery. For example, it has now been scientifically proven that fasting is very beneficial for head trauma. It probably would have been better to heal my knee that had a cartilage removal in 1970 (and then caused arthritis and lower back problems - partly because it was botched surgery). Dr Joel Fuhrman, a nutritional medicine doctor, cured a serious heal injury with fasting rather than surgery (an elite athlete - the injury put him in a wheel chair). Fasting also up-regulates autophagy (cellular self-digestion) which is a biological process that is dis-regulated in Alzheimer's and Parkinson's. It also lowers homocysteine, a chemical component associated with most neuronal diseases (including depression) and cardiovascular disease.
Given that such an approach is so beneficial, why hasn't there been more funded research done on it? You can say it is because there is no profits for external parties in self-responsibility. But taxpayers pay a very large slice of the national health bill, so a lot of those costs would be saved if we had more education, encouragement and incentive to heal ourselves. The weakness in the system, therefore, seems to be at the political and legislative level. Research funds should be made available to treatments that don't offer potential profits, but still offer cost savings.Feb 9 2014: "We can reduce cost of education and increase number of doctors and it will reduce the cost"
. How would increasing the number of doctors reduce the cost? Cost to each patient or cost to the system as a whole?Feb 9 2014: Patients vs Profit is not the issue.. Would you ask that question about Ball players, stock brokers, actors,drug makers?
It is not only expensive to be doctor but requires higher degree of drive, commitment and training period. It falls right into our economic value systems. Society has a opportunity to reduce medial cost. We can reduce cost of education and increase number of doctors and it will reduce the cost. We have efficiency and other structural problems that we can resolve to lower the unit cost. We can educate patients to use medical services judicially. We can increase child mortality and lower life span of older non productive people.
One of the greatest disappointment of ACA was failure to deal with cost and practice and other issue I indicated above. I want first grade steak at best restaurant at low price. Our economic system do not allow it. TO hype a issue for false diagnoses does nto advance solution.Feb 9 2014: Patient portals and digital health platforms will make your experience better and hopefully less costly. Physician entrepreneurs make it happen
Feb 9 2014: And according to your profile, you just happen to be the President and CEO of the Society of Physician Entrepreneurs. It looks like you are promoting that Arlen.
Physician Entrepreneurs facilitates bringing health care innovations to market, and it appears that you have misrepresented yourself and your intent Arlen, because you and your organization are more about business than health care.
Feb 10 2014: My intent in posting this question and moderating this discussion was to create a forum where we could discuss what I felt to be an important healthcare policy issue.
The organization I am proud to lead is about innovation and getting ideas to patients. As a practicing surgeon, I try to place the interests of patients above profits but struggle, like most,with how to deal with conflicting interests most doctors face.
Those that have taken the time to post and express their thoughts are free to judge whether I have misrepresented that intent or not.
Feb 10 2014: I think you have made your particular interests clear via your profile, as a professor of ENT and head and neck at the University of Colorado medical school, a practicing doctor, and an entrepreneur.
I notice the article Colleen has helpfully linked has a typo in a quote attributed to you. You may want to ask the site to make the correction. It says "no irreconcilable" when you surely said "not irreconcilable."Feb 9 2014: We;re getting off track discussing the amount of ER care for illegal immigrants (maybe another TED discussion?) but Emergency Medicaid is another complicating issue
http://www.kaiserhealthnews.org/stories/2013/february/13/medicaid-illegal-immigrant-emergency-care.aspxFeb 9 2014: http://cnsnews.com/news/article/while-there-are-about-12-million-illegal-aliens-us-today-cbo-estimates-senate-health
in 2009., about 10%
The number of illegals has dropped since then .
ONe reference is the American College of Emergency PhysiciansFeb 9 2014: Which people.? How would you hold the accountable?Feb 9 2014: Moral hazard refers to the tendency for people to take cost free risk , like using healthcare resources as long as they don't "have to pay " for itFeb 9 2014: Dr. Meyers,
I would like to bring to light a recent clash of healthcare advancement and capitalist interest that perfectly serves this conversation. As of December 2013 the FDA has approved Sofosbuvir for the treatment of Hepatitis C. The drug has been hailed as a 'landmark advancement in the treatment of Hepatitis C" by the CDC. Sofosbuvir will eliminate the virus entirely in 90% of patients treated with the drug according to clinical trial data. Currently 3.2 million people worldwide are afflicted with chronic Hep C. This drug represents a triumph in the business of healthcare research as Gilead Sciences incentivized by profit potential has come close to curing a major source of human suffering.
This major advancement, however, comes at a cost unbearable to all but the wealthy elite or third party payers who may or may not choose to cover it. The suggested price of this drug is around $1000 per tablet or $84,000 for the full 3 month treatment recommended. Pharma can choose to set prices on drugs however they see fit. We cannot simply call this an unethical businesses practice though without first considering that it costs an average of 1 billion dollars and 10 years R & D to bring a new drug to market through the FDA. Does the consumer mantra of "you get what you pay for" apply here or is big pharma majorly exploiting the ignorant masses? My personal contention is that business ethics and healthcare ethics are not compatible due to the fact that the human demand for healthy life and survival is insatiable and therefore gives too much power to the industry that supplies medical goods and services.Feb 9 2014: What is the best way to remove the moral hazard?


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Program, Musical
NCM Fathom brings the ultimate stage spectacle - The Met: Live in HD - to movie theatre screens nationwide. The broadcast of Verdi's opera Aida will be presented live for only one day on Saturday, October 24, 2009 at 1 PM ET / 10 AM PT in select movie theatres. Set in ancient Egypt, Aida is both a heartbreaking love story and an epic drama full of spectacular crowd scenes. A cast of powerful voices and a grand production bring the story to life on the Met stage and on the HD screen. Among the score's highlights is the celebrated Triumphal March.
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Cast: Roberto Alagna, Violeta Urmana, Carlo Guelfi, Olga Borodina, Roberto Scandiuzzi, Dolora Zajick, Johan Botha, Marco Berti, Hui He, Liudmyla Monastyrska
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Directed by: Daniele Gatti, Alexei Ratmansky, Fabio Luisi
Written by: Giuseppe Verdi, Antonio Ghislanzoni
Running time: 3hr 40min
Opens: Nov 23, 2012 Limited


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For first-year and transfer students.
Associate and bachelor's degree programs for men and women 4 full years out of high school.
Elementary, middle level and secondary certification for men and women with a bachelor's degree.
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Recent events at Pennsylvania State University (PSU) have caused uproar and public outcry. Assistant football coach of PSU, Jerry Sandusky, is accused of inappropriately contacting or sexually assaulting at least eight underage boys on university property.
In addition, several school officials were charged with perjury or dismissed for allegedly covering up Sandusky's crime and/or failing to report it to police. Among those dismissed was the popular head football coach, Joe Paterno. President of PSU, Graham Spanier, was forced to resign in the aftermath of the event.
There are many other reports of college institutions covering up wrongdoing and scandal to protect the college's reputation. This begs the question; if PSU was willing to hide internal corruption, would Wilson College do the same?
While inappropriate actions may not be visible to the student body, they are likely noticed by those surrounding the situation. It is the responsibility of all parties at a college to report misconduct to the proper authorities. Any information about such an event is inherently relevant to the student population. Students pay a great deal of money to attend the finest universities to obtain an education in a safe, reliable and reputable environment. If this transparency is compromised, students have the right to know what happened, how the matter is being handled and how to stay safe.
Speculation and rumors began surfacing on campus last spring semester that students were being sexually harassed by a professor. When the stories first circulated, many students were confused and awaiting an official report by school administration. However, a notice was never sent to students, but rumors and accusations persisted.
One student recalls, "One day we had to move our class to another room because our professor said that another professor was escorted off campus that day. There was a fear that they might return to campus out of anger. I didn't really know what was going on, but other students said that the professor was allegedly harassing other students. I hadn't heard about it until then. After that the more I talked with other students, I learned that numerous students were affected by his stalking tendencies. It freaked me out. But, I never heard anything official."
There is no evidence that administration is required to inform students about harassment cases. But, does that make it acceptable to not address such a situation? The Blue Book states, "The College will take steps to educate the college community, communicate and implement the institution's harassment policy." It is logical to believe that such extreme rumors would be addressed in some fashion or another, particularly pertaining to the safety of students.
The fact that administration had no comment on the allegations or dismissal does not make them false anymore than it makes them true. If the claims are false, then why did administration not deny them? It only seems fitting that administration follow the Honor Principle, which they stress heavily to students, and notify students regarding the validity of such accusations. Given that the circumstances may be false is not grounds to ignore the situation and leave the safety of students and faculty, and the college reputation at risk.
If a similar situation occurred in the future, how should administration respond? It seems obvious that they take the accusations very seriously and investigate it closely. Pending the results, administration should handle themselves accordingly and inform the student population about the event(s) once there is a resolution.
Conferences of the individual graduating classes or a larger communal conference could be an effective form of communication between administration and the student body. Such meetings can help maintain the transparency of the college.
In a mistrusting world, it is difficult to find a location that feels safe. Even a quiet campus like Wilson can be shaken by the hands of tragedy and scandal. To prevent events like those at PSU and the University of Illinois, there should be consistent, open and honest dialogue between students, faculty and staff. Addressing rumors that cause unease and speculation is a step towards a trusting and responsible community.
If you or somebody you know is being stalked or harassed on campus, contact the Dean of the Faculty, Mary Hendrickson, the Dean of Students, Carolyn Perkins or a trusted professor/faculty member as soon as possible.


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Oct 25, 2011Wretched Retro Recipes Edition 1
Yup. I am constantly reading and re-reading my cookbooks and this time decided to do so with a purpose: To find the grossest recipes from the 1940′s. I have found a few that are going to be really interesting! (Let me just say that Wal Mart is very happy that I am going through some of their plain gelatin!)
Today I am starting with a fairly simple one:
Oct 21, 2011Halloween Cherries and Intestines
I recently taught a cooking class on Halloween night meals. Usually we get pizza, to tell the truth, but we came up with some good, kid friendly, palate friendly foods!
Oct 19, 2011Back to the Future...Hot Pockets
I am diverging just a bit from our usually "Retro" business to give you a highly requested recipe for my healthier and much tastier version of Hot Pockets. These are great for the freezer and bake up quite well. Another reason that I posted this, is because I found a great way to thaw them…ready?…cast iron.
Yup. I said cast iron!!
Oct 13, 2011The Sherpa
The Sherpa
Really, I enjoy a cold plain cheese sandwich, cold pork and beans with an Oreo cookie chaser, when I'm out hunting (that was hunting lunch during my childhood).
However, because I can, I'd rather have a grilled Turkey and Swiss with a can of hot Clam Chowder. Enter the Sherpa…..
Oct 13, 2011Freezer Corn
Freezer Corn Day!
I have to say…. This is a first for me!
I am definitely still learning about canning and food storage, but as of late I have been trying to work on some of my food storage options (like for example actually having food storage). I love corn on the cob! It is one of the best summer foods, in my opinion.
My parents h
Oct 10, 2011Brownie Winner!!
Just as a reminder, here are the brownies again…
The one on the left was brownie #1 and on the right, brownie #2.


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BLUEWATER BAY — Twenty years after it opened to motorists, the Mid-Bay Bridge is one of the area's most vital and heavily-used corridors.
In two decades the 3.6-mile span has allowed millions of locals and tourists to travel over the Choctawhatchee Bay between Niceville and Destin. It has cut commute times, helped energize commerce on U.S. Highway 98 and withstood major hurricanes, fulfilling the role local leaders carved out for it in the earliest planning stages.
"The whole idea was hurricane evacuation," said retired Air Force Gen. Gordon Fornell, chairman of the Mid-Bay Bridge Authority. "We needed an alternate (route)."
The Bridge Authority was created by the state Legislature in 1986, and by 1992 Indiana-based Traylor Brothers engineering firm had begun construction. The $86 million bridge opened in June 1993.
"That's pretty good work in a short amount of time," said Jim Vest, executive director of the Bridge Authority.
Since then, the bridge has enhanced the economic development of Destin and points east, Vest said.
"The timing was right for Destin to boom, if you will," he said. "It was going to happen anyhow, and the Mid-Bay Bridge kind of connected everything right in the middle there."
Fornell said the bridge is the result of "a great deal of continual effort" by numerous community leaders.
"It's been a marvelous civic effort," he said.
County Commission Chairman Don Amunds said the bridge has improved public safety in Okaloosa County.
"It's helped us during emergency situations, whether it be tugboats and cranes hitting (Brooks Bridge) or whether it be hurricanes and getting people out of here," he said. "It's been a huge blessing."
The Mid-Bay Bridge also remains controversial. People still criticize its tolls, which have increased twice since the bridge opened.
Others say the bridge has improved commerce and traffic flow but puts too much of a strain on their budgets.
Katy Fields said she uses the bridge only in emergencies.
"I believe it has helped many people and is great for hurricane evacuations," she said. "If the price to cross were not so much, I too would use it more often."
Like many residents, Fields said she would like locals to get a discount.
"Locals could use some breathing room," she added. "The bridge is there to get as many tourists into Destin as possible. Let them pay elevated costs to get there."
In 1993, two-axle vehicles paid $2 to cross the bridge. That increased to $2.50 in 2004 and to $3 in 2010, according to the Bridge Authority's most recent annual report.
In 2012, 6.5 million vehicles used the bridge, generating about $15.7 million in toll revenue. An average of 17,877 vehicles crossed the span each day.
While 2012 saw a slight increase over the previous year, bridge traffic has dropped every year since 2006, when it peaked at an average of 20,897 vehicles a day and 7.6 million for the year.
The tolls are critical because they generate money to pay off the bridge's debt, Vest said.
"The bridge is not paid off," he said.
Vest said he understands the public's frustration with the tolls, but likened the bridge to a mortgaged home that's been refinanced multiple times for improvements.
"We've made major improvements," he said. "We still have $260 million worth of debt."
The bridge has had three toll booth expansions in its 20 years. The Bridge Authority also is building the Mid-Bay Bridge Connector, a limited-access highway to connect the north end of the bridge with State Road 85 just north of Niceville.
The final portion of the connector is expected to open in early 2014, according to the Bridge Authority's website.
"(The bridge) has been a big addition to the infrastructure for the whole county. … It was billed as the bridge to nowhere," Vest said. "That was proved wrong by as early as 2003."
Contact Daily News Staff Writer Kari C. Barlow at 850-315-4438 or firstname.lastname@example.com. Follow her on Twitter @KariBnwfdn.


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Men's Kimtah WP Mesh
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Additional Information
Spider 365™
One rubber, huge range of uses. Spider365 Rubber is the spork of our rubber arsenal.
T.I.D.E Seal™
The best way to make sure your feet dry quickly? Make sure they don't get wet in the first place. T.I.D.E Seal membranes will seal out the water (get it?) and keep you high and dry.
Shoc Pad™
You wouldn't ride a bike without a seat. The same logic applies for our Shoc Pad™ technology, which will give you a smooth ride without inhibiting your performance.
Mush® Infused Insole
Now we're not necessarily splicing Mush® genes back in the T.I.D.E Lab to build a hybrid mutant insole, but we do have an insole that's worthy of the Mush name.
- Our Spider365 Rubber sole will hold its grip in all kinds of environments.
- An aggressive lug design for grip on loose terrain.
- Our T.I.D.E. Seal waterproof membrane will keep your feet dry as you trek through water.
- Waterproof leather upper.
- Full grain leather lining.
- A soft Shoc Pad™ in the heel gives you serious shock absorption.
Weight: 15.9oz
Product Reviews
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- Comfortable (4)
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Reviewed by 6 customers
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- Breathes Well
- Comfortable
- Cushions Impact
- Durable
- Good Arch Support
- Stylish
- Versatile
Best Uses
- Work
Comments about Kimtah WP Mesh:
- Sizing:
- Feels true to size
- Width:
- Feels true to width
- Comfortable
- Cushions Impact
- Durable
- Stylish
- Versatile
Best Uses
- Casual Wear
- Going Out
- School
- Travel
- Wet Weather
- Work
Comments about Kimtah WP Mesh:
My last Teva hiking shoes lasted 10 years until I retired them for lawn care duty for 5 more years. These have the famous Teva Spider rubber that I am confident will last longer than the Goodyear tires on my Jeep. You can't beat the price considering these shoes will last years of everyday wear instead of months.
These are extremely comfortable with extra room for big toes. They are stylish enough to wear with jeans or khakis. They are perfect for everyday wear and for light hiking.
I just wish Teva would make work boots and work shoes with steel toes and steel shank.
- Sizing:
- Feels true to size
- Width:
- Feels true to width
- Comfortable
- Cushy In Sole
- Good Looking
- great gripping sole
Best Uses
- Casual dress shoe
- Stand All Day Shoes
Comments about Kimtah WP Mesh:
I have tender, soft feet. If a pair shoes doesn't fit right at the outset, the shoes go back to the store. Definitely not the case with these shoes. Did not have to break them in. Comfortable, flexible, warm and keep my feet dry during Colorado's winter.
Also they're good looking. Kind of monochromatic in color which what I like, so you can wear them with jeans or casual dress. They don't look like a hiking shoe.
Can't think of anything to say against these shoes. They are reasonably priced are exactly what I wanted to buy. I highly recommend them and Teva products in general.
- Was this a gift?:
- No
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- Kimtah WP Mesh
Q:Does the mesh on this shoe allow for breathability or is it cosmetic only?
I have the full leather Kimtah which I like but do not breath well.
Thanks,Asked on 10/2/2013 by Chad from Elkhart, IN
1 answer
A:The mesh is there to prevent the passage of most dust and debris. It will be more breathable material than the leather Kimtah.Answered on 10/3/2013 by Teva Product Specialist
Do you have questions about this product?Ask a Question


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The ECC provides therapeutic intervention for infants, toddlers and preschool age children with developmental delays and disabilities who have associated behavioral difficulties and young children presenting concerns primarily in their social emotional development. Young children referred to the ECC receive relationship-based developmental therapy, phychotherapy and/or behavioral interventions individually, in groups, and in dyadic sessions with their parents or caregivers.
Developmental and psychotherapeutic supports are provided to young children in foster care, and guidance is offered to foster parents and child welfare personnel to support children's progress and permanency. Parent groups enhance the guidance, support, information, and advocacy offered to all families. A specialized attachment-based group intervention programs is offered for infants and toddlers and their parents. Outreach projects provide developmental and psychotherapeutic supports for young children in other systems, including primary pediatric clinics and preschool programs.
An Infant Mental Health Program provides therapeutic services to infants with developmental and emotional/behavioral problems, and preventive services for infants who are at risk due to problems in their caregiving environments. All services are available in English and Spanish. In 2006, the ECC opened a new program, the Center for Infants, Toddlers and Families, to better serve its patient population. Located in the community around Einstein, the new Center was founded with support from the Robin Hood Foundation, the Women's Division of the Albert Einstein College of Medicine, and New York City.
ECC' s Infant-Parent Court Project was initiated in 2009 to address the specific needs of children under age 3 who are involved in the child welfare system. The Bronx-based Court Project works with parents and their young children who have been placed in foster care due to allegations of maltreatment. The intervention addresses the issues of trauma and attachment that are vital to improving parenting, securing permanency and preventing recurrence of maltreatment.For more information on the Court project >
An integral part of CERC, the Harold Diner Special Care Dentistry Center was founded in 1965 by Dr. Harold Diner. Today, the dental program provides comprehensive dental care to children and adults with developmental disabilities and a variety of chronic medical conditions. A highly skilled staff offers wide-ranging special care dental services which accommodate the unique needs of this population. All of the clinic personnel are trained in the latest behavior management techniques. The facility is also able to offer sedation on an out-patient basis, which makes dental treatment possible for the most apprehensive and behaviorally resistant patient.
Dental services include prosthodontics, endodontics, oral surgery, restorative, pediatric dentistry and periodontics, to individuals with developmental disabilities throughout the New York City metropolitan area. Each year, the staff provides more than 4,500 patient visits, including over 300 sedation visits. We are one of only a few providers in the metropolitan area that offers dental treatment under intravenous sedation for individuals with these health care needs, alleviating the need for these patients to require general anesthesia in an operating room setting for their dental care.
In addition to being a source of treatment to this at-risk and underserved population, the Harold Diner Special Care Dentistry program assures that another generation of dental professionals will be available to care for these individuals in the future. The clinic is home to a long-established clinical fellowship program, a one-year, full-time experience in which dentists receive clinical training in dentistry for persons with developmental disabilities. In addition, the staff trains residents from five other general dentistry residency programs. Trainees have unique opportunities for interaction, both clinically and in a didactic setting, with a variety of other professionals who are involved with this special needs population. Our professional staff includes pediatric dentists, special care dentists, general dentists, dental anesthesiologists, and oral surgeons. CERC Dental Clinic, Dr. Farah Alam
The Harold Diner Special Care Dentistry Center is located on the 1st floor of the Rose F. Kennedy Center, 1410 Pelham Parkway South, telephone 718.430.8528.
The FLC coordinates all CERC activities in the treatment of learning disabilities in children, adolescents, and adults. The Center also trains a broad range of professionals from health, psychology, education, vocational rehabilitation and related fields through fellowships, externships, workshops, conferences and seminars. It houses:
The Fisher Landau Center for the Treatment of Learning Disabilities is located on the 2nd floor of the Rousso Building, 1165 Morris Park Avenue, telephone (718) 430-3900.
Click here for the LD Access Manual - A Practical Guide to Using Technology with Learning Disabled Adults in Adult Literacy Programs developed by the Adult Literacy Program faculty and staff (Adobe Acrobat Reader required).
The Children's Evaluation and Rehabilitation Center provides multidisciplinary evaluation and treatment for children of all ages with Autistic Spectrum Disorders.
The RELATE program offers in-depth multidisciplinary diagnostic evaluations and treatment for children, birth to preschool, with language, social, and/or behavioral difficulties including Autism and other related disorders.


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Who's Wee Dug wrote:Well done M! can we all come for coffee.
mC wrote:Oooww yes! Make that an iced one, sinced it's so hot over there..
....off to work this morning rain so heavy i can see 2inches in front of me. shopping center full of buckets roof leaking all over the place shops shutting from 1 pm no customers. head home and half the trees are on the road, had to go three different ways home as roads are covered in water. .. where my mum lives in on the 9 news as it is flooded again, power go's off and on, and now the tv has blown up, all in all an eventful day, lucky for red wine i say,
Catch-up wrote:Yikes! And, I agree, red wine can be a life saver. Sometimes it's other people's lives.
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