The KHIT Blog: Number Go Up,

Sunday, October 15, 2023

Number Go Up,

then number inexorably go down.

Jen Taub interviews the author.

A totally enjoyable read. ⭐⭐⭐⭐⭐

BTW: I know we're all supposed to be fashionably hatin' on Michael Lewis at the moment. Nah, not me.

Who is Jen Taub?

Click here.

Her book has long been in my stash. Also ⭐⭐⭐⭐⭐. I've been keeping tabs on white collar crime and malfeasance for decades.

OFF-TOPIC ERRATUM

Another read now underway:

Very cool.

FOREWORD
LEBRON JAMES

There’s a story behind the urban legend of how Rich Paul and I became brothers.

The legend is that I saw a little guy I had never met before wearing a rare football jersey in the airport, and I wanted to know where he got it. But the jersey didn’t really matter. The minute I met Rich, I knew he was different. He understood me from the jump.

A young Black man can be a lot of things with no judgment from his community—athlete, student, hustler, rapper, father—but what he cannot be is vulnerable. When I met Rich, he saw me as just a kid from Akron, Ohio. He knew that even though the LeBron James thing was starting, I had the same fears and dreams as every other young person who grew up the way we did. It didn’t take long for me to realize that Rich is great at paying attention: to people, to the different environments that we move in, to why we feel how we feel. Rich sees things deeply. When Rich looked at me, I didn’t have to hide anything. The world was coming at me so fast when I was a teenager, and not just basketball. My first son, Bronny, was on the way. I had no dad and no siblings. My mom was struggling. Rich helped me find my strength in that chaos, a chaos that he knew all too well. Rich never asked me for anything. He didn’t care whether I was a future pro or the kid across the street. He just knew I needed his help, and he gave me what I needed most—the space to be vulnerable.

That’s why Klutch Sports Group is the best agency in the game. Rich’s superpower is understanding what people truly need.

After I was drafted in 2003, Rich spent several years working directly with me and learning about the NBA. Then he spent more years working at an agency and a sportswear brand, learning what works for athletes, and why. When Rich started Klutch in 2012, he was better prepared than anyone to take that step, but so many people still slandered his qualifications. It’s straight-up disrespectful when they say, “Rich Paul is only successful because he’s doing this with LeBron.” That’s like saying I don’t demand the same excellence from my partners that I demand of myself, or that Rich’s other clients don’t think for themselves. I don’t believe in giving my friends free passes—nobody I work with is “given” anything. Compared with the lawyer types who controlled the representation game before him, Rich had to work ten times harder to succeed, because of what he looks like and what he comes from. The only thing Rich received from me is an opportunity.

Rich and I started out as two young Black men from Northeast Ohio who loved music, fashion, and sports; and whose childhoods had been stalked by crack, guns, darkness, and trauma. We lived in neighborhoods where it felt like the government was working to lock up any Black person it could. We both had single mothers who had to fight a broken system way bigger than themselves. Rich and I didn’t become brothers because of a throwback jersey—we bonded through unwavering faith in our moms.

Mothers brought us together, but Rich’s relationship with his father is the heart of his story. That story has a lot of loss and struggle, but Rich’s dad was also a source of wisdom that Rich has passed on to me and other clients over the years, and now he’s sharing it with readers of this book. This is the best kind of wisdom, because it was earned the hard way. Rich always knew he was special, but he didn’t know just how much he would be able to accomplish. It’s amazing to see my brother in full stride, and for everyone else to see what I always saw in him. So when you flip these pages and witness the kind of pain that we felt growing up, don’t flinch. Hard truths make us stronger.

Paul, Rich. Lucky Me (pp. vii-ix). Random House Publishing Group. Kindle Edition.

Yeah.

More shortly...

__________

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Sunday, October 15, 2023

Number Go Up,

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