If you are going to do something, go ahead and do it right. Honestly, that's why I write the blog (in part). I wanted to know more about the interface between diet, lifestyle, inflammation, and the pathology of mental illness, and I couldn't find a trustworthy source. It requires a lot of work and combing the literature, but at least it is interesting, and I learn a lot.
However, I have to say, much of the literature is pretty sad. There are a bunch of quick & "easy" research projects requiring people, in general, to fill out some forms. Occasionally medical records are chased down, and sometimes some physical markers are followed. Then someone brings in the statistical wizard to generate the results, and the authors try to tie it all together with some references. Occasionally there is a randomized trial, but the whole experiment has holes one could drive a truck through, so to speak, so one hardly knows what the information means. I'll take what I can get, and it's easy for me to be critical as I am not a researcher and I don't have to generate grants to keep my office real estate in the academic medical center. But it is always nice to see a paper where they went that extra step. They closed the loop, and with actual testing, not just extra math.
Black Keys--Gold on the Ceiling (right click to open in new tab)
The paper of the day is impressive for a variety of reasons: Gastrointestinal inflammation and associated immune activation in schizophrenia (via the twitter feed of that zen dude Chris Kresser.)
And let's step back and think about the history of schizophrenia for a bit. Nowadays in the era of specialized medicine, psychiatrists think BRAIN when it comes to "organic" issues and CHILDHOOD/LIFESTYLE/PERSONALITY when it comes to coping problems. The pendulum has swung back and forth between the two (coping vs. brain pathology) in a crazy psychiatry war, more or less. A better understanding of the functional metabolism of the brain is finally bridging the gap, but let me tell you, in a post 1960s academic medicine setting, no one except the radicals were tying the gut to schizophrenia. It just wasn't on the radar.
And if you really think about it, once thorazine and the other dopamine blockers began marching out the doorways of Big Pharma, we had a nice and pretty brain-centered theory wherein the neurons began going haywire, producing psychosis. Since drugs like cocaine and meth that increase dopamine can produce psychosis, and dopamine blockers reduce psychosis, everyone was happy. And while a bunch of other neurotransmitters like glutamate and serotonin and acetylcholine and histamine appear to be tied in, it was still all the same variation of the same theory, and you know if we could just get the right combination of drugs to block the right neurotransmitters, maybe we could beat this thing. The conception of a special, protected space beyond the "blood brain barrier" led to this lack of holistic thinking as well.
What we forgot is that schizophrenia has always been a whole-body disease, particularly involving the gut. Celiac has a special link with schizophrenia, and adults with schizophrenia at autopsy often have extensive inflammatory changes in the GI tract. These associations have gone back to the literature from the 1920s, prior to the development of the antipsychotics. In the present day, it is nearly impossible to separate the effects of the illness itself from possible effects of antipsychotic medication. Antipsychotics are known for slowing motility and probably affect the gut immune system by reducing the inflammatory response there, perhaps even reducing gut leakiness. Curtis Dohan thought this last bit might actually be the primary therapeutic action of antipsychotics, rather than all that fancy dopamine blocking stuff in the brain.
(Do you know the doctors most likely to use the old fashioned antipsychotics and antidepressants, all of which have pretty impressive GI effects? Psychiatrists, neurologists, and gastroenterologists. Reglan and phernergan are dopamine blockers, chemically not all that different from antipsychotics like Haldol or Thorazine).
Think how radical that idea is. Dopamine blockers ameliorate psychotic symptoms by reducing inflammation in the gut?? Okay, it's a cute theory, but except for Dohan and Dickerson, not a whole lot of good folks were doing work on it for many decades.
So this "Gastrointestinal inflammation and associated immune activation in schizophrenia" paper from Schizophrenia Research is rather like a bolt of lightning. It was done at Sherppard Pratt/Johns Hopkins, for heaven's sake.
Here's the design. Take a group of folks who developed schizophrenia within the past 24 months. Then take a group of folks who have had schizophrenia for many years (average > 20 yrs). Then compare to some normal controls recruited from the community. These normal controls from the community were determined to be relatively free of psychiatric disease via a structured clinical interview (SCID), which is the gold standard. (These little gold standard touches take some extra work and make me happy. It can take an hour or more to administer a SCID. I remember a Maes paper where he recruited the controls from employees in his lab. Often folks who work in psych have an interest due to personal issues or close family members who have psychiatric problems, so the research field employees might make for biased controls. I don't always comment on these issues with papers because there simply isn't time…) The researchers then checked the subjects for serum antibodies to gluten, casein, T gondii, Saccharomyces cerevisiae, and some other bugs associated with schizophrenia or gut issues, and crunched the numbers. (So we have an observational study, but with some nice data collection and a further twist I will get into later) Antibodies to S. cerevisiae in the system (called ASCA) are used as a marker of intestinal inflammation (and can be used to help diagnose Crohn's disease, for example).
There are some gender-related twists and turns, but for the most part, they found that folks with new onset and longstanding schizophrenia had significantly elevated ASCA levels compared to controls. High levels of ASCA correlated (for the most part) with anti-casein and anti-gluten antibodies, which would make sense. If you have gut inflammation, then casein and gluten proteins could seep into the system, and your immune system starts to attack them. Since gluten and casein could be neuroactive (and maybe neurotoxic), they could be another part of the pathology of schizophrenia (and autism, etc.). ASCA levels did not significantly correlate with anti-gluten and anti-casein antibodies in the control group, which is interesting.
All right, but who cares. All these folks with schizophrenia were recruited from Johns Hopkins, and pretty much all of them will be medicated. The medication could be a part of some of these immune and inflammatory effects. The researchers thought of this tangle, and they designed a second experiment with a second cohort comparing unmedicated recent onset schizophrenia patients in Germany with medicated recent onset schizophrenics from the same area. Those recent onset unmedicated schizophrenics had about 1.5X the ASCA measures of the recent onset medicated schizophrenics from the same German cohort.
And, tying it all together with other associations between infections and schizophrenia, the new onset patients had significantly higher positive antibodies for T. gondii than the non-recent onset folks or the controls.
SO, we have found that folks with schizophrenia have a higher level of gut inflammation and antibodies to glutein and casein than conrols. Could these vulnerabilities somehow begin in the brain? Or does the issue start with the gut, immune activation, and systemic poisons (neuroactive food fragments and infections) hastening an inflammatory decline in the brain in the genetically vulnerable? Do antipsychotics work by being anti-inflammatory in the gut, by decreasing dopamine activation in the brain, or both? (or neither?).
All pretty interesting questions.
Friday, March 30, 2012
Thursday, March 29, 2012
Hospitals and Insurance Company Competing for Patients In Pittsburgh–Contracts In Question
In this case it’s Highmark and UPMC in the Pittsburg area. It’s interesting to listen to the comments in the video and the “deals” are discussed here. They bring up United Healthcare buying up physician’s groups and we have that big in the OC. 
This is really getting tough for patients and again being here in the OC I am hearing a few issues and Blue Shield is suing the part of United that is part of the two big doctor groups. It was just a couple months ago that Blue Cross and Highmark bought NaviNet which is used by several insurance companies so the insurers here have a joint effort. Highmark also handles a lot of Medicare through contracts from CMS.
Blue Cross and Highmark back in 2009 tried to merge with each other which I believe was not allowed as they are both obviously different companies still. I’m glad this is starting to get some national attention as again I see it here in the OC and it’s doing nothing for patients here either. BD
WSJ's Anna Mathews examines a battle being waged between Pittsburgh's UPMC hospital and insurer Highmark over patients and how consolidation in the health-care industry is spurring similar tensions.
Orange County Oncology Doctor Who Couldn’t Stop Defrauding Medicare Will Get His License Back After He Serves Time & House Sold for Just Under $10 Million
This was the oncologist that couldn’t help himself and made millions and on top of this the government seems to have messed up with the auctioning of his big house. The sale of his house was supposed to pay off damages and give the government some money back but the government liens were not filed against the Justices as individuals so the trustee says they will get zero.
The house by the way sold for just under $10 million so the defrauding business was good while it lasted and this was his second go around as he was slapped on the hands basically the firs time. If there were big payments due on that house, no wonder he couldn’t help himself maybe? BD
Orange County Oncologist Gets Sentenced to 18 months Prison – Diagnosed With “Co-Dependency”- Couldn’t Stop Fraudulently Billing Medicare
A technical glitch overlooked by federal prosecutors may impede the U.S. government from collecting nearly $7.6 million owed by an Orange County physician convicted of Medicare fraud.
The sale of Dr. Glen Justice’s beachfront Corona del Mar house was supposed to pay off damages and restitution he owes the government.
But a court-appointed trustee maintains that the government should get nothing from a sale now in the works because government liens were filed against the Justices as individuals and not against the trusts named on the deed.
Justice pleaded guilty in 2010 to five counts of fraud for billing the government and private insurers for expensive cancer drugs that were never given to patients.
http://lansner.ocregister.com/2012/03/23/did-feds-goof-in-convicted-doctor-case/160064/
The Wrath of Dr. Khan–ER Versus Medicine Video (Humor)
This is just too funny…only an ER doctor…and glad he has a sense of humor too.
Wrath of Dr. Khan
We certainly need a break now and then. BD
Monday, March 26, 2012
BATS Stock Exchange IPO Rogue Algos–Attack of the Killer Algorithms Chapter 34–See How Other Killer Algorithms Occur in Every Day Life With Healthcare & Credit
If you haven’t figured this one out yet, it’s about computer code and “rogue” algorithms and this can happen at any time, any place and so forth. Most all in tech know that even the best engineers cannot predict when and where but they do 
happen and you can reflect back on the big Amazon cloud disruption that took place last year. We don’t like it of course but it’s something we have to live with and the folks at BATS were smart in shutting it down immediately and not seeing a a self heal function would take place. In addition, the circuit breaking “code” algorithms kicked in, which is a good thing. Smart engineers made the right decisions at BATS and they will have to regroup and make their come back.
This is just one example on how we as consumers are all at the mercy of the Killer Algorithms at some point in time. When you have servers running 24/7 making life impacting decisions about you that you can’t see, touch or talk to, it is frustrating for sure. In healthcare, insurance companies live and die by their algorithms which analyze information and categorize almost everything about us.
The big problem today is “flawed data” gets in there either by accident or by human error, or by a rogue algorithm. Below is a digest of links and a great video that debunks a lot of the reports and methodologies used at times and how some of the marketing for profits created “designed” algorithms that specifically move money and you don’t even see it. Context is everything today and when we roll in some big data and we have some flaws in the integrity of what gets rolled in, then sometime we can’t see the bottom or the top. Ever wonder why it takes so long to get errors fixed? Some folks 
don’t update frequently enough too. You just never know when the algos are going to bite.
Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012
This also looks like a good spot to repeat the TED video from Kevin Slavin who talks about how algorithms shape our world. If you have not seen this video, take a look now at this mini crash and see how Nanex and other companies study these rogue algorithms to find out how the machines with no input do a lot of this. It’s machine talking to machine and again when human is in there with potential flaws, time to pay a little attention here.
“It’s a bright future if you are an algorithm” but we can’t say the same for humans right now.
This is a good time for me to repeat a link to a post I made 2 years ago and I think we are almost here in needing a Department of Algorithms or something like it very soon. Business trumps government every time when it comes to algos for profit sadly. BD
“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws?
How Algorithms Shape the World
Not only has BATS CEO Joe Ratterman released a letter to investors and clients, when you visit the Lenexa, Kansas firm's web page, you have the option of downloading a PDF explaining what caused the meltdown. If this self-inflected wound weren't damaging enough, the BATS meltdown also drove down Apple's stock price an estimated 9 percent with it before the circuit breakers kicked in.
The BATS IPO auction system glitch played a role in an issue resulting in the halting of Apple Inc.'s stock for five minutes. Three erroneous prints occurred that triggered a single stock circuit breaker for the AAPL ticker. Normal trading in AAPL resumed after the five minute trading pause and the three erroneous trades were later broken.
While it was unfortunate that our issues impacted another security, the industry's single stock circuit breaker system worked as planned and proved that recent improvements in U.S. equity market structure are working as intended.
Sunday, March 25, 2012
Discussion on Supreme Court Hearing on Healthcare Reform–How Will This Play Out With Current Day Algorithms of Commerce And Unintended Consequences-Video
Do we think that they are immune from politics is one of the questions discussed here. Granted there are changes to be made and amendments but to throw out Healthcare revision totally is not wise. When you stop and think of all the unintended consequences that will arise, it’s scary. Again I go back to reviewing how it will play out with IT infrastructure as that’s what’s running the country anyway once it is put in place.
You do have to admit as complicated as things are today you have to do your best to look at each portion and what changes would take place. The business and banking areas are prepared as they always are to adjust their algorithms to maintain profit levels and THEY WILL RUN THEIR ANALYTICS and probably already have 
done some work in this area with projecting several different outcomes so they can move quickly in whatever direction they need. It is what it is today with intelligence and formulas. One health insurance company United recently hired the former US Assistant Attorney General from Minneapolis as a general counsel so that somewhat signals an area of preparedness on the part of big business here.
Supreme Court Likely to Rule on Healthcare Law Early Next Year–This Gives The Justices Time to Rent Some Computing Space from the DOE As They Will Need It
With other attempted rulings we have had judges with potential conflicts of interest arise and this was mainly due to the fact that there seemed to be a huge neglect of mergers and acquisitions within the industry, which is pretty much still ignored to a degree and not discussed enough.
3 Judges in Health-Care Lawsuits Caught Up In Potential Conflict of Interest-It’s Called Subsidiary Watch-Be Aware of Your Investments With Mergers and Acquisitions
Last year too I did raise the question of any judge being capable of a decision as it’s not easy and how will the language be interpreted. Once the text goes into place, next stop is the IT infrastructure and I know many don’t like to hear this or talk about it much but again it’s the reality of world we live in today.
Healthcare Reform Law– Is Any Judge Fully Capable of A Decision on a Law That is Challenged By Constantly Changing Algorithms?
If the ruling is not modeled correctly with looking at how each part would change and affect consumers and those in the industry, we are in for a huge roller coaster ride and perhaps more of a return to the Wild West.
The Good and the Killer Algorithms will move forward based on rulings and decisions made so again I hope the court is cognizant of this fact in what ever they choose.
Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012
How many laws come to think of it are “unworkable” today? Intellectual arguments can be made but the ultimate answer here I think is to embrace a single pay system as the bandaids are not working and again economic times have changed since the law was put in place, so to strike it down completely would also be foolish at this point. We don’t live in times any longer where laws last forever as passed. BD
Does Congress have the power to mandate that everyone in the U.S. have health insurance? The Manhattan Institute's Avik Roy and Columbia University's Gillian Metzger discuss the Supreme Court's hearing of the case with WSJ Legal reporter Ashby Jones.
Technorati Tags: Healthcare,Supreme Court,ruling,Manhattan,Institute,disucssion,insurance,hearing,politics,Congress
US Chamber of Commerce Working on Full Scale Mission With Seeking Life Sciences Opportunities in Israel
You can see some of the major companies included in this area and when you think 
of it a lot of the Intel technologies for chips has come from Israel for a long time; however in this instance the focus is Life Sciences. Biotech conventions in Israel are also very hot and I do website that features interviews with many of the CEOs of Israeli companies and you can view a collection here.
Another example is the Mayor of Akron who attended the ILSI BioMed Conference last year, getting educated and seeing what biotech interests he could bring back to hospitals in his city. BD
The U.S. Chamber of Commerce on Sunday embarked on its first full-scale mission to Israel, with the focus on the nation’s burgeoning life-sciences sector.
The U.S. Israel Business Initiative, a special section of the U.S. Chamber of Commerce launched in 2010, is meeting with key Israeli business and political leaders. A dozen high-ranking executives from major U.S. companies, including General Electric [GE 19.78 -0.07 (-0.35%) ], Boston Scientific [BSX 5.97 -0.03 (-0.5%) ], Oracle [ORCL 28.55 -0.08 (-0.28%) ], Merck [MRK 38.005 0.41 (+1.09%) ], and MedImmune, are on the tour. Myron Brilliant, senior vice president of the Chamber of Commerce’s international division, is leading the delegation.
One of the main goals of the trip is to facilitate investment and cooperation between American companies and Israeli leaders in life-sciences industry, including companies that specialize in medical devices, bio-pharmaceutical firms, and genetic research. Over the next few days, executives on the Chamber's mission will meet with leaders in Israel’s life-sciences sector directly.
“There’s a real entrepreneurial spirit in Israel,” said Marc Perlman, global vice president, health care and life sciences, for Oracle. “It’s clear Prime Minister Netanyahu is very excited about Israeli innovation. When it comes to bringing investment into this country he gets it.”
http://www.cnbc.com/id/46850417
Technorati Tags: Life Sciences,Israel,US Chamber of Commerce,healthcare,biotech,medical devices,bio-pharma,innovation
Friday, March 23, 2012
“Remote Area Medical–California” Begins Four Day Free Medical Clinic in Oakland–Volunteers Needed
Folks are traveling all the way from Napa to get care at the free medical clinic. RAM does good work and thank goodness they are here and this is a reminder of the failing healthcare system in the US for sure.
The same problem exists in 
California as they have had at other free clinics and that is getting enough volunteers. RAM was just in Sacramento and Oakland last year and has done a lot in California. RAM has grown to have it’s own California branch so again what does that tell you about people needing medical care and having to go to the Coliseum to get it.
Remote Area Medical Wraps Up Free Medical Care Clinic in Sacramento and Moves to Oakland For Another 4 Days of Free Care
For additional information you can visit the RAM California website to check on times and dates. Now notice one thing here again, we have a group that is dedicated to California which is part of the over all RAM group, so again the free clinics are growing as our healthcare system continues to fail. When you watch the video they had to close early as they didn’t have enough volunteers. BD
OAKLAND, Calif. (KGO) -- An amazing four-day program is underway in Oakland to provide free dental, medical, and vision care.
It is being offered by the Remote Area Medical Foundation (RAM) and
the program filled up quickly Thursday. The problem was not the turnout of patients. Instead, it was the lack of doctors that forced them to close down early.
At 3:30 Thursday morning, volunteers handed out 400 numbers to people looking for a free health exam. Some of them camped out for their spot in line. "It's a long wait. It's cold, but it's worth it," one man told ABC7. By 9:00, the clinic was full. "I'm shocked because I came all the way from Napa. I didn't expect it to be closed for the day," Kenneth Profit said.
The problem is not space or lack of equipment. There are plenty of empty dental chairs set up inside the Oakland Coliseum. The issue is finding enough dentists and eye doctors. "We don't have the number of volunteers today that we would hope to have," RAM founder Stan Brock said.
Ann Dukes, R.N., is a manager at Kaiser Hayward, but on Thursday, she was doing triage. "When I'm at Kaiser I'm supervising, not touching per se. Here is hands-on," Dukes said. When asked what kind of satisfaction did that give her, she said, "A lot more than supervising."
http://abclocal.go.com/kgo/story?section=news/local/east_bay&id=8591009
Wells Fargo Bank Files Suit Against Medical Development Intl Over Loan Defaults And Asked Judge to Appoint Receiver–Business Analytics Tactics and Algorithms Questioned
With $55.3 million in assets and $74.9 million in liabilities the money analytics are alive and running. Medical Development according to the article here says that Well 
Fargo became a “corporate raider” to divert company assets.
Part of their business is in the Healthcare Analytics area with consulting for provider solutions. The site states they have been a government contractor for years and has built healthcare networks and has a contract with the VA and also offers solutions for self funded employers.
“MDI works along with healthcare payers to provide custom care networks, efficient administration and powerful analytics solutions. Our products and services allow administrators and healthcare professionals to:
- Identify actionable items to reduce costs and manage risk
- Create custom networks and plans for your clients
- Eliminate overspending on duplicate or incorrect medical claims
- Evaluate complex health data in interactive, easy-to-use platforms
- Create custom health programs for high-risk patients and disease groups
- Predict future spending from the individual patient to the corporate level “
All of our services are backed by dedicated cross-disciplinary support teams who provide IT assistance and personalized customer service, ensuring you'll always be equipped with the knowledge and ability to make practical, informed decisions. This one appears to be one worth watching as perhaps their algorithms for analytics are either not making enough money or Wells Fargo perhaps was not providing adequate direction for them…who knows. Now the company is also suing Wells Fargo too and is seeking $15 million in damages.
Banks and Health Insurance companies locking horns here and I bet the battles comes down to who’s business analytics algorithms caused the damage. BD
Wells Fargo & Co. (WFC), the fourth- largest U.S. bank by assets, sued prison-service provider Medical Development International Ltd. in Delaware Chancery Court (1400L) seeking to recover $30 million in loans.
Wells Fargo said in complaint filed today in Wilmington that Medical Development, based in Ponte Vedra, Florida, has been in default on the loans “for quite some time” and asked a judge to appoint a receiver.
The company and affiliates have “also engaged in a series of self-dealing transactions including, among other things, so- called ‘loans’ to executives” for a “working farm,” a biographical screenplay and payments for “a Tesla Roadster,” lawyers for San Francisco-based Wells Fargo said in the complaint.
Technorati Tags: Wells Fargo Insurance,Medical Development Intl,Florida,Analytics,lawsuit,money,management,insurance
FDA Considering Digitally Driven Kiosks for Self Diagnosis With Specific Conditions Via Algorithmic Processes
If you have heard or read the news of late it has been all over that the FDA is considering making certain drugs available over the counter that are now prescription only. With that thought they are also investigating to see if a Kiosk 
would be able to assist with helping patients find the correct medications along with doing a self diagnosis. We have seen the kiosks that tele connect but these would be without the pharmacist and all done by the machine. You can see what they have done in the UK with tele-pharmacists at the link below.
MedCentre Prescription Kiosk ATM-Like Machines May Give Pharmacies Some Competition in the UK – Installed at 5 Hospitals in the UK
The concern though is the usual error factor and mis interpretations and patients getting the wrong medication. In essence though when you think about it this is not much different than today and buying the wrong thing when we self diagnose for the flu and other ailments we may have, except this is offering more knowledge available and if some of the current prescription drugs become OTC this is a concern as we are talking new drugs out there. The targeted conditions/drugs presently being looked at are asthma, diabetes, high blood pressure, high cholesterol and migraines so there’s plenty of room for discussion here as well as development of an algorithm that could do the job without risking safety.
I’m not sure we may see this anytime soon for some of the conditions as there’s a lot of work involved here with writing the code, testing and so forth. I could see it initially available to perhaps do refills as a starting point. The FDA has a way to go here with this project, but nothing will occur until decisions are made about which drugs come off the prescription list I would guess and there’s still the question of enough engineers at the FDA. BD
FDA and Medical Devices-Who Doesn’t Get This, They Are Looking for Engineers Just Like Technology Companies Are Doing- Get Some Congressional Digital Literacy in Place
Certain prescription drugs may soon be available to consumers through digital kiosks, rather than a doctor's diagnosis, underscoring the methods technology is transforming healthcare.
The Food and Drug Administration is mulling digitally-driven patient kiosks where people can self-diagnose for specific conditions through an algorithm-based survey. The process would drop the prescription requirement for certain treatments and common ailments.
Self-diagnosis would let users get medical care in a more convenient way. The kiosk concept under FDA consideration indicates the regulatory agency is taking a serious step towards using digital technology to deliver healthcare, moving away from relying on third-party app developers.
As the FDA hashes out its plans to eliminate the need for prescriptions, relying on modern technology is one way to streamline a process to help save medical professionals valuable resources in an overburdened system. But to make sure patient care remains a top priority, the FDA and industry professionals are sure to carefully determine how to make the process work without compromising a potentially life-changing diagnosis.
CVS/Caremark Sends Letters to Tufts Members Containing Personal Information Like Medical Conditions/Meds Info to Wrong Patients–Attack of the Killer Algorithms Chapter 24
This is chapter 24 addressing flawed data this time. The article said that CVS would not discuss this, well if you are in technology you know what happened, it was a rogue algorithm, in other words a programming error and this is what “The Attack of the Killer Algorithms” is all about. This time it was private information sent to the wrong people but what’s it going to be next time. If you read my series on the “Attacks” there’s tons more like this. This why we need not rush the programming that takes place with developers. Companies who put rushed deadlines on developers of software and push for releases before their time are fools, but it happens. 
Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012
There’s one story above about people who don’t get jobs because data is flawed or mismatched and this is becoming more frequent and let’s not forget the huge profits made here with CVS selling data too. There’s a few lawsuits floating around out there on this subject and the data sellers should be taxed as they make billions selling data they get for free. How times do rogue algorithms like this attack the data they sell? That’s a good question to ponder and it does and is getting to be more frequent.
Consumers Lose More Privacy With New CoreLogic Credit Reporting–”Score” Marketed For Insurers and Employers To Gain Information-California Prohibits Potential Employers – From Using As Jan 1 - Killer Algorithms Part 8
Independent Pharmacies Not Able to Compete with Big Chains and Fear Going Out of Business–They Don’t Have Same High Levels of Data To Sell to Profit- Attack of the Killer Algorithms Chapter 23
So the patients at Tuffs were screwed with privacy and they get an “I’m sorry” for the mistakes the CVS algorithms made, but let’s don’t talk about the maybe billion dollars they made “selling’ your data too..don’t forget that happens. The lawsuits below implicate the SEC 2010 statement from Walgreens on their intangible data profits.
Walgreens And CVS Accused of Selling Customer Prescription Data in 2 Separate Law Suits-Sales for Marketing Data Continues and the Data Bases Gets Larger with Technology
This case fits the “Killer Algorithms” because what to do the recipients do? They 
can’t talk to that algorithm and it made decisions and sent out flawed information, matched to the wrong person. If you haven’t figured it out yet, this is why the entire Occupy movement got started as it’s not what you see but it’s rather the intelligence that runs in the background you DON’T see. That’s the problem and issue as we base too much of the economy today on algorithms and making money selling data rather than investing in manufacturing and using more technology there.
Occupying Wall Street–It’s All About the “Attack of the Killer Algorithms”–The Unfair and Marketing Exploit of Ethics Using Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie
So there you have it, Chapter 24 of the Killer Algorithms and stay tuned for Chapter 25 when I find it..sadly the chapters will keep coming. BD
CVS Caremark Corp. said Friday that it mistakenly sent letters to about 3,500 Tufts Health Plan members, giving them personal information about the medical conditions and medications of other members enrolled in a supplemental Medicare plan managed by Tufts.
The mistake was due to an unspecified “programming error,” CVS Caremark, pharmacy benefits manager for the Tufts Medicare Preferred Plan, said in a statement.
“We are monitoring this situation and CVS Caremark’s response and outreach to Tufts Health Plan’s Medicare Preferred Plan members,” said Sonya Hagopian, vice president at Tufts Health Plan, which is based in Watertown and operates in Massachusetts and Rhode Island.
CVS Caremark spokeswoman Christine Cramer said the company would not discuss the incident beyond what it said in the statement.
Technorati Tags: CVS,Caremark,drugs,conditions,healthcare,Heatlh IT,medications,algorithms,Massachusetts,Health Plan,flawed data
Trans Fats and Aggression.. Also, Walter Willett.
Beatrice Golomb is one of my favorite researchers. She is holding the line that statins might, just maybe, be rotten for the brain and cause cognitive difficulties. And here she shows up as the primary author on a cool little observational study linking trans fats and aggression.
The weaknessess of the study: observational, food frequency questionaires, not too many confounders accounted for (I'll get to that later). The strengths: decent sample size (>1000), long follow up, prospective (meaning following and measuring people from the beginning rather than restrospective, which means looking back and is pretty much the least reliable way to run a study).
I'm on kind of a Schubert kick. Here is his Serenade.
The details of the study are a bit boring, but in short, a bunch of ordinary folks already lined up for a statin study (who weren't on any lipid lowering meds during this study) were co-opted to track trans fat intake. Researchers use the same people for different studies all the time. This study was done back before the USFDA required the amount of trans fat to be labled, so people could eat Hostess "Donettes" in blissful ignorance, and manufacturers had little incentive to get rid of the nasty stuff.
So, what did they find? Well, amount of trans fat reported consumed in the beginning of the study FFQ correlated linearly with aggression scores measured years later. The researchers accounted for aggression at baseline, sex, age, alcohol consumption, education, smoking, and exercise. In fact, dietary trans fats were more predicitve of later aggressive behaviors than any of the other known confounders, and predicted aggression similarly in women and men. Dietary trans fats were also associated with depression.
What is a plausible biochemical mechanism of trans fats causing crankiness? Well, the neurons need plenty of omega 3 to keep the lights on, so to speak, and trans fats interfere with omega 3 metabolism. In addition, trans fats on their own seem to cause inflammation, cell energetics problems, and oxidative stress. Yuck.
I linked this Schubert piece a long time ago, but it is worth a revisit. It was written when he was gravely ill and knew his death was imminent. Despite his prodigious body of work he was barely into his 30s.
What don't I like about the findings of this study? I've looked at a number of other studies about diet and aggression. The most rigorous are the Diet and Violence studies done in prisoners, showing boosting micronutrient intake an several replicated randomized controlled trials significantly reduced violent acts. There is also another throwaway observational study linking soda consumption to adolescent violence.
We all know that trans fats in the American diet circa 1999 were of the garbagey processed food variety. Literal junk disguised as tasty treats, though synthetic vitamins might have been sprayed on the flour used as dictated by law. Delicious! So trans fats consumption is not only a marker of mere trans fat consumption, but also nutrient poor, calorie rich crapola that will decrease the amount of micronutrients one would take in. At the same time, the energetics of the cells are compromised by the trans fats and the omega3 levels are torched. One doesn't typically enjoy a meal of wild-caught pacific salmon and donettes, after all.
(Another very sticky point -- trans fat consumption correlated with the amount of linoleic acid taken in, yet Walter Willett has about a thousand powerpoint slides linking amount of omega 6 fatty acid consumption and good health. How does he do it?)
I do find it very plausible that synthetic trans fatty acids are terrible for your brain and behavior. And very plausible that processed foods cause problems too. Here is what irks me about the government guidelines for food. By adding the focus on total fat reduction, polyunsaturated fatty acids and whole grains, they steer folks away from nutrient-rich whole foods and towards convenience foods engineered to meet government guidelines, like lowfat whole grain goldfish crackers and electric green yogurt "food." I actually think Walter Willett's purported breakfast of "kashi" (I'm sure he eats the real stuff, not the processed cereal), is probably, in general, a reasonable choice. I think grains are relatively nutrient-poor compared to eggs and meat and dark green leafy veggies and the like. I also think grains taste worse, though they can stretch out a meal and help with variety, and I am rather famous for my partiality to steak so I'm hopelessly biased.
I wish the government food plate looked more like this one. I think we all agree trans fats are nasty, and this study is one more reason to look upon them with a wrinkled nose and suspicion.
Oh, man, when I posted this article I hadn't seen Willett's take on the red meat study yet! Here's my personal take on the moustached epidemiology nutrition crusader, in case you haven't read it yet. My opinion: there will probably be a greater public health benefit from encouraging people to eat steak than to eat kashi (because who is really going to eat kashi?)…
The weaknessess of the study: observational, food frequency questionaires, not too many confounders accounted for (I'll get to that later). The strengths: decent sample size (>1000), long follow up, prospective (meaning following and measuring people from the beginning rather than restrospective, which means looking back and is pretty much the least reliable way to run a study).
I'm on kind of a Schubert kick. Here is his Serenade.
The details of the study are a bit boring, but in short, a bunch of ordinary folks already lined up for a statin study (who weren't on any lipid lowering meds during this study) were co-opted to track trans fat intake. Researchers use the same people for different studies all the time. This study was done back before the USFDA required the amount of trans fat to be labled, so people could eat Hostess "Donettes" in blissful ignorance, and manufacturers had little incentive to get rid of the nasty stuff.
So, what did they find? Well, amount of trans fat reported consumed in the beginning of the study FFQ correlated linearly with aggression scores measured years later. The researchers accounted for aggression at baseline, sex, age, alcohol consumption, education, smoking, and exercise. In fact, dietary trans fats were more predicitve of later aggressive behaviors than any of the other known confounders, and predicted aggression similarly in women and men. Dietary trans fats were also associated with depression.
What is a plausible biochemical mechanism of trans fats causing crankiness? Well, the neurons need plenty of omega 3 to keep the lights on, so to speak, and trans fats interfere with omega 3 metabolism. In addition, trans fats on their own seem to cause inflammation, cell energetics problems, and oxidative stress. Yuck.
I linked this Schubert piece a long time ago, but it is worth a revisit. It was written when he was gravely ill and knew his death was imminent. Despite his prodigious body of work he was barely into his 30s.
What don't I like about the findings of this study? I've looked at a number of other studies about diet and aggression. The most rigorous are the Diet and Violence studies done in prisoners, showing boosting micronutrient intake an several replicated randomized controlled trials significantly reduced violent acts. There is also another throwaway observational study linking soda consumption to adolescent violence.
We all know that trans fats in the American diet circa 1999 were of the garbagey processed food variety. Literal junk disguised as tasty treats, though synthetic vitamins might have been sprayed on the flour used as dictated by law. Delicious! So trans fats consumption is not only a marker of mere trans fat consumption, but also nutrient poor, calorie rich crapola that will decrease the amount of micronutrients one would take in. At the same time, the energetics of the cells are compromised by the trans fats and the omega3 levels are torched. One doesn't typically enjoy a meal of wild-caught pacific salmon and donettes, after all.
(Another very sticky point -- trans fat consumption correlated with the amount of linoleic acid taken in, yet Walter Willett has about a thousand powerpoint slides linking amount of omega 6 fatty acid consumption and good health. How does he do it?)
I do find it very plausible that synthetic trans fatty acids are terrible for your brain and behavior. And very plausible that processed foods cause problems too. Here is what irks me about the government guidelines for food. By adding the focus on total fat reduction, polyunsaturated fatty acids and whole grains, they steer folks away from nutrient-rich whole foods and towards convenience foods engineered to meet government guidelines, like lowfat whole grain goldfish crackers and electric green yogurt "food." I actually think Walter Willett's purported breakfast of "kashi" (I'm sure he eats the real stuff, not the processed cereal), is probably, in general, a reasonable choice. I think grains are relatively nutrient-poor compared to eggs and meat and dark green leafy veggies and the like. I also think grains taste worse, though they can stretch out a meal and help with variety, and I am rather famous for my partiality to steak so I'm hopelessly biased.
I wish the government food plate looked more like this one. I think we all agree trans fats are nasty, and this study is one more reason to look upon them with a wrinkled nose and suspicion.
Oh, man, when I posted this article I hadn't seen Willett's take on the red meat study yet! Here's my personal take on the moustached epidemiology nutrition crusader, in case you haven't read it yet. My opinion: there will probably be a greater public health benefit from encouraging people to eat steak than to eat kashi (because who is really going to eat kashi?)…
Small Businesses Question Health Insurance Tax Being Affordable–Economics Have Changed Since Law Was Written-Tax “Millionaire Data Sellers” Instead - Much Bigger Pot To Make Up for Lost Budget Funds
If you read here often enough you may have stumbled across my little campaign to tax the profits that banks, corporations, high frequency traders, drugs store chains and so on make getting “data for nothing and the profits for free”. The potential is huge if Walgreens made just under $800 million on their SEC statement in 2010 and I would almost guess they could have broke a billion in 2011.
Why should the big conglomerates profit so heavily and the “algorithmically generated profits” be so high? There’s no incentive to set up factories and hire people when a company can grab a couple programmers, write the web mining algos and start running a few queries and reports and sell the data which they get for free. We try and base too much of our economy today on algorithms and while we need them, we all need balance with manufacturing too. You know the best part of this idea is that insurance companies make millions selling data too so maybe a nice little revenue/tax bonus here and they still make enough to keep shareholders happy to boot.
Here’s my thoughts on this topic and the average consumer has no clue that all this is made as you can’t see, touch, feel or talk to those algorithms but they have teeth and take your money and your data behind scenes if written to “maximize financial dollar profits” whether they are accurate or not.
Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US
Small businesses are being pinched and this is no exception. It’s not that the Healthcare Law was bad but the economy evolved and a few modifications are needed, and especially in the math areas. Nobody is accountable there and with some of the big data capabilities coming in it’s hard to get to the bottom with multiple layers of code running. By the way thanks to all who are now searching for “The Attack of the Killer Algorithms” on search engines as it looks like that’s becoming a keeper.
There are many very good provisions of the Healthcare law and who’s the fool that thinks this doesn’t need to be revisited and adjusted all the time, it’s the world we live in so a total repeal like some folks talk just shows a lot digital illiteracy with politicians and lawmakers.
I said a while back that our new consumer protection chief better have some good understanding of math and algorithms as big business is using all of it for profit. I have no problem with companies making profits but when technological formulas are widening the inequality someone needs to dig in here and get with the math and algos. The link below has about 20 chapters on the Attack of the Killer Algorithm examples if you want to dive in further and see how formulas that run on servers 24/7 make life impacting decisions about out with a bunch of flawed data in the works. BD
President Appoints Richard Cordray as New Consumer Financial Protection Chief - Hope He Knows And Understands Correcting Flawed Math and Formulas To Battle the “Financial Attack of Killer Algorithms” On Consumers With Banks and Corporate USA
Small businesses are very mindful of their spending especially when it comes to healthcare. The Health Insurance Tax that's included in the Patient Protection and Affordable Care Act is raising eyebrows among business owners.
He's talking about the Health Insurance Tax that's included in the Patient Protection and Affordable Care Act.
Roche Cutting the Price of 2 Cancer Drugs in India To Potentially Avoid Compulsory Law Provisions That Allows Generic Drugs When Cost Is Not Affordable
It was just last week that India took the very first step to make cancer drugs more affordable with Bayer and it looks like Roche might see some writing on the wall. We all know how expensive cancer drugs are and how unaffordable they can be for the patients who need them most.
India Authorizes Local Drug Manufacturer to Make and Sell Generic Copy of Patented Bayer Cancer Drug To Make It Affordable
By jumping ahead of the game and making the drugs affordable up front they could stand to remain outside of the laws in India and again hopefully they will be affordable. The two drugs Herceptin and Mabthera will also be renamed to market under a different name. After last week I wondered if some flood gates would begin to open and it looks like pharmaceutical companies, at least Roche took notice. BD
Roche Holding AG is cutting the price of two expensive cancer drugs in India—and giving them new names—in an effort to gain market share and avoid competition from generic drugs in the fast-growing economy.
The move marks a shift for the Swiss drug maker, which long has argued that consumers everywhere should pay the same price for its medications. By giving the drugs new names in India, Roche hopes to avoid losing pricing power elsewhere, though it isn't clear the company will succeed on that score.
The arrangement involves Herceptin and Mabthera, the wholesale costs of which are about $3,000 to $4,500 a month per patient. Tuygan Goeker, head of Middle East and Asian markets at Roche, said the prices would be cut in India starting next year, though he declined to say by how much. By offering lower-priced versions, Roche also aims to avoid being compelled under Indian law to allow generic-drug makers to produce less-expensive copies.
Roche's plan also partly is aimed at preventing India from demanding a so-called "compulsory license" for Roche drugs, which would allow a generic-drug maker to make less-expensive copies. Indian law gives the country's patent regulator such authority if a medicine is priced beyond patients' reach.
http://online.wsj.com/article/SB10001424052702303812904577297673910205972.html?mod=googlenews_wsj
Thursday, March 22, 2012
Worried If your ACO Is Going to Be Too Costly? HCP Offering Accountable Care Reinsurance–Once You Figure Out What Your ACO Model Is…
It didn’t take long for this to pop up especially with so many unknown factors that are out there today as even the best laid plans with analytics are in a model, technology can show up tomorrow and throw a left hook at any time. We have a lot of created and non-created disruptions in healthcare and some good and some not so good.
ACO Stop Loss Reinsurance is the actual name and there premiums paid and it can be spread over a number of payments. Many managed care organizations have purchased re-insurance policies as well and sells malpractice insurance to doctors as a primary business.
Last year in the Cayman Islands, Aetna took out a reinsurance policy in case their medical operating loss numbers went over 104%. BD
Aetna Takes Out Reinsurance Deal In The Cayman Islands- $150 Million to Kick When Medical Loss Ratio Hits 104%
HCP National Insurance Services, Aliso Viejo, Calif., is now offering accountable care organization reinsurance for participants in the Medicare Shared Savings Program.
The company, which also specializes in providing medical malpractice insurance, described reinsurance for ACOs as “a big growth area” for the company in a news release.
http://www.modernhealthcare.com/article/20120322/NEWS/303229960/
IBM Watson Going to Work at Memorial Sloan-Kettering Cancer Center–Data Loading and Training To Begin
This is actually very good to compile cancer data and we can certainly learn from it. The process will take a while as the data has to be fed in. When used for diagnosis knowledge, patient input, drugs, and so forth this is great. Even big data has the 
same issues though as what we have used for years and that is being assured of what data you load as it’s still a machine. At the end of 2011 it was also announced that on the west coast that Cedar Sinai was going to explore the system for the same or similar purposes.
Wellpoint to Bankroll Use of IBM Watson at Cedar Sinai Medical Center to Research Cancer Data/Information To Provide Guidance for Physicians
For research this is great but hold your breath before bringing in the coding and billing portions of all of this as that’s where caution is needed. If you read the news today how many stories, and there are tons of them with coding, billing and reimbursement thus if one leaves the work of Watson to research and clinical areas without that mess, we might have some good intellectual break throughs. I commented on that a while back as when you have multiple layers of new code running through the machine does what it learns and is taught and you run close of getting to a bottomless pit at times, but again for research and clinical use this is a good deal.
Machine Learning Software Working Behind the Scenes Should Move With Caution in Healthcare-Writing the Unreadable With Rogue Algorithms With No Human Intervention
As the article states it’s going to be a while before the Watson processes are going to be available for use and data integrity along with credibility is going to be key in the preparation. On the other side of the coin though in the financial areas, something for consumers to be aware of with big data as nobody checks the math of banks and a lot of the big investment firms so more place to hide code to enable desired results more so than accurate results as we know what happens when money is involved. The SEC certainly is going to need some “big data” capabilities soon or as consumers we are sunk.
IBM Watson Going to Work At Citigroup on Wall Street–Congress Didn’t See Big Data As A Tool (Hadoop Framework) When They Had Their Chance…For Consumers The Attack of the Killer Algorithms–Chapter 22
When left to it’s own, and not regulated and audited, we get what I have written about below with formulas running a muck and hurting consumers. BD
Attack of the Killer Algorithms–Digest & Links for All Chapters–See How the Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You
WHITE PLAINS, N.Y. — The medical training of IBM’s speedy Watson computer will continue with a residency at a renowned Manhattan cancer hospital.
IBM and Memorial Sloan-Kettering Cancer Center said Thursday that they will add the latest in oncology research — and the hospital’s accumulated experience — to Watson’s vast knowledge base, and keep updating it.
Watson will be fed textbooks, medical journals and — with permission — individual medical records. Then it will be tested with more and more complicated cancer scenarios and assessed with the help of an advisory panel, Kohn said. It’s expected to speedily suggest diagnoses and recommend treatments, ranking several alternatives.
Watson can even be instructed about individual patient preferences, Kohn said. When evaluating treatments, for example, it could take into account that a patient feels strongly about not losing her hair.
Rite Aid Stores Hosts RV Tour From the Skin Cancer Foundation Coming To A Store Near You For a Free Skin Cancer Screen
This is pretty cool as a big RV comes around and had 2 private exam rooms so each person has privacy while being screened. All locations in each state have not been posted yet but it looks like Florida is right at the top of the tour.
The tour is accredited with finding over 5,000 cases of pre-cancer and 239 cases of melanoma as well. There’s also a page where dermatologists can sign up to volunteer. Most states have laws to where MDs can’t cross state lines to assist so they need local doctors to make it work. BD
Rite Aid Road to Healthy Skin
Press Release:
CAMP HILL, PA (March 22, 2012) – Thousands of Americans can receive free full-body skin cancer screenings this spring and summer thanks to The Skin Cancer Foundation's annual Road to Healthy Skin Tour presented by AVEENO® and Rite Aid. Starting this week, the Tour’s 38-foot customized RV is stopping at more than 50 Rite Aid stores as it zig-zags across the country.
The Tour draws on the expertise of local dermatologists who volunteer
to perform free, full-body skin cancer screenings, which The Skin Cancer Foundation recommends receiving annually. In its fifth year, the Tour is reaching out to new communities and adding new stops in Georgia, Virginia, Pennsylvania, upstate New York and Ohio. Many of the Tour stops are at Rite Aid Wellness Stores, which are Rite Aid's latest store prototype and feature expanded pharmacy services, an enhanced selection of wellness products, and regular health events and screenings such as these.
“We're proud to have sponsored the Road to Healthy Skin Tour every year since its inaugural journey," said Robert Thompson, Rite Aid executive vice president, pharmacy. "These screenings are a great example of the kind of proactive health and wellness resources that Rite Aid is committed to providing. Rite Aid pharmacists can help customers select the right sunscreen and counsel on possible medication interactions, such as the increased sun sensitivity that accompanies many common prescriptions."
The four past Tours have caught nearly 5,300 potential skin cancers and pre-cancers including more than 200 suspected cases of potentially deadly melanoma. Visitors are screened in one of two private exam rooms on the RV on a first-come, first-served basis. They also can sample sun protection products and learn about skin cancer prevention and early detection.
Visit www.skincancer.org/tour to view an interactive map of the Tour.
The Skin Cancer Foundation is the only global organization solely devoted to the prevention, early detection and treatment of skin cancer. The mission of the Foundation is to decrease the incidence of skin
cancer through public and professional education and research. For more information, visit www.SkinCancer.org.
Rite Aid Corporation (NYSE: RAD) is one of the nation’s leading drugstore chains with approximately 4,700 stores in 31 states and the District of Columbia and fiscal 2011 annual revenues of $25.2 billion. Information about Rite Aid, including corporate background and press releases, is available through the company’s website at www.riteaid.com.
Robb Wolf, James FitzGerald and the Ghosts of Crossfit Past
Lessons in life are often repeated, and we may not get it the first time around. A high school reunion is coming up, and I've had the opportunity to chat with some old friends not in touch for 20 years. And despite those decades they are still the same, still terrific people. When I find such friends I do try to keep in touch nowadays, as it is so easy to link a facebook account. But of course there is no substitute for seeing someone live and in person. Biologically speaking we use all our senses when meeting up with someone, note chemokines, subtle changes in expression, a lively or reserved manner, the sparkle in one's eye… or the threat, as it is likely murder was a big contribution to mortality in the past. These non-verbal signals are why in clinical psychiatry practice even a video therapy session will never quite replace the in person visit.
Schubert Impromptu No. 3 (right click to open in new tab)
At PaleoFx12 I had the great pleasure of meeting several fellow "paleo MDs." After the final panel I went with two of them (we shall call them Catfish and Hollywood*) to BBQ and the wild Austin scene of SXSW on a Friday night. When one meets another paleo blogger intensely interested in the science, as at AHS and PaleoFx, it is rather like crawling out of the desert into an oasis of likemindedness. Meeting other paleo doctors is like crawling out and finding the Taj Mahal. I hate to get all "poor me, I'm a physician," but the current suffocating paradigm of American medicine can be so deflating. In psychiatry we are squeezed into this impossible space between the FDA, Medicare, the scientific literature or "evidence base", common sense, expectations, history, and ethics. Sometimes there are no right answers, and clinical practice becomes the square root of a negative number. So to meet other doctors who look at the evolutionary paradigm, and have succeeded in their personal lives implementing it and are thinking about implementing it for their patients is exhilarating. They understand the legal and cultural ramifications of such a change. In a very real sense, we are a brotherhood, and they are my kin. Such meetings can be intense, but fulfiling. We walked together past the Texas State Capital at midnight, knowing we would meet the next day for an after-conference training session at a local Crossfit (appropriately enough).
The training session was an OPT presentation by James FitzGerald. Apparently he has the honor of being kicked out of Crossfit just like Robb Wolf. And to me this situation (ghost-like at paleoFx as the last time Robb and James were in Austin was for the infamous Black Box Summit where they were summarily dismissed from the official Crossfit fold) is absolutely remarkable.
Have you ever met Robb Wolf? He is an incredible presence. Intense, organized, smart, driven, good-looking, and by all accounts devoted and kind. Any reasonable business would love to have him as the poster boy of the Good Example. James FitzGerald was a similarly impressive specimen. It is hard to define him without using swear words (as he ended about every third sentence with one or another), but it is clear from his presentation that he thinks in 17 directions at once, he cares intensely about athletes and training, and he has the wisdom to break it down and know what is going wrong to you can set it right. Though much of the presentation went over my head as a non-trainer, I was captivated by James' ideas and break-down of the essential problems facing an athlete in an intense moment. Is it blood flow, psychologic barriers, lungs, training, diet… whatever it is ask the athlete his or her experience after the WOD and he or she will tell you. James has been in the research game from the beginning, and he noted with excitment that we could throw out the numbers from endurance athletes and straight -up weight training, as the differences with Crossfit-style training showed whole new numbers, and whole new possibilities of human capability.
How could Crossfit HQ dismiss James and Robb for the crimes of suggesting paleo nutrition, the idea of on-ramp beginners training rather than ubiquitous "scaling" and *gasp* periodization?
The answer is in my wheelhouse. Personality. James and Robb with their brilliance and drive were a threat to the powers that be. At that moment HQ were more comfortable jettisoning the bright stars than accepting new ideas. As wildly off base as such a business decision could be, it makes sense in light of an understanding of a personality in charge confronted with the young challengers.
In the paleosphere we have the same challenge. There are flamboyant and brittle personalities who insist they are correct, and new information coming online all the time. What does the newbie hold onto? With opposing and strongly-argued viewpoints, what do we believe?
Forget the paleo myths. Forget the personalities. Are you eating (for the most part) real food (excepting autoimmune disease). Are you exercising? How is your sleep? What are you feeling? What are the pitfalls? What is your family doing?
Fix those issues and answer those questions first. Know where you are, and then look for more guidance. We are working on a network of doctors who might help. I hope cults of personality won't get in the way, but don't let it confuse you. What makes sense, from every angle? Never suspend disbelief.
* so named because a woman at a restaurant mistook him for a Hollywood star. And while he was certianly ruggedly handsome and in good shape, I felt the incident serrved as an example of how a good lifestyle and exercise regimen could beautify someone to more mythical status...
Schubert Impromptu No. 3 (right click to open in new tab)
At PaleoFx12 I had the great pleasure of meeting several fellow "paleo MDs." After the final panel I went with two of them (we shall call them Catfish and Hollywood*) to BBQ and the wild Austin scene of SXSW on a Friday night. When one meets another paleo blogger intensely interested in the science, as at AHS and PaleoFx, it is rather like crawling out of the desert into an oasis of likemindedness. Meeting other paleo doctors is like crawling out and finding the Taj Mahal. I hate to get all "poor me, I'm a physician," but the current suffocating paradigm of American medicine can be so deflating. In psychiatry we are squeezed into this impossible space between the FDA, Medicare, the scientific literature or "evidence base", common sense, expectations, history, and ethics. Sometimes there are no right answers, and clinical practice becomes the square root of a negative number. So to meet other doctors who look at the evolutionary paradigm, and have succeeded in their personal lives implementing it and are thinking about implementing it for their patients is exhilarating. They understand the legal and cultural ramifications of such a change. In a very real sense, we are a brotherhood, and they are my kin. Such meetings can be intense, but fulfiling. We walked together past the Texas State Capital at midnight, knowing we would meet the next day for an after-conference training session at a local Crossfit (appropriately enough).
Have you ever met Robb Wolf? He is an incredible presence. Intense, organized, smart, driven, good-looking, and by all accounts devoted and kind. Any reasonable business would love to have him as the poster boy of the Good Example. James FitzGerald was a similarly impressive specimen. It is hard to define him without using swear words (as he ended about every third sentence with one or another), but it is clear from his presentation that he thinks in 17 directions at once, he cares intensely about athletes and training, and he has the wisdom to break it down and know what is going wrong to you can set it right. Though much of the presentation went over my head as a non-trainer, I was captivated by James' ideas and break-down of the essential problems facing an athlete in an intense moment. Is it blood flow, psychologic barriers, lungs, training, diet… whatever it is ask the athlete his or her experience after the WOD and he or she will tell you. James has been in the research game from the beginning, and he noted with excitment that we could throw out the numbers from endurance athletes and straight -up weight training, as the differences with Crossfit-style training showed whole new numbers, and whole new possibilities of human capability.
How could Crossfit HQ dismiss James and Robb for the crimes of suggesting paleo nutrition, the idea of on-ramp beginners training rather than ubiquitous "scaling" and *gasp* periodization?
The answer is in my wheelhouse. Personality. James and Robb with their brilliance and drive were a threat to the powers that be. At that moment HQ were more comfortable jettisoning the bright stars than accepting new ideas. As wildly off base as such a business decision could be, it makes sense in light of an understanding of a personality in charge confronted with the young challengers.
In the paleosphere we have the same challenge. There are flamboyant and brittle personalities who insist they are correct, and new information coming online all the time. What does the newbie hold onto? With opposing and strongly-argued viewpoints, what do we believe?
Forget the paleo myths. Forget the personalities. Are you eating (for the most part) real food (excepting autoimmune disease). Are you exercising? How is your sleep? What are you feeling? What are the pitfalls? What is your family doing?
Fix those issues and answer those questions first. Know where you are, and then look for more guidance. We are working on a network of doctors who might help. I hope cults of personality won't get in the way, but don't let it confuse you. What makes sense, from every angle? Never suspend disbelief.
* so named because a woman at a restaurant mistook him for a Hollywood star. And while he was certianly ruggedly handsome and in good shape, I felt the incident serrved as an example of how a good lifestyle and exercise regimen could beautify someone to more mythical status...
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