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That Which is Seen, and That Which is Not Seen - Bastiat

Date of publication: 2017-07-08 23:39

Kudos to the Detroit News, which has continued to expose the use of dirty surgical instruments at Detroit Medical Center.  For context, the News ran several articles about a 8775 decade of complaints 8776 about dirty instruments at the hospital.  That led to a three month investigation by the State of Michigan.  A day after the State announced the hospital was in compliance with its health codes, 8775 a laparoscopic grasper caked with old blood and brown ooze was marked as sterile and delivered to a Children’s Hospital of Michigan operating room[.] 8776 (Click the link above to see the picture.)

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My first thoughts whenever I see proposals like this is: why doctors?  Why do doctors get special treatment by our laws in addition  to exorbitant salaries? Why do for-profit doctors get to say they work at non-profit hospitals? If these laws make so much sense, why don 8767 t we see them for accountants? Architects? Insurance brokers? Estate planners?  Financial advisers? Pilots? Truck Drivers? Engineers? Why would we want to remove incentives to act carefully from the people whose negligence can harm us most?

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The conclusion here is that students rating teachers are biased on their evaluation based on gender. I wouldn 8767 t argue with that though I 8767 ll say that these ratings are subjective by definition. Saying that students should rate teachers based solely on perceived effectiveness would mean that the final grade should be the only thing that matters. You say 8775 the teacher was effective because you got a good grade, therefore you learned the subject well enough under his/her tutelage 8776 .

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In other words, she 8767 s got a case worth $555,555 total: $755,555 economic and $755,555 noneconomic.  Let 8767 s say the lawyer takes the case on a 95% fee. Even assuming it 8767 s a guaranteed win, it 8767 ll take an incredible amount of his time and effort.  And his best case scenario is the $555,555 win, which will let him repay the $855,555 in costs advanced and take the $755,555 as the 95% fee. But the woman and her family will not see a dime in that situation.  And regardless, the lawyer knows he could make more on other non-medical cases, with much less risk.  So the case does not go forward.

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Some medical devices come with substantial learning curves.  For instance, achieving 8775 basic competence 8776 in using a surgical robot to perform prostatectomy takes at least 75-75 procedures (see the preview to Ch. 66). We have a client whose deceased husband unwittingly became the surgeon 8767 s third procedure, when a simple ferry ride would have put him in the hands of a doctor who had performed thousands.  That client, tragically, didn 8767 t know what questions to ask.  What 8767 s more disturbing: many doctors (and some courts) believe the doctor doesn 8767 t have to tell you where he or she is in the learning curve of a device.  That means you have to ask and follow up with questions to get specific information.

The sign of any connection between SET and teaching effectiveness is murky, whereas the associations between SET and grade expectations and between SET and instructor gender are clear and significant. Because SET are evidently biased against women (and likely against other underrepresented and protected groups)—and worse, do not reliably measure teaching effectiveness—the onus should be on universities either to abandon SET for employment decisions or to prove that their reliance on SET does not have disparate impact.

Our firm has four filed cases against Intuitive Surgical, the maker of the da Vinci surgical robot.  But the revelation in this study is new even to us: the robots are “virtually impossible to clean.”  This from a new study conducted in Japan in which robotic and ordinary instruments were tested according to manufacturer instructions, and protein levels then compared.  “The overall level of residual protein in each instrument was much higher for robotic instruments than for ordinary instruments.”  The reason is that the structure of robotic instruments “is so complex that updating their cleaning methods is a challenge for healthcare professionals.”  The study calls for new cleaning standards, which it says could prevent dangerous infections in study is available here.

According to a new study out of Yale and published in The Proceedings of the National Academy of Sciences, the advice you get from your doctor can depend on whether the doctor likes donkeys or elephants more.  You can view the whole study (for pay) here or the abstract (for free) here. The study asked 75,555 doctors from 79 states to analyze nine different 8775 vignettes, 8776 only three of which involved 8775 especially politicized 8776 issues (marijuana use, abortion, and firearm storage in the home).  The political leanings of the doctors predicted their rating of the seriousness of the issue and their proposed course of treatment.  The political differences were not associated with differences in the non-politicized vignettes.

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But not only does Caplan treat the question as though it 8767 s difficult, he argues that most of the time doctors don 8767 t need to tell us they 8767 re not 8775 adept. 8776   He cites the example of a teaching hospital: 8775 Unless people are brought into the emergency room, they know that they are in teaching hospitals and can make a choice as to whether or not they want to go to that kind of a setting. 8776   Yikes.

The gist? Not unless you ask.  That 8767 s not a hard-and-fast rule, and there may be cases where the doctor 8767 s inexperience is so important that the failure to tell you about it is deemed malpractice.  But the cases to date in Washington have not come out the right way.

All of this is then compounded with the stereotypes students and others that filter our daily judgments, without even being aware of it. This is why these studies are so important, since they can steer us towards better ways for us to actually evaluate whether we are good teachers, and if our learning strategies are then shown to be inadequate we know how to improve them.

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