Wednesday Night #1306

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The Silver Anniversary was spectacular and our heartfelt thanks go to the Self-appointed committee – and all its helpers – who, with glee and awe, organized an awesome Wednesday Night, not to mention those who came from afar, headed by Marc and Fiona, without whose presence, the evening would have been incomplete.
Neither we, nor the computers, have recovered sufficiently to have an adequate posting on the Website, but it will soon come. Furthermore, inexplicably, our Faithful Scribe has failed to submit a compte rendu of Wednesday Night #1305.
However, there must be no resting on the laurels that were heaped upon us. If, as Peter Trent suggests, we are to meet the bimetallic challenge, we feel it incumbent to continue to challenge you and thus we offer a short menu of topics for this Wednesday Night.
First, however, Dr. Alexandra Tcheremenska-Greenhill, who promises to be with us this week, has reminded us that beginning at sundown, March 14 is Purim, “one of the liveliest of all the Jewish festivals. The Feast of Purim honors the execution of the Persian Haman, who attempted to eliminate the Jewish people. Queen Esther, with the help of her uncle Mordechai, risked her life to abort Haman’s plot, and Haman was later hanged by Esther’s husband, King Achashverosh. Parties are held at synagogues and in the streets, and special triangular cookies — symbolizing the three-cornered hat of Haman (the hat of a fool) — are prepared.” We are not sure why she sent us this information, but if you feel that you or we should act upon it, state your case.

Topics – or not:
Conversely to Mr. Charest’s inexplicable calling of an election whose campaign would compete (well, not really!) with the Silver Anniversary and deny some of our media friends the possibility of being with us, this week the Leaders will debate on Tuesday, giving ample fodder for Wednesday Night’s political analysis.
On Wednesday, true to our tradition of breaking news, the Conrad Black trial opens in Chicago, with Ringmaster Patrick Fitzgerald fresh from the Scooter Libby circus.
Climate Change is rarely off the Wednesday Night menu these days and lo! the media, with the Gazette in the lead, are gasping (in shock and awe) “Expect water shortage in 20 years
In fairness, this fourth report of the Intergovernmental Panel on Climate Change (or IPCC to the groupies) contains far starker warnings than the previous assessments. At least Europe is paying serious attention with signature of an agreement on plans to reduce Member states’ ecological footprints. See the Economist
On a related topic, and one which is frequently discussed on Wednesday Night, last week Global TV broadcast an extensive report, “Promise Land”, on the oil boom in Alberta including consideration of the geopolitical and environmental issues of development of the tar sands, and the impact on greenhouse gas emissions (See Monday’s Report)
While the awful drama continues in Iraq, amidst new fears of war over Kurdish lands, we note with interest that Halliburton is moving its headquarters to Dubai and wonder what the story behind this story is. Will Dick Cheney and Donald Rumsfeld follow?
How many of you knew that Osama bin Laden turned 50 on March 10? In a lengthy analysis, The Observer looks at “the continuing evolution of the phenomenon of ‘al-Qaeda’ [which] continues to surprise – and deeply worry – those charged with keeping us safe”. It is a somber outlook.
Meanwhile, President Bush has been on a lightning visit to Latin America [not the usual focus of this administration] – ostensibly to create an alliance that would give Brazil a key regional and global role. We regretfully agree with Fernando Báez’s op-ed in the New York Times : “Time is the one thing that the current White House administration has most flagrantly wasted, and given the electoral campaign that looms on the horizon, the Republicans’ rush to reactivate the dialogue with Latin America isn’t seen as a step forward in the development of constructive policies. On the contrary, the visit seems to underscore an ever-growing discrepancy between American desires and those of the leftist movement championed by Venezuela along with Argentina, Bolivia, Ecuador and Nicaragua.”
Harking back (can one ‘hark forward”?) to the fascinating Feb 7 evening with Misha and Tom Windmuller (#1301), we wish to draw to your attention “Europe is united only by its contradictions” from last week’s Economist
Maintaining our fascination with the French presidential campaign: Jacques Chirac has declared that he will not stand for reelection – among the media comments, we commend the view from the International Herald Tribune ,while we marvel that he has been in power almost half of Wednesday Night’s lifetime.
No doubt by Wednesday there will be other matters on our and your minds, but do treat these topics as a starting point.
Please come, the candles have been refreshed, the flowers are still lovely and the house is restored to its pre-party glory.

The Report

Although it might have been expected that the first night of the next 25 years would be sparsely populated, the presence of Dr. Alexandra Tcheremenska-Greenhill for her last evening for the foreseeable future encouraged a number of Wednesday Nighters to join in wishing her bon voyage to Vancouver and great success in her new position of Associate CEO with the BC Medical Association (BCMA), which is the second largest provincial medical association in Canada and, according to Alex, “beyond representing doctors, is doing some fantastic innovative work”.

A new member of the OWN
The announcement that the Chairman and Mouse had made an executive decision to award Alexandra membership in the Order of Wednesday Night was greeted with enthusiastic applause. [See the citation on Alexandra’s OWN page]

Rate your Doctor
The American Internet site where patients may rate their doctors has become very popular and also controversial. It encourages patients to rate the performance of their physicians on the basis of punctuality, helpfulness and knowledge. Noting that equivalent sites exist for rating professors, the evolution of the McGill experience was raised. Formerly, a departmental secretary distributed sheets to students and collected them, then they were analysed. Today, students are told they may go to a website and it seems that only the “disgruntled, psychotic and angry” go to the Website while those who are more or less satisfied are not heard from. On the other hand, it would be useful for the public to be able to go to a site where they could check a doctor’s credentials and qualifications and whether or not there have been complaints lodged against them.
In principle, no professional, technical, political or unspecialized person offering services to the public should be beyond evaluation. However, anonymous feedback, while possibly accurate as a reaction, may sometimes be unwarranted or misplaced. While many Wednesday Nighters expressed their belief that this was the only valid means of expressing their disenchantment with a health care provider, others, while acknowledging the increasing popularity of this and like websites, were far less enthusiastic for several reasons.
The principal concern was the anonymity of the person posting the criticism, depriving the professional of the opportunity of responding or of seeking redress to libellous or slanderous attacks. The anonymity of the complaint precludes the posting of a response from the physician or divulging confidential information. A fundamental tenet of common civil law is the requirement to hear the other side.
It is the Professional bodies, in this case the College of Physicians and Surgeons, that are responsible for maintaining professional and ethical standards and it is to them that complaints should properly be addressed and the blame placed if they are not.
It is only medical practitioners among all professionals that are permitted to perform medical, but more particularly, surgical acts without risking being charged with the commission of an assault. A verbal, or at times, written contract has been entered into, one point of which is informed consent. A patient visiting a Doctor’s office is presumed to have consented to treatment.
Some years ago, a study of patient complaints was commissioned by the board of management of a major teaching hospital in Montreal. To nobody’s surprise, it was determined that few, if any of the complaints related to the treatment and were very specific as to the nature of the hospitalization. No complaints had been received from psychiatric patients; obstetrical patients almost always complained about the perceived cleanliness of the bathtubs; surgical patients about the cleanliness of the rooms, especially the drapes around the beds and medical patients about the meals. It is not unusual for frightened or upset patients to explain their anxiety, concerns or fears by criticizing their care providers.
The fact that the site is vastly more popular in Canada than its counterpart in the United States speaks to the frustration felt by Canadians in seeking out timely medical care, the result of poor planning for the provision of medical care. A large part of our Federal and Provincial budget goes to maintain our health care system, yet comprehensive planning to meet the medical needs of the population remains inadequate. This is not confined to Canada; there is not a country in the world that has a perfect health care system.
Note: See also New Yorker

Cuba (See also Jacques Clément’s Report on Cuba)
The world is waiting to see what happens in Cuba following the expected death of Fidel Castro. One of the wild cards is the population of Cuban exiles in Florida – who do not necessarily all share the same view of what the future should be. A recently returned visitor, who has been going there for over 10 years says that in the past 10 years, little has changed with respect to poverty; however economic growth last year is claimed to have been 7%, (on $36 billion GDP) largely attributable to tourism, but there are also important mining activities and a large trans-shipment industry.
Recent polls indicate that an increasing number of the population is becoming disenchanted with socialism (43%), however it is questionable how many Cubans feel confident that they can answer any poll honestly. There are requests for half a million over a year visas to the U.S.
The average Cuban has lived his or her entire life under Castro. People are afraid to speak and believe that Castro is their father, friend and Cuba is the greatest country. To understand what will happen when Castro dies, you have to look to former communist regimes in Europe. It won’t change overnight, but will happen gradually.
For largely ideological reasons, the U.S. has obsessed about Cuba for over 40 years. The Embargo has caused much misery and the only concessions the Americans have made is to permit Cubans residing in the U.S. to send $1500 per year home to their families and to have somewhat relaxed the prohibition against export of pharmaceuticals to the island. At least one observer believes that the U.S. is anxious to exploit the resorts and tourism potential of Cuba where currently, American firms (airlines, hotels, developers) are frozen out of the marketplace.

The Stock Market
There is some concern that the end of the bull market in equities may be approaching. However, predicting the date and time of the last gasp remains difficult. Our Wednesday Night technician points to the decennial history of the market in years ending in seven from 1887 to the present, each indicating, without exception, a decline ranging from nine percent in 1947 to forty percent in 1937. Cautious investors should be afraid, but at least one market guru believes that whilst we have turbulent times ahead, the time is not nigh for the end of the bull market. The fundamentals are still good. It’s right to be cautious for the present time. In 1929, the crash occurred on September 21 and on September 20 of that year, President Hoover declared that the health of the American economy was never better.

[Editor’s note: while we generally avoid disputing any facts advanced on Wednesday Night related to the stock market, we must put in our two cents – a small investment: the crash actually occurred in October of 1929, more precisely on October 28 and 29]

A new phenomenon (and new term to many) is America’s subprime-mortgage market, which is the subject of much media coverage that has dented investor confidence again. The Mortgage Bankers Association reported a rise in mortgage defaults and activity in home foreclosures in this market, which lends at a 2-3% premium to borrowers with weak credit.

Lord Black in Chicago
Lord Conrad Black, who was born in Canada and made his money in the U.K., is currently on trial in the United States. Egalitarian Canadians appear to exhibit some glee in anticipating the fall of the mighty but it is doubtful that Americans will have the same prurient interest. The selection process will tend to eliminate jurors [if any exist] who have followed his career to the extent that Canadians have and there will be witnesses for the defence who will be in a position to contradict the prosecution, on such issues as the designation on non-compete fees to Conrad Black. Further, the type of business he is in and the relationship between the individual and the business presents a grey area in which it will be difficult to define the line between business and personal – even if extravagant – expenses. It must be remembered that these are criminal charges and must be proved beyond any reasonable doubt. The one act that has the potential to trip him up was the illegal removal of files. Significantly, when he was removed from the company, the shares dropped from fourteen dollars to one.

4 Comments on "Wednesday Night #1306"

  1. Diana Thébaud Nicholson July 21, 2007 at 6:34 pm ·

    With an increasingly aging population, what is disturbing is the lack of some transparent method of planning at either the federal or provincial level for numbers of doctors, nurses …

    Charest has restricted [places] in Québec – it’s all being controlled by people in the Finance Department.

    There is not a country in the world that has a perfect healthcare system – we need systems that enable us to test solutions, manpower planning.

  2. Diana Thébaud Nicholson July 21, 2007 at 6:35 pm ·

    Poverty is poverty and is rampant throughout many parts of the world.
    There are a lot of other countries in Latin America – and elsewhere – where there is extreme poverty, so ideology is not the only issue.

  3. Diana Thébaud Nicholson July 21, 2007 at 6:36 pm ·

    It is sad that in this ‘middle class country’ [Canada] there is a strain of jealousy and pettiness that stifles all that is dynamic, entrepreneurial and creative.

  4. Diana Thébaud Nicholson July 21, 2007 at 6:45 pm ·

    Having taken a look at the Canadian site, it strikes me that they’re making the same errors that university ‘evaluation’ of teaching advocates have. In the case of ‘teaching’ we lack a clear model of ‘good teaching’ to use as a touchstone so the evaluations typically focus on other things. Moreover long ago two very different studies showed [1] that students rate most highly instructors from whom they learn least and [2] lecturers trained by a drama coach improved their ratings considerably despite not changing content/method. So what is good teaching? Not sure if the same applies to physicians; who/what is a good doctor?
    — David Mitchell OWN —

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