byrd & belle — iPad Sleeve – Grey Wool Felt and Brown Leather

I just got mine and it’s awesome. It’s from a self-made artist in Minneapolis making quite a nice living on Etsy:

As sales heated up for the holidays, Angie Davis, a former project architect in Minneapolis who lost her job last year, said her Etsy shop, Byrd and Belle, which sells handmade handbags and cases for iPods, laptops and cellphones, has “easily matched a month of architecture salary in five days, but I’m also working 16 hours a day.” To deal with the holiday rush, Ms. Davis said, she had to produce 112 cases in 48 hours, which involved turning her loft into a mini assembly line, where she cut leather and stitched and sewed cotton and wool fabric until 10 p.m. “It’s surprising how physical it can be on my core muscles,” she said. To get the work processed in time, she had to call in her mother from Iowa to help make tags and press fabric.



Monthly rent $ 1083.25

down payment professional liability (medical malpractice) $ 1974.80

monthly professional liability $ 2032.76

I need to ramp up patient panel!

For readers living in Philadelphia who want an awesome doctor, please visit Dr. Bruce Hopper in Rittenhouse Square. He’s one of my favorite people ever and he’s just started his practice and it’s powered by Hello Health. He’s blogging about his experience and being totally transparent about the challenges and successes of opening up an authentic, accessible doctor’s practice in today’s healthcare climate. And he’s using tumblr!

The telephone was an aberation in human development. It was a 70 year or so period where for some reason humans decided it was socially acceptable to ring a loud bell in someone else’s life and they were expected to come running, like dogs. This was the equivalent of thinking it was okay to walk into someone’s living room and start shouting. it was never okay. It’s less okay now. Telephone calls are rude. They are interruptive. Technology has solved this brief aberration in human behavior. We have a thing now called THE TEXT MESSAGE. It is magical, non-intrusive, optional, and, just like human speech originally was meant to be, is turn based and two way. You talk. I talk next. Then you talk. And we do it when it’s convenient for both of us.

A previously generic drug is now branded and expensive

Colchicine is a commonly used drug to treat gout. It used to cost pennies a pill, but now its price has since soared to $5 or more a pill.

What happened? It’s an unintended consequence of FDA regulation. Colchicine had been used for centuries, but was caught up with the FDA’s zeal to regulate unapproved drugs. A profit-driven pharmaceutical company swooped in at the opportunity, and performed the studies showing that the drug, of course, was safe. It then began selling it at markedly higher prices, and is suing the generic manufacturers for infringing on its branded drug.

The biggest loser, of course, are patients. What normally would cost $5 to $10 a month, now costs up to $150 monthly.

A previously generic drug is now branded and expensive

India has more cell phones than toilets.

India has 545 million working cell phones thanks to its booming emerging economy, a number expected to reach 1 billion by 2015, the UN University said Wednesday.

That number exceeds the number of people who have access to toilet or sanitation facilities – only about 366 million, or 31 percent of the 1-billion strong population.

Cell phones are a “growth industry.” Basic necessities that are vital to a functioning, healthy society are not? This reminds me of the quote Hugo Chavez made in Copenhagen a few months back:

“If the climate was a bank they would have already saved it.”

India has more cell phones than toilets.

C-section rates and its association with lawsuits

The C-section rate has reached the astronomical level of 32%, an increase of more than 50% since 1996. This is disturbing news. Why is the C-section rate sky high?  The C-section rate is skyrocketing primarily for non-medical reasons. While doctors blame the tort system as the proximate cause, the fundamental cause rests with patients, not lawyers or insurance companies. The fundamental cause is an inability to tolerate any risk to a newborn. In the current legal climate, there is no possible justification for not doing a C-section, regardless of how tiny the risk posed by vaginal delivery may be. Unless and until people stop penalizing doctors for not doing C-sections, they will continue to do them in ever increasing numbers. They really have no choice. You cannot say to obstetricians, “Give me a perfect baby or I will sue you for failure to perform a C-section” and then express shock and dismay that obstetricians will perform C-sections in order to guarantee that you will have a perfect baby. The sky high C-section rate all too predictable result of parental expectations. As long as parents continue to sue for failure to perform a C-section, the C-section rate will continue to rise.

And here’s my comment on Kevin’s blog:

Excellent post. However, the other side of the argument is missing. OB/GYNs are paid more for C-sections.

As physicians, we’re going to have to be up front with the general public about the conflict of interest we’re in– the more we do, the more we get paid. Is this a moral business model that maximizes “do no harm” and one we’d like to embrace? Or is this the business model that’s always existed? Shouldn’t we advocate for a new business model to get paid for doing what’s right for our patients, not what’s best for our profitability?

None of these issues will change unless both doctors and patients want them to change.

C-section rates and its association with lawsuits