Friday, December 08, 2017

how Money begets More Moneycontrol


https://www.ft.com/content/e4f1c550-0762-11e4-81c6-00144feab7de

“If you are a large, wealthy multi-billionaire you can put that into an M&A transaction and earn 15-20 percent. If you’re an ordinary American you earn 2 percent on your investments. That disparity has to be democratized. It’s now possible to take those frictions out. That is an important concept because it expands the number of people who are in the financial sphere. That has a positive growth impact. At the same time, it is about unmet needs.” I have an office and it’s Grand Central Station: everyone comes through. That shouldn’t be surprising His pitch is that technologically-savvy financial start-ups can squeeze the banks and bring down financial costs, though he concedes there are only nascent signs of this happening.

Vikram Pandit

For a lady with Millions at her disposal wonder why Lynn Tilton did not go for a BOOB job ?




From her company website ."


LYNN TILTON’S STORY

Lynn Tilton’s life journey has evolved from her birthplace – Bronx, NY- through the ivory towers of Yale and Columbia Universities to the male-dominated world of Wall Street. Today, as the founder and CEO of Patriarch Partners, she focuses not only on her more than 75 portfolio companies but also on ”the Main Streets” of once thriving towns across America, that struggle for survival in the new economy that has turned its back on the American worker. Under Ms. Tilton’s leadership, Patriarch’s mission to rebuild America one company at a time and one job at a time have been made possible through tireless work ethic, innovative spirit and an unwavering quest for truth and light where others see hopelessness.
Ms. Tilton’s dedication to the achievement of excellence was fostered at an early age. As a teen, she was a nationally ranked tennis player, practicing nightly to improve her game from 12:00 am to 2:00 am when court time was free-of-charge.
Ms. Tilton later went on to play tennis at Yale University, where she earned a B.A. with honors in American Studies. It was during her junior year at Yale that she married her high school sweetheart, and lost the father who had been a great inspiration and motivational force in her life. Adulthood came without much warning. As graduation approached, Ms. Tilton sought the advice of friends as to which career path to pursue, and soon began interviewing at investment banking firms Morgan Stanley and Goldman Sachs, among others. She was the only candidate in her graduating class at Yale to be accepted into Morgan Stanley’s analyst program – an event that would serve as the launching pad for her career in finance.
Ms. Tilton left Morgan Stanley in 1983, managing restaurants that she owned while attending Columbia Business School. Upon graduation, she took a position with Goldman Sachs’ corporate finance group, focusing on IPOs, and later with Merrill Lynch, at their merchant bank, with a focus on leveraged buyouts. At 25, Ms. Tilton was the single mother of 2-year old Carly Jade, working 100 hours each week. After nine years at various investment banking firms, Ms. Tilton developed a clear understanding of how to successfully restructure leveraged buyouts gone bad and became fascinated with the investment side of the business. This led her to a position at Kidder Peabody, working on distressed debt research and sales, and proprietary investments in distressed assets.
In 1993, with the intent to spend more time with her daughter living in Florida, she began working from that state while commuting every other week to NY for Amroc Investments, the first firm to specialize in the trading of bank loans and trade claims. Five years later, at the urging of several of her accounts, Ms. Tilton left her partnership interests and founded her own bank loan research and broker-dealer firm, Papillion Partners, which would later be the basis for what is now Patriarch Partners.
Using her own funds, Ms. Tilton founded Patriarch Partners in 2000 on the investment principle that making money and making the world a better place are not mutually exclusive concepts. Led by Ms. Tilton’s strength and innovative vision, Patriarch Partners rescues, restructures and breathes new life into companies left for dead and piled upon the heap of creative destruction – a business practice for which few others possess the courage and dedication required to succeed.
Since 2000, Ms. Tilton and Patriarch Partners through affiliated investment funds have committed to debt and equity investments and provided operational and strategic expertise to more than 240 companies, representing more than $100B in combined revenues, thus preserving more than 700,000 American jobs that would have otherwise been lost through liquidations. It is Ms. Tilton’s belief that our country’s most valuable asset is human capital – and that job creation is the essential element to a true and sustainable economic recovery and prosperity. Her commitment to saving and creating jobs motivates her tireless daily leadership of the companies that currently comprise the Patriarch platform."

"The subtle cultural bias he encountered at Morgan Stanley" Is it really Subtle?

There’s almost too much awk to handle in today‘s New York magazine story on Vikram Pandit but we’re going to attempt to get through it, for you. Each moment of second hand embarrassment for Tickle a Vickle and the franchise at large makes us feel torn between a) standing up and declaring that we believe in Pandito and his diversified whorehouse and b) trampling old ladies as we make a disorderly line for the exits, setting fire to nearby buildings as we GTFO.
Like when VP tells writer Joe Hagan he’s been keeping up with the jokes at his expense, particularly those which regard job security. On the one hand, he’s able to laugh about this stuff, which is good, and perhaps indicates a thicker skin than we thought? On the other, it kind of sounds like nervous laughter that’s about to segue to tears preceding a meltdown on the floor of the C-suite.
Pandit is trying to keep his chin up. “Look, I don’t want to leave until the job is done,” he tells me late last week. “I don’t want to lose the opportunity to put this company in the right place, because I believe I can do it.” Not everyone agrees, of course, and the consensus is that he might already have been replaced at Citi if the government could find anyone willing to take the thankless job. (“The funniest blog was e-mailed to me by a friend,” he jokes wanly. “ ’Pandit Gets to Keep His Crappy Job.’ ”)
And then there’s the uncharacteristic but increasingly frequent screaming and cursing. This is a side of Count Vikula we’ve never seen and kind of like. Maybe he should be getting angry! Maybe calmness no longer works. Maybe some well-placed outbursts and threats to “fucking kill you” are the spark the Big C needs, and being on HR’s shit list is never a bad thing. On the other: Nobody make any sudden movements. We’re all going to get out of here alive.
Pandit and Citi had relied on what amounted to the legal version of a handshake to secure the deal with Wachovia. And they dragged out the process while trying to separate Wachovia’s wealth-management division from the rest of the company, feeling it had too much overlap with Smith Barney. (Lew Kaden told a private group, “We’ve got 15,000 complainers, we don’t need 15,000 more.”) Pandit left just enough room for Wells Fargo to swoop in with a bid for $7 a share and snatch the bank out from under Citi.
Pandit was beyond infuriated. After learning of the coup during a middle-of-the night phone call, he angrily demanded to senior executives at Citi that they pull Wells Fargo’s credit lines. “Pull their fucking lines!” he screamed. “Pull their fucking lines!” A senior executive in the room calmly explained that Citigroup had no business with Wells Fargo. There was nothing they could do. Ultimately, Citi filed a lawsuit against Wells Fargo for breaching what Citi considered an exclusive deal.
Increasingly, Pandit was acting out of character, barking profanities in the hallways. One former Citi executive says that the head of human resources expressed concern about Pandit’s expletive-laced outbursts he’d had in the C-suite. (Pandit denies any such outbursts.) The Wachovia incident, says one longtime friend, “was the first time I have ever seen him go nuts.”

“Engineer”? Or plumber, up to his elbows in shit?
Pandit has very little time to use whatever power he has left to try to turn things around at Citi–news of the Treasury deal sent the stock plunging to a historic low. A friend jokes that the CEO is the “MacGyver of the private sector banking system,” out to “save Citi before the timing device runs to zero.” But Pandit has never seen himself as the hero type. He looks at the problem with the eyes of an engineer: “My job is to figure out which pipes go where and which pipes have to be cut off, which pipes have to be unclogged,” he told a close associate. “It’s going to take me a year and a half to two years and then the water will flow, and when the water will flow, the stock price goes up. The stock price goes up, everybody will come around.”
And then there’s this. Maybe it’s what Citi needs: an adorable ball of dork, lacking your typical CEO sheen. Or maybe we should just turn the whole thing over to this guy, one of five people in the world that can rescue the dump:

While this article seems to suggest that Vikram Pandit was meek, was not quite there when he was needed etc, a very interesting video of his at wharton- http://www.youtube.com/watch?v=98oR4iYYAsM
suggests he is extremely articulate and was very analytical in terms of what was the problem with the banking sector and simplified it to the extent that laymen can understand. I wish these newspapers instead of publishing such articles about Indians- Rajat gupta at all, would give credit where it is due. Vikram has cleaned up the bank and has done immense service to the company. Appreciate this and also appreciate the fact that the mess was created by Sandy Weill etc who incidentally have become very rich in the process

Since this article was published, Vikram Pandit has turned the tides to make the CitiGroup profitable once again. Impressed with his skilled leadership, After posting five consecutive quarterly profit Citigroup announced $23.2m retention award to Pandit making him one of the highest paid CEOs. Its worth noting that he had voluntarily accepted a $1 compensation until he made CitiGroup Profitable. 

Now here's my question: Why is it that when I google Vikram Pandit I still see only the 2009 articles criticizing him? Why was there such a negative bias while reporting his so-called shortcomings? Why hasn't most of the media reported his stellar achievments afterwards? What about balanced reporting? It was essentially the skin color and ethnic origin of Mr. Pandit that was causing people to write horribly ill-researched articles as this one. And now that he has succeded, the same reporters have gone silent. Shame on such reporting.



Pandit made gestures toward the trappings of Wall Street success, buying a house in Greenwich, Connecticut, next to former Lehman Brothers CEO Dick Fuld and sending his children, Maya and Rahul, to Trinity School on West 91st Street (Pandit eventually joined its board of trustees). In most ways, however, Pandit remained a cultural outsider: While he paid dues to the exclusive Country Club of Purchase, part of Morgan Stanley’s unofficial social agenda for managing directors, a friend says Pandit never actually saw the inside of the club. His parents lived with him for part of the year in his Manhattan apartment, and Pandit drove the extended family around in a minivan. A fellow executive who once saw him at a movie theater was shocked to see Pandit out of his usual C-suite suit and tie, wearing an oversize anorak, stonewashed jeans, and white sneakers. He looked like “a nerd in the computer faculty,” says the onlooker.
Pandit was of two worlds, and the subtle cultural bias at Morgan Stanley didn’t make it easy to fit in. His wife, Swati, was frequently invited to Morgan Stanley events in which wives were expected to appear, but she never did. “Nobody has seen her at one work function,” says a former colleague at Morgan Stanley. Her absence didn’t help with the perception among some at Morgan that Pandit had a bias against women. A female executive who once worked for Pandit says he was uncomfortable having women in anything other than supporting roles. In 1998, one of Pandit’s female underlings filed a legal complaint against Morgan Stanley that resulted in a $54 million sex-discrimination settlement.
Pandit also took heat over his alliance with an Indian equities trader named Guru Ramakrishnan. Pandit and Ramakrishnan had come from the same Brahmin caste in India and had both gone to Columbia before seeking their fortunes on Wall Street. But that’s where the similarities ended. Ramakrishnan was outwardly confident and even arrogant—he once bragged that an astrologer told him he was going to be the head of sales and trading at Lehman Brothers. Many at Morgan considered him unpleasant and prickly. When he lost money, he had a habit of insisting “why he was right and the market was wrong,” says a person who worked with him. Some suspect that Pandit abided Ramakrishnan because he was a useful henchman for the conflict-averse president. “When Vikram wanted to browbeat somebody, he didn’t want to do it himself. He’d send Guru to do it,” says another former Morgan Stanley executive. It also didn’t hurt that Ramakrishnan was worshipful of Pandit: He once cried when he thought he would be unable to fulfill an order Pandit gave him. “Guru was very well protected by Vikram,” says a former colleague. Non-Indians at the company privately referred to Pandit and Ramakrishnan, along with two other Indian executives, as the “Indian Mafia.”
In 2001, John Mack, Morgan Stanley’s charismatic CEO, was edged out by Phil Purcell, the Dean Witter CEO who had merged his company with Morgan. Pandit was not bothered by the change at the top. Former colleagues say he told a group of people that it wasn’t a big loss because Mack wasn’t that smart. (Pandit denies saying this.)
In principle, Pandit and Purcell were aligned on the crucial subject of how much risk to take—neither was entirely comfortable with excessive leverage. By contrast, Zoe Cruz, the president of the fixed-income division, felt the credit markets were ripe for bigger bets and more leverage—and she was bringing in more money than Pandit. Pandit and Cruz jousted for influence with the CEO.
Meanwhile, in 2005, eight veteran former Morgan Stanley executives, known as the Group of Eight, made a run at Purcell’s power, co-opting disgruntled senior executives—including Pandit’s No. 2, Havens—to plot against him. To recruit Pandit, the G8 dangled before him the CEO job at Morgan Stanley—if Purcell was driven out, Pandit would eventually take over. It was a risky move: There was no guarantee that the coup would work. But when Purcell asked Pandit for his loyalty, Pandit refused, betting his chips on Havens and the G8. “He does not like conflict and does everything to avoid it,” says a person involved in the Morgan Stanley battle. “But this was an irreconcilable conflict and he acceded to Havens as he almost always does.”
Given Pandit’s coy style, Purcell was shocked when he learned Pandit had turned against him. “I don’t understand. Vikram was my guy,” he told a friend. “I saved his job three times.” When he learned of the betrayal, Purcell promoted Cruz, ousting Havens and Pandit.
On his way out, Havens walked through the trading floor to standing ovations, but Pandit left the building alone, taking only his raincoat into a cold March drizzle. “It was the most upsetting thing that ever happened to him,” says a friend and former colleague. Morgan Stanley, says another, “was his soul, his identity—home.”

The year that followed was difficult for Pandit. He was out of a job. And his mother, Shailaja, died of breast cancer, a blow that cracked his otherwise cool façade. He nearly broke down while telling a fellow executive the details, pausing to collect himself before he could speak again. In her memory, Pandit started the Maina Foundation for Raising Breast Cancer Awareness.
That same year, 2006, Pandit regrouped by forming a boutique hedge fund called Old Lane Partners with John Havens, Guru Ramakrishnan, and several other Morgan Stanley refugees. The name gave it the air of a Waspy clubhouse, but during a charity roast for Pandit in 2007, an Indian colleague joked that it should be called “Brown Brothers and Havens” because of all the Indians working there. Ramakrishnan, the only one with hedge-fund experience, was named CEO. He spearheaded $500 million in infrastructure projects in India.


Pandit would be the leader of the biggest bank in the world, what amounted to a small country, population 350,000, and he would have at his disposal four airplanes, a helicopter, cars and drivers, chefs, dozens of aides, and the ear of the White House. Better still, running Citi would be his chance for redemption after missing his shot at Morgan Stanley. Once the deal was done, Rubin personally went from division to division praising Pandit to staffers.

Pandit is trying to keep his chin up. “Look, I don’t want to leave until the job is done,” he tells me late last week. “I don’t want to lose the opportunity to put this company in the right place, because I believe I can do it.” Not everyone agrees, of course, and the consensus is that he might already have been replaced at Citi if the government could find anyone willing to take the thankless job. (“The funniest blog was e-mailed to me by a friend,” he jokes wanly. “ ’Pandit Gets to Keep His Crappy Job.’ ”)
this is the only reason  he was retained and  Not  a WASP or a Jew replaced him 


"Either we’re getting soft in our old age or just kind of exhausted by the CEO witch hunt, but the following sentence in today’s Wall Street Journal actually made us feel a twinge of pity for Citigroup CEO Vikram Pandit.
In November, as part of the sweeping rescue, federal officials privately discussed the possibility of replacing Mr. Pandit, who became CEO in December 2007. But the government decided not to remove him, in large part due to a dearth of qualified replacements.



Ugh. Can you imagine if that were you? Like if your boss was all, “We think you suck, but we may as well keep you on and allow you to absorb the blame for the years of mismanagement here, until someone better comes along. Then we can make a big production of firing you, and act like you were the thing that’s been holding us back all this time.” Sure, Vikram hasn’t done the best job and he hasn’t been the best communicator, but he’s only been in the top job for over a year; it wasn’t like he was the one singlehandedly operating the helium pump that caused Citi to swell into a bulbous misshapen monster. (You try wresting the company jet away from Sandy Weill.) It just seems kind of unfair, and totally underminer-y, of the “federal officials” who put that out there. Now how is he supposed to gain the confidence of his own employees — never mind shareholders or the American taxpayers, who may soon own a 40 percent share in Citigroup? It’s just embarrassing



Of course, unlike the rest of us, Pandit can soothe himself by going over to his private safe, extracting a bar of pure gold, and rubbing its smooth surface up and down his face." by Jessica Pressler


The Wachovia incident, says one longtime friend, “was the first time I have ever seen him go nuts.”


Pandit The Plumber To Fix Citi Toilet?

You scratch my back,Is USA any Different from Mera Bharath mahan ?

It was Rubin who helped push through the Gramm-Leach-Bliley Act that effectively allowed the merger of Travelers and Citicorp. A year later, Weill made Rubin a board member at the company he helped create, paying him a salary of $17 million a year.
Satya Nadela, Microsoft CEO
Sundar Pichai, Google CEO
Indira Nooyi, PepsiCo CEO
Rajeev Puri, Nokia CEO
Ajaypal Singh Banga, MasterCard CEO
Shantanu Narayen, Adobe Systems CEO
Francisco D'Souza, Cognizant Technology Solutions - CEO

A unique immigrant family where all the kids go to a Prep school!

 Today I was reading about "All in the family" in Fortune magazine Tech Focus.
this was about  Uber CEO  Dara K. ( I am just being  American, We do not like too long names unless they are actors, Politicians, sportspersons or Tech Billionaires.
Dick Hackett goes all Ga, Ga over how the  various off shots of  "Khosrowshahi Diaspora"

 What struck me  is

Here is a struggling immigrant family  whose Kids attended a prep school in Tarrytown, NY

2017-2018 Tuition Costs
  • Lower School (K-Grade 4) - $37,450.
  • Middle School (Grades 5-8) - $41,350.
  • Upper School (Grades 9-12) - $44,225.
  • 5-Day Boarding Fee - $13,400.

I too come from an immigrant family and all my children went to Public schools. Although I am a physician.

In spite of being  quite intelligent, they are struggling to get good employment due to not having  "connections"

  The family tradition sounds more like " Nepotism " to me.

OPTUM PREACH! but Do not Practice!

 Recently, I saw an ad by OPTUM in Fortune Magazine.
At first, I was surprised why a Healthcare company is advertising in  Fortune magazine.
Next, I was impressed by the implication of what they are preaching.Look at the image
below


This feeling was very Short lived I was brought back to Mother earth When  I Took a look at my inbox with the Bulging Bundle of paper with preauthorization requests, advise about the need to talk to Noncompliant patients (decided by pharmacies with their  Buggy software and stupid  Artificial intelligence programs) about the need for  Compliance.Homecare agencies with their almost Incomprehensible care plan.

Thursday, December 07, 2017

Reading this made my day! 9 top 9 for docs

I don't Know who wrote this in Medical Economics 
but I couldn't stop Laughing just imagining such Ludicrus situations
9. What if fire departments had to deal with prior authorizations…
“Is there smoke coming out of the building? OK, but can you actually see the flames? Well, we are only going to give approval for one fire truck, but you can appeal if you think you need more than that. Can I put you on hold for half an hour?”
8. What if office workers lacked interoperability…
“I received your urgent contract as a Word document, but I don’t have anything that can open it and neither does anyone else in the office. Can you just print it out and send it in the mail or maybe fax it over? We’ll just re-enter it in our system once we receive it.”
7. What if drivers were subject to quality reporting…
“Once you return from your trip, you’ll need to pick 25 out of these 100 good-driving behaviors to show that you are not recklessly driving your car. We’ll compare your score to other drivers to determine how well you performed, but we won’t tell you the results for two years. In the meantime, we’ll just assume you are a bad driver.”
6. What if pilots had to deal with the equivalent of changing formularies…
“Yes, I know you were scheduled to land in Chicago, but Chicago is no longer on our formulary. You will now have to land in St. Louis, even though Chicago always worked really well for people who wanted to actually go to Chicago. You can appeal if you like and we’ll have an answer for you in six weeks, if you want to stay in the air that long.”
5. What if meteorologists were subject to malpractice suits for errors…
“The man on the stand has been wrong 80% of the time, yet he still practices every day, ruining one family outing after another. You, the jury, must put a stop to this heinous, out-of-control malpractice of meteorology and send a message to other forecasters that they need to be right 100% of the time or they shouldn’t be practicing weather!”
4. What if traffic control devices were developed like electronic health records…
“Traffic is backed up for two miles on Main Street because we have 25 traffic lights developed by 25 different vendors, and each uses its own timing and color scheme. On one corner, green means go, while on another, it means stop, and some lights have five phases while others only have one. We could get some of them to work together, but we can’t afford the upgrades and they appear to be sabotaging each other to prevent any communication attempts. And the railroad crossing is a disaster because the gates and lights are from different companies and neither communicates with the railroad, but it does come with a really nice mobile app.”
3. What if employers denied pay to employees the same way doctors get stiffed by insurance companies…
“I’m sorry, but I can’t pay you for last week because you did not properly document that you attended the staff meeting. Yes, I saw you there, but unless you fill out the form correctly, we refuse to pay you. And while you say you worked on the Jenkins report for two hours, I’ll need you to explain how you worked on it and what you did so we can pay you. Make sure you use the proper codes from this 1,500-page book—the process should only take about four hours to complete.”
2. What if the police had to deal with internet experts the way doctors deal with Dr. Google…
“You know, officer, I can see you are busy with this hostage situation, but I saw this YouTube video that says the best way to resolve these conflicts is by throwing echinacea dust through the window, which will calm the gunman until he gives up. If that doesn’t work, the people on Reddit suggest doing a cleanse.”
1. What if everyone else had to go through maintenance of certification testing to keep their job…
“Well, to keep your job and prove you are actually as good an accountant as you claim after 20 years in the field, we have prepared this test based on your college classes of philosophy, art history and French.”
“What does this have to do with being a good accountant?”
“I don’t know, but you owe me $1,200 for the test.”
I Am NOT doing my MOC for American Board of Internal Medicine.
The first step of the  Bolshevik/Physician revolution.

“Physicians need to be more like the Ritz-Carlton to improve healthcare” what are you Smoking ?

A Delusional, hallucinating guy, who apparently was the COO of Ritz Carlton  
 says

Horst Schulze
Horst Schulze was former COO of the Ritz-Carlton Hotel Company, and was a founding member of the company. He currently serves as CEO of Capella Hotel Group, a luxury hotel management company, and as a board member of ChenMed.



“At a luxury hotel, it’s fair to say the experience is the opposite of that at a doctor’s office. Yet, that makes no sense, as health is more important than a vacation. And as any doctor will say, spending more meaningful time with a patient is essential for quality care.Of course, there are concierge medical practices in which patients pay anywhere from $250 to $25,000 a year to get the “Ritz-Carlton” treatment in their medical care. But to truly reform our healthcare system, we need to bring concierge-level care to every patient”

First, bring “ medical care” to all citizens  then you can talk of “concierge-level care”
To build trust with patients, physicians need to take a page out of the hospitality industry’s playbook and do three things.
First, doctors must prioritize customer service and the patient experience. Like all customers, patients have some fundamental expectations. Customers expect the product to be free of defects. They expect timeliness. And they expect their interaction to be pleasant.
Indeed, a satisfied customer is one who walks away from an interaction that meets these expectations. But a loyal customer is one who walks away from an interaction that exceeds these expectations because their interaction was not just nice, it was caring.
First impressions matter. Ritz-Carlton employees never greet guests with “hi.” Within nine feet of a guest approaching, they smile, look the guest in the eye, and say “Good afternoon, Mr. Smith.” This is not only welcoming; it shows all guests they are individually respected and valued. This warmth permeates all interactions.
That’s why it’s unconscionable that the average time primary care doctors spend face-to-face with patients is 21 minutes Annually.

I wish I had even 10 % of my patients with whom I have to spend only 21 minutes every year!

How can patients trust someone they only see for a few minutes? Good medicine requires more physician face-time with patients and services that help them overcome any obstacle they face accessing care—from dispensing medications on-site to providing courtesy transportation for those who need it.
Similarly, doctors are not more efficient when they reduce time with patients
Hotels are not more efficient when they reduce the number of linens, because that eventually requires the housekeeping staff to take more trips in the elevators, which slows down service for everyone.
Similarly, doctors are not more efficient when they reduce time with patients


As a Board member of ChenMed  I hope you have implemented all this in your  centers. Where  primary care physicians  spend at least an hour with each patient and  see them right on time.and the center picks up and drops off the seniors from and to the clinic from their residence.
And there are reviews galore from many such satisfied clients.

I do not know how a Doctor can write such things

Dr.Ken Fisher writes in Medical economics

"Using simple math with $550 billion per year and 72.5 million participants in Medicaid, this could amount to about $7,500 deposited into each individual’s health account, more than enough to purchase catastrophic insurance for this mostly young and healthy population "

Really ken!
when was the last time you saw a Medicaid patient?
I work in a community clinic in Big Spring  Texas.
And see a substantial number of Medicaid patients.Most of them are so sick, I find iit very difficult to care for them when Medicaid texas Pays only for 3  scripts a month.

Now Doctors have to be actors too!

Now Doctors have to be actors too!

 From  Medical economics  11/25/2017

"Should patients be allowed to record their doctors?

You are about to explain some exercises you'd like your patient to do for her injured neck. She holds up her phone and asks if it's OK to record your advice so she can remember it better and so she can share it with her caregiver.
Should you let her? ( with most cell phones it will be) a video recording for sure!
It’s a question more physicians may be facing soon. Cellphones are ubiquitous and patients are increasingly accustomed to using these tools to document their daily lives. Indeed, one recent UK study showed that 15% of patients are secretly recording doctor visits already.The study also found that 11% of patients said they knew someone who had done this and 35% said they'd consider secretly recording in the future. Another 34% would record if given permission.
Smartphones are transforming professional conversations, says the study’s author, Glyn Elwyn, MD, a professor at Dartmouth Institute for Health Policy and Clinical Practice and former primary care physician. "Patients are beginning to understand that they have a legitimate right to request a recording."
 And Doctors have a legitimate right to deny a request for a recording.

Let me give you a reason.
when I am giving oral instructions it is like a summary, it is to make it easy for the patient. it is not the whole enchilada which can be used by his/her lawyer.
( I would like to see the face of that lawyer if his client  requests the  same type of recording for his advice)
I can always hand him /her a bunch of paper having the instructions. the  ER routinely does this Hospitals do this, and  90 % of patients do not read them.
( Disclaimer: this is not based on and  Randomized double-blind control trial)

Tuesday, December 05, 2017

Ghost tweeting ! Congress Rahul


I am pretty sure this was written by a ghostwriter


प्रधानमंत्रीजी-7वाँ सवाल:

जुमलों की बेवफाई मार गई
नोटबंदी की लुटाई मार गई
GST सारी कमाई मार गई
बाकी कुछ बचा तो -
महंगाई मार गई

बढ़ते दामों से जीना दुश्वार
बस अमीरों की होगी भाजपा सरकार?

Monday, December 04, 2017

The various names used for cannabis in India

ajaya the unconquered, invincible
 ananda the joyful, joyous, laughter moving, bliss
bahuvadini causing excessive garrulousness
bhang, bhanga hemp, mature cannabis leaves
 bhangini breaks three kinds of misery
bharita the green one
chapala agile, capricious, mischievous, scatter-brained
chapta light-hearted
chapala the light-hearted, causer of reeling gait, causer of vacillation
charas cannabis resin (hashish), either hand-rubbed or sifted
cidalhada gives happiness to mind
divyaka gives pleasure, lustre, intoxication, beauty
dnayana vardhani knowledge promoter ganja unfertilized female cannabis flowers
ganjakini the noisy, vibrator
gatra-bhanga body disintegrator
harshani joy-giver
harshini the exciter of sexual desire, the rejoicer, delight-giver, causer of elation
hursini the exciter of sexual desire
Indrasana Indra’s food
jaya victorious, the conquering
 kalaghni helps to overcome death
madhudrava helps excrete nectar
madini the intoxicator, sex intoxicator
 manonmana accomplishes the objects of the mind
matulani wife of the datura
matkunari an enemy of bugs
mohini fascinating
pasupasavinaini liberates creatures from earthly bonds
ranjika causer of excitement
sakrasana the worthy food of Indra
samvida manjari flower causes garrulousness
sana cannabis
sarvarogaghni which cures all diseases
sawi green leaved
Shivbooty Shiva’s plant
siddha which has attained spiritual perfection
sidhamuli on whose root is siddha
siddhapatri vessel of highest attainment
siddhi success giver
siddhidi which endows siddhi on others
sidhdi emancipation, beatitude, fruit of worship s
uknidhan fountain of pleasures
tandrakrit causer of drowsiness
trailokya vijaya victorious in the three worlds, conqueror of the three regions of the universe
trilok kamaya desired in the three worlds
ununda the laughter mover
urjaya promoter of success
vijaya victorious, promoter of success, all-conquering
vijpatta the strong leaved
virapattra leaf of heroes vrijapata strong nerved