Medicine for the Future

Our medical system in the U.S.A. has been envy of the rest of the world for many years. The inventions and innovations for surgeries, pharmaceuticals, improved hospital systems, medical educational institutes, training of doctors and nurses, creating efficient emergency medical system, probably the best trauma system in the world and most notably the most well trained physicians by the modern medical and surgical residency systems that every other country tries to imitate.

However, there is one glaring element that has been overlooked for many years. That is the “Customer Care.”

America is probably the most innovative nation on earth. We invented more things that changes lives than any other countries. Just look at the Electric Light Bulb, Modern Medicine, Airplanes, Movies, Phonograph, Skyscraper, Liquid Fuel Rocket, Sunglasses, Computer, Nylon, Automatic Transmission for Automobiles, Microwave, Laser, LED Lighting, Shopping Malls, Laser Printers, Fiber Optic Cable, Internet, E-mails, GPS Navigation System, IBM’s Watson, Artificial Intelligence, iPhones, and FaceTime. 

With all of the innovations and inventions came the surprising advancement in marketing and selling. The urban cities have seen the invention of supermarkets, downtown shopping malls come and go. One thing that was important for these service sectors to survive is to cater to the customers’ needs and their wants. The customers want faster and convenient service with kind human touch. Just look at the most successful shops that are still with us today. The Nordstrom, 7-11, QuickLube, McDonad’s, Costco, etc. These are where people want to go shop and enjoy the consistent, uniform services with excellent customer care and consistent human touch with reasonable prices.

In modern medicine we have come far with inventions that changed the world with its innovation and its applicability in extending human lives. The CNN top ten lists are Human Genome Project, Stem Cell Research, Atripla-Triple HIV Treatment Tablet, Targeted Molecular Treatment for Cancer Cells, Minimally Invasive Surgeries, Smoke-free laws, HPV Vaccine Gardasil, Transplants Technology, Birth Control, Bionic limbs.

However, the one overlooked area of medicine is the customer care. It starts with the experience of the each and every patient at the doctor’s office. The doctor’s office must be able to achieve the following convenience factor. It must offer the immediate pain free laboratory exams including the basic complete blood tests, urine tests, pregnancy test and chest and extremity x-rays and basic ultrasound. These tests must be available for immediate viewing and uploading to the patient’s digital devices and must have immediate and preliminary interpretation by the machine that performs this test. The overall test results should be discussed with the same physician at the end of the initial visit. The doctor must not be liable for missed diagnosis because there are professional pathologist, hematologist, radiologist and other specialists that are trained to read the x-rays, lab results and histopathologic slides to determine if and when these things are relevant. However, during the initial consultation the preliminary readings of the x-rays and laboratory results must be available for viewing by the patient and the physician based on the algorithm  so that the physician is not under pressure to make the exact and absolutely final diagnosis. However, further detailed analysis will be done by the experts upon request by the patient for more expensive charges for the later date.

Finally the patient must have the medications individually packaged for the duration of the treatments ready by the time the initial consultation and treatment plans are agreed by the patient and the physician. The pharmacist must be available during the same time that the doctor’s office operates whether it is from 8 o’clock until the closing of the office usually 5 or 6 p.m. The medications must be in an individual transparent biodegradable packet with one sheet of explanations of which tablet does which treatment and the side effects in a simple to read and understand language and the packet should have printed on it at what time to take these pills.

The customer must know exactly how much these services cost and they must be able to pay with their insurance plans with reasonable and consistent co-pays. The co-pays cannot be different for each and every practitioner. It must be uniform whether it is for a family doctor or internal medicine doctor or OB/GYN or pediatrician. Once these common illnesses are found and treated, then the more advanced treatment plan can be formulated and referred to a bigger clinic and hospital based system. If the patient needs a surgeon or oncologist or neurologist, the patient must be referred to them immediately and the appointment system must be made from doctor’s office to doctor’s referral specialist office bypassing any need for the customer’s to get involved.

These must be done so that American medicine reflect upon the convenience and customer care that we are so proud in implementing in almost every other aspect of the society where the competition for public’s money demands and dictates the surviving service sectors. The health care system must learn from the likes of Nordstrom.

Francis
10/20/2017

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Venezuela Must Wake Up!

Venezuela in trouble!

There are many things that we can learn from a social and political experiment of Venezuela. When the popular president Hugo Chavez came into power by promising to  give away benefits to the mass essentially turning a free democratic nation into government controlled Socialist-Communist experiment such as Cuba and North Korea, it completely destroyed the fabric of society. When the high crude oil prices gave a huge windfall to the country, it seemed that the give away Socialist government was right for the people of Venezuela. However, there was absolutely no investment for the future of the country. Instead of using the surplus capital freely coming in by selling the oil at high price for building the infrastructures, capital improvements, building manufacturing factories to provide jobs and education of the masses, the ruling class and the people started borrowing heavily to spend on consumer goods from other countries.

While the oil priced remained high and the demands for the sweet crude oil flowing from the ground of Venezuela, the society was humming along with free things from the government, however when the market correction happened and the crude oil price started plummeting, the borrowing and freely spending party was over.

The Socialist-Communist experiment has come to an end. When the society bases its system with free hand outs from the government and stops working toward manufacturing goods that are essential for their lives, stops investing in the infrastructure such as Bullet train, public transit systems, clean water, recycling plants, consumer goods production, clothing and farm products and also stops investing in the education systems to educate the upcoming work forces, then the only thing that is left is to rot like the Venezuela is experiencing now.

The implosion of the society with rampant corruption and poor management of monetary policy, massive exodus of the brain and top 10% of the population, highest inflation and devaluation of Venezuelan currencies and world wide embargo of its oil spell only one thing, total isolation and failure of the poor country.

Now is not too late. The Venezuela must change its fabric of society by investing heavily in all of the infrastructures and manufacturing basis and invest in the roads, bullet train, mass transit system, public safety and schools, encourage privatization of certain manufacturing and service sectors so that people will have future to look forward. The corruption must end and the government must become democratically elected and transparent soon or the inevitable revolution and chaos with massive human suffering will be inevitable.

Wake up Venezuela.

The Graduate: Film review 1/4/2018

My very first film which I truly loved is The Graduate. It is now a very old film. Most of the people involved in this film are near retiring age or passed away. Even with this in mind, this film has something to offer to anyone who is a fan of comedy drama of everlasting beauty. There are certain things that are classic and timeless. There are poems and books and movies as well as music whose popularity will never disappear or diminish with time. This movie is definitely one of them. It is classic not because it doesn’t have any script that caters to the late 1960’s of America, yes it does. It has many moments that shows what it was like in southern California during the late ’60’s with reference to Topless club, drive-in hamburger joint, and some reference to the students who were “agitators” against the Vietnam war. Some of the songs also briefly alludes to the restless society against the social ills of the time. However, having said all that, the timeless quality of this movie is all about the young man’s journey into a manhood and sexual maturation and full realization of finding out the true love through an illicit affair with older woman.

The story is very simple indeed. The young Graduate of a liberal college with excellent grades and stable parents comes home to have a nice summer after the graduation and suddenly becomes an object of sexual desire of an older but very attractive woman who is very close to his family. She is a wife of a lawyer who is a partner in the father’s law firm . This older woman educates him to become a sexually mature man in a short time and slowly changes this innocent young man to become a moody, guilt-ridden and depressed man who only goes out every night to be with this older woman. The audience slowly watches in fascination how a focused, happy young man, who is an athletic, smart and really innocent  but aimless college graduate slowly falling into the arms of older seductress who is depressed, alcoholic, selfish and deeply troubling older woman. She turns him into the same brooding, guilty, depressed, hopeless man with the initial fascination of nightly sex, which slowly turns into the sheer boredom that he feels. Then he actually meets a young woman of his age, whom he truly falls in love with and he  transforms back to a whole person with hope, love and salvation. The story has remarkable timeless quality to it. The script and its delivery by the actors show the near perfect work of the director and writer. The comedic elements are almost everywhere without obvious efforts. When the main  character played by the legendary Dustin Hoffman is trying to get a hotel room for the first time in his life reminded me of every young man trying to act like a seasoned and older person who may be in a same situation. It was so life-like, I sensed so many of us identifying with similar activities, like the first time you snuck into a porn movie or first time that you smoked in secret.

However, the one of the most captivating thing about this movie is the music and how heartfelt the mood set by the music by Paul Simon and Art Garfunkle is throughout the entire movie. The quiet guitar intro to the last song of the movie called the Sound of Silence and the poetic song of April Come She Will in the album Sound of Silence released in 1966 caps the mood of the movie so well. The four seasons of love found and love lost in the perfect poem to describe the fleeting moment of intense passionate love affair just sums up so beautifully, I can never tire of watching that portion of the movie.

The conflicting emotions portrayed elegantly by the two main characters of the movie played by Dustin Huffman when he truly realizes that he was in a bad dream seduced into it by Mrs. Robinson and the female love interest realizes that she is possibly and truly in love with this young man are not only breathtakingly beautiful to watch but also heart breaking to watch.

The comedy in the movie is very subtle but definitely the entire movie is a darkest, black comedy barring close to the tragedy. However, the story and acting and the iconic songs that make this movie one of my all time favorite movie to enjoy over and over again. What a periodic timepiece which is really timeless and beautiful. For a serious film lover, I strongly recommend this movie. 

Solutions to Deteriorating Downtowns In the U.S.A.: Los Angeles

It is disheartening to see some of iconic cities in North America deteriorating to the point where the tourists and residents alike feel threatened by the sheer dirty trash, rats, graffitis, homeless situations, mentally unstable individuals and drug usages. My recent trip to Hong Kong, Seoul, Tokyo, San Francisco, LA, New York, Baltimore and London gave me some ideas to “how to solve the problem of deteriorating cities in North America.”

There are no easy solution to the situation but the following observation and remedy may help.

I will deal with only one city at a time due to complexity of issues and individual city may present with different sets of problems and solution. Let’s talk about LA.  For the sheer size of LA and its huge tax income, the city has literally failed in its policy toward deteriorating downtown specially near the garment district, jewlery district and for certain at the Skid Row. It is also really bad around Compton and other areas around Rampart. The situation requires multiple inputs and solutions.

Most importantly the city officials and downtown residents must unite in one thing, keeping the downtown clean of the following. Trash, homeless population, drug users, mentally ill patients, illegal street vendors, litters, squatters, deteriorating public facility and graffitis. First the city must allow its residents tools and power to keep their area clean, safe. The city must give the residents not only power to keep it clean but also give them assistance as well as legal rights to connect with a special unit of police, city cleaners, trash collectors, social service by giving the store owners, store keepers and downtown residents a special and cohesive team of city workers under their power. That means that certain numbers of police responders, trash collectors, special unit of social workers, clerks and graffiti removal team, power washers, tree cutting service dedicated to the certain area of city that needs the help the most.

For example, the City must have a concentrated one hundred people team made up of the following: Social Service People, police, trash collectors, painters, health counselors and nurses, communication specialists, mental heath care workers, relocation specialists and a unit leader. They must have a partnership with the building owners, shop owners, frequent shoppers, residents and others who benefit from cleaning the place like the Skid Row. Then each resident and shop owners must be given the following instructions and equipments. They must be given 1-800 numbers that are available 24 hours 7 days a week. When they call and report a complaint even if it is a drunk defacing the public property or using the street as a bathroom, the responders must immediately dispatch a police, social worker or mental counselor to the area to deal with arrest, warning and possible incarceration and relocation of the perpetrators. The owners must have in their disposal basic equipments that need to keep the street in front of their shop and apartments clean of gums, trash, urine, rats, etc. It must be a partnership.

The city must build a temporary tent city away from the downtown with clinics, hospital beds, mental institutions, jail, juvenile homes, women shelter, orphanage, school, baby sitting, kitchen and cafeteria and adequate personnels to maintain the tent city and start building permanent facilities immediately nearby.

Any perpetrators who are defacing the city either by graffiti defacement, public intoxication, drug usages, prostitution, disorderly conduct, display of mental illness all must be screened immediately by the police, social service, mental health care people and determine whether they should be given a warning and citation, arrest and relocation, incarceration for criminal charges, etc.

The residents should be rewarded for keeping the area clean and engaging the trusted city officials and police and the special task force team by lowering their tax burden and given official stamps to park in the nearby safe parking places, special invitations to meeting with the special unit task team and be invited in participating in higher level. Once they sign up to become the special team to clean up their neighborhood, they must be given a special phone, right to their frontage and permits to redeem for discount in city tax items, state income tax and special parking permits as well as various rights given to the law abiding citizens and residents.

We must give the opportunity for the police and social service the much needed place for homeless people and orphans and women to live in peace temporarily in the simpler tent city with services of shower, bathrooms, beds, foods and clothing. Thereafter, the permanent buildings for mental hospitals, drug rehab, clinics, schools, cafeteria, social service, orphanages must be built and services provided.

Without the initiatives and leadership like this, LA will deteriorate further driving people away from the downtown and its surrounding area causing the unstoppable deterioration that I see in places like San Francisco, Chicago, certain parts of New York City and Detroit. We must make a stand and start working today.

Follow me at MyBelief2017.WordPress.com.

Future of Mentally Ill Patients

Many Americans are aware of the plight of mentally ill patients in our midst. Most of them run into law, police and homelessness. Many of them wonder the streets of San Diego, San Francisco, New York, Los Angeles, Portland, etc. The numbers of people who are homeless are growing and the mentally ill patients make up a majority of the homeless folks.

The reason why we are inundated with mental patients out on the street is obvious. Our government will not spend the money and resources to fix this problem. We had stopped building and maintaining the mental institution to treat these patients appropriately and sent them out to the streets and depended on the existing health care systems such as private hospitals, academic hospitals to house these patients temporarily until they were stabilized with medications and send them out with a  taxi cab fare.

This type of shifting a huge social problem to the police and hospitals, which I believe are inadequately trained to deal with many mentally ill patients are causing influx of the homelessness and poverty and overall dangerous climate for both law abiding citizens and the mentally ill patients.

We must wake up from the nightmare and face the reality. We as a nation must put some priority and pass the legislations to deal with this problem immediately. Anyone who is homeless and shows mental illness must be treated in a controlled, residential facility with competent and caring psychiatrists, psychologists and BSN and RNs. We must build enough new facilities in all of the cities who are faced with the epidemics of homeless mental patients now. We cannot kick this issue down further for our future generations to face.

Thanks for reading. Follow me at MyBelief2017.wordpress.com.  So long. 

 

How To Play Tennis: Beginner’s Guide Chapter 8-Net Play

The most difficult technique in tennis is to play at the net. Unless you are supremely confident, it is very difficult to master the play at the net. It is awfully daunting task of starting to play at the net since the time it takes for the baseline ball to travel across the net is half of time than if you were playing the baseline. Since it is faster across the net and you are inside the service box facing your opponent very closely, you have to be quick.

Here is the technique. First your grip on the racquet must be slightly higher and firmer. Your forehand and backhand grip is quite close to the baseline forehand and backhand grip but it has to be gripped so that the forehand and backhand must face the ball more direct and flat. Depending on the height and speed of the ball, you must hit the balls as if you are pushing the ball in front of you. The racquet must be held upright and near 90º and start at your shoulder height and push forward and push the ball through and stop until the ball leaves your racquet with firm speed and crispiness with fantastic clapping sound. Don’t let the speed of the ball and force of the ball displace your racquet backward. You have to keep your grip firmly and moving forward before the ball reaches your racquet so that the racquet will not waiver when it hits the ball.

Now here comes the important lesson about the hitting surface of the racquet. Your racquet has a 98 in² and about 68 in² of a sweet spot. I am just guessing at the sweet spot’s area. However, the sweet spot is right at the center of the racquet. You must learn to hit the ball at the center of the sweet spot. It is very important that you learn to hit every net volley ball at the center of your sweet spot.

Second most important skill to know is the footwork. At the net the footwork is extremely vital. When you are hitting the forehand, you must step forward with your left foot. Right foot comes out for the backhand. Sometimes you don’t have a chance to turn left or right, then you have to firm up your wrist and shoulder and hit the ball in front of you with a cocked up wrist. You must push the racquet forward and slightly downward to keep the ball into the court and as close to the back baseline as possible.

Quickness, early racquet preparation, watching the tennis ball until you hit the ball and keeping the racquet straight up and firm are all the basic things that you must do to be a great net volley player. If you can do this well, you will definitely improve your game to the next level.

This is my final chapter and end of the book for Beginner’s Tennis Playing Guide. Good luck to you. Thanks for reading my blog. Follow me on my blog at MyBelief2017.WordPress.com.

How To Play Tennis: Beginner’s Guide Chapter 7-Lob

Lob is probably one of the most defensive tennis technique. When you are in trouble, you must lob over your opponent’s head and his racquet’s reach. It is important that you learn to lob perfectly so that you don’t hit to ball too low or too long. It can be as high as you want it to go but it cannot go out of the court or lands so short that your opponent will have time to get to the ball and smash it for a winner. Sometimes the lob can be an effective offensive game winner if your opponent is not very good at putting away the lob.

The lob is a high ball that is hit creating a perfect arc across the net. Usually the lob is only played when you cannot hit the ball effectively. This is how you hit the lob. Your racquet must be flat and go from the lowest point that you can start and push upward toward the ball in the direction that you want the ball to create an arc over the head of your opponent.

Whether it is a backhand lob or forehand lob, you must play exactly the same way over and over again until you can get the perfect height and the right distance near the baseline. It is a hard ball to hit but excellent defensive shot. Many good players do not know how to to the lob well since they don’t practice it. Many of bad players only learn to lob over and over again. Therefore, the lob technique should be something that you should learn and practice after you learn the Forehand, Backhand, Service and Slice. It is one of the five great skills to play the tennis well. However, please, reserve the lob only when you are in trouble.

Best of the luck in beginning your journey through the most exciting sports. Please, follow me on my blog, MyBelief2017.WordPress.com.  Thank you. 

How To Play Tennis: Beginner’s Guide Chapter 6-Slice

The next skill set that you must master is how to slice a tennis ball in your forehand and backhand. The slicing is one of the most reliable way to place the ball in your opponent’s court when you may be in trouble. If you cannot move to the ball quickly enough and your positioning is really awkward, you must use the slice to keep the ball in play so that you can be ready for the next shot.

The forehand slice is relative easy. You must grab the racquet firmly and the grip must be same as your forehand with the second finger’s knuckle on the third bevel and the heel of your palm must be just above the edge of the racquet. At 45º angle on your racquet head starting at the level of your shoulder you must strike the ball at that angle from your shoulder high down to your waist level hitting the ball in a oblique downward angle at a speed to send the ball across the net with a spin. When the ball hits your opponent’s court, the ball will hit the ground and spin back toward you.

The forehand slice should be practiced with a ball bounced in front of your body and your left foot should be in front of you and your back foot or right foot 45º behind your body and the racquet has to be slightly in front of you with the head of the racquet starting from your head high and coming down slicing it to the waist level. You must practice this for hundreds of times to make the balls travel across and above the net and land at the opponent’s side of the court safely inside and consistently bounces backward.

Backhand slice is much more difficult. You must have the racquet head at 45º angle with your shoulder roared to your left side and right foot forward and left foot back and your racquet must travel from the level of the head and slice downward and forward stopping right at your waist level. The ball must be hit right in front of your body and the ball must cross the net just above it and land the ball and again it must bounce backward. Extreme angles of your head will actually cause the balls to bounce backward a lot more if the angles are more extreme. The speed at which you hit the ball also makes the slice ever more difficult for your opponents to hit back.

Practice hard and consistent slicing technique is one of the most important skill set that you can learn and employ reliably all the time. Good luck with your game and continue to follow me on my blog, MyBelief2017.Wordpress.com. Thank you for reading and good luck.