Not To Be Trusted With Knives

The Internet’s leading authority on radicalized geese

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Finish It!

Finish/Start About a month ago I decide to make the name of every blog posting I made this month end in the word “it”. Because it seemed like the thing do do. And today, being the last day of September, marks my last “It!” posting!

I didn’t think I’d write that many postings this month, as I had a crazy amount of homework to get done, but, as it turned out, I blogged at least once a day right up until the 23rd, and then I really had to hunker down to get my many assignments and much studying done. But still, I managed 28 blog postings this month, including this one. Apparently having a title theme inspired me!

Now, October is going to be a super duper insanely crazy month, as the core part of my program is wrapping up, which means I have assignments to get done, 2 economics exams to prepare for, and then a take-home core final1 – not to mention eleventy billion things to get done at work, so I’m really not expecting to do that many blog postings… which, of course, sounds familiar. I guess we shall see how it goes!

Image credit: Posted on Flickr by I Like with a Creative Commons license.

  1. I.e., an integrated exam on all the subjects we’ve been learning over the past 9 months. []

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Fill It!

At the dentistWent to the dentist for a wee filling in one of my molars. I haven’t had very many filling in my life, but the few times I have, I tend to get all the way to the dentist’s office and into the chair before it really registers that they are going to give me a needle. And you know what I don’t like? If you guessed “needles”, you win1

The needle gave me a wee bit of a panic, but I survived and the putting in the filling part was pretty simple and over quite quickly. And then, despite having benefits that “cover” fillings, I had to pay $50. Because apparently insurance companies only cover the cost of amalgam fillings, which no one has done since about 19982. So I had to pay the difference between what an amalgam filling would have cost if anyone actually still did them in this century and the cost of regular filling3. You suck dental insurance company. You suck long time.

  1. I would have also accepted the answer “spiders”. I hate those guys. []
  2. Seriously, I asked my dentist when the last time she put in an amalgam filling and she said 1998. Another dentist told me that they don’t even teach dental students how to do amalgam fillings at dental school anymore – and that was about 10 years ago! []
  3. OK, I know that I should really shut up because lots of people don’t have any dental coverage at all. #FirstWorldProblems. []

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Donate To It!

This is Dan rappelling in a cave. Wouldn’t you like to see him do this off the side of a 13 storey building?

My friend Dr. Dan wants to throw himself off the side of a building, but he needs your help.

More specifically, Dan is raising funds for Easter Seals, a charity that helps children with disabilities, and if he raises $1,500, he gets to rappel down the side of a large building. Rappelling, for the uninitiated, is where you hang from a rope and use it to descend down a long distance – usually a cave or a cliff. In this case, Dan will be rappelling down form the top of a 13 storey building! But only, as I mentioned, if he can raise the required sum of money for Easter Seals. And that’s where you come in. Will you consider making a donation to this fundraising effort?

Easter Seals (from their website):

Easter Seals is dedicated to fully enhancing the quality of life, self-esteem and self-determination of Canadians with disabilities.
As Canada’s largest local provider of programs, services, issues-leadership and development for the disability community, Easter Seals is dedicated to helping more than 100,000 Canadians with disabilities participate fully in society.

They do things like camps for kids with disabilities, as well as “year-round active living opportunities, as well as the provision of specialized mobility and access equipment such as mobility aids, assistive technology, adaptive computers, augmentative communication devices and adaptations to homes and vehicles for wheelchair accessibility.”

That sounds like a worthy cause, right?

Donate!!

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Train For It!

Today I ran my last long run before the Victoria half marathon. It was 20 km, which required me to run from the New West Quay, which is near my place, all the way to Vancouver and back!

2012-09-23 20 km run

20 km is a lot of kms.

As you may recall, I decided back in June that I was sick of my rampant weight gain1 resulting from not doing any sort of physical activity whatsoever, and so I therefore decided that I would train for the Victoria half marathon. For me, races seem to be the only way to get me motivated to hit the pavement. If I’m just like “I should go for a run,” I rarely do. But if I have a race I’m training for and, more importantly, a training plan to tell me when to run and how far to run2, I tend to get out there. I originally vowed “I will at least do all the long runs in my training program and at least another run or two per week.” The first part of that statement turned out to be true, but the second part – not so much. But no matter – deciding to do the Victoria half resulting in me doing 21 runs during which I ran 205 km since the time I made that decision. And that’s 21 runs and 205 km that I’m pretty sure I would not have run otherwise. And I’ve managed to keep up with my school work, because I really do think more clearly and work more efficiently when I’m well exercised! The bathroom scale remains stubbornly on the same number as it did before I started my training, but happily (a) I have at least halted the weight gain, and (b) I’m getting more toned3.

Not wanting to lose the keeping-exercise-in-my-life momentum, I’m contemplating whether I should look for a fall race to train for4 or if I should activate the Groupon I got for the yoga place that is about a 30 second walk from my building. I also have the hockey seasons having started, so that will help keep me fit too!

  1. Not to mention how bad it is for my health to be highly stressed with no exercise. []
  2. Because I am indecisive and need someone to just tell me what to do. []
  3. So I think that the bit of fat weight I’ve lost is being balanced out by the muscle that I’m building. []
  4. Not another half marathon, but maybe a nice 8 or 10 km race. []

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I’m Sexy and I Know It!

Props again to Cath for coming up with this blog posting’s title!

Got my hair done by the amazing Jenny Lynn at Rain Hair Salon:

20120922-132128.jpg

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Quiche It!

Spinach and gruyere quiche with a hashbrown crust

Spinach and gruyere quiche with a hashbrown crust. A crust made out of hashbrowns solves my like-quiche-but-dislike-pastry problem.

Spinach and gruyere quiche with a hashbrown crust

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Summarize It!

Note: This is probably of interest to no one except me, as it’s just a summary of the key things – or at least interesting things – I learned from the conference I was at this week, along with some random thoughts I had and connections I made to other things that I’m doing. Rather than reading this, might I suggest you check out my Hockey Hotties instead?

  • Two health ministers (current health minister for Alberta & former health minister for Quebec) talked about the social determinants of health! Music to the ears of this Public Health professional! Moreover, the former health minister from Quebec, who is a neurosurgeon, said that after being a minister of health, he felt like he “should have gone into Public Health”!
  • In Alberta, about 40% of visits of primary care practitioners are for mental health.
  • Physicians should be compensated for using evidence-based practices (rather than paying for specific activities regardless of if that activity is appropriate for a given patient) and we should stop paying them to do things we don’t want them to do. This made me think about how we are learning in Organizational Behaviour/Human Resources (OBHR) at school about how businesses often don’t align their incentives with what they actually want to achieve.
  • It’s difficult to stop paying for something we’ve been paying for – which made me think of OBHR class again – “losses hurt more than gains feel good.”
  • Many younger physicians don’t like the fee-for-service model, as it asks them to go against what they are trained to do.
  • New techniques I learned about:
    • Multi-Criteria Decision Analysis (MCDA) – Analytic Hierarchy Process (AHP) vs. Constant Sum (Budget Pie)
    • Program Budget & Marginal Analysis (PBMA) – this was discussed so often at the conference, an audience member actually asked “Is there anything to priority setting other than PBMA? PBMA is nice because it’s a rigorous method that you can use to align decisions to the intended strategic direction of the organization, to be transparent about how decisions are made, and to be able to defend decisions that you make. It can also be used to make decisions about allocation of resources other than finances. Most effective proposals for re-investment use evidence to support their proposal and clearly show how re-investment is aligned with the strategic priorities. I see similarities with patient engagement in that this requires you provide all the information – including constraints – needed to make decisions to the people you are engaging, so that they can make suggestions that are feasible and so they can understand why you can’t implement everything they might want. Also, patients/public can be engaged in setting criteria and/or weighting criteria. Also, there seemed to be lots of enthusiasm for PBMA from those who had done it (and they said that those who got involved in it – right down to front-line staff – became convinced of its value after being involved).
  • We can view “austerity measures” as an opportunity rather than a crisis.
  • Priority setting work is bringing together economists and ethicists, but it might now be time to bring in those with expertise in organizational behaviour, because this requires change management.
  • We can bridge silos through shared values – we all want to promote health and well-being after all!
  • To do more of some things, we have to do less of something else. This can be doing the same things for less cost (e.g., Lean) or taking resources from one area of care (either ineffective care or care that is less effective than the new proposed thing).
  • If you use your limited resources more effectively, you’ll have to make fewer trade offs than you would if you kept using your resources ineffectively.
  • Priority setting needs to be a part of the way we do business, not just something we do when we have to make cuts.
  • There is no such thing as “the Canadian Health Care System” – it’s a patchwork of provincial systems.
  • Though the marginalized/vulnerable population uses more health services than the general population, they “dont’ use as much as they ought to in order to meet their needs” *and* we end up paying a lot of money to “rescue” them (e.g., ER), but we won’t spend a little money to support them/prevent the problems in the first place.
  • You can include “equity weightings” for your criteria – giving more weight to those in most need. You could even alter these equity weightings in an “ethical sensitivity analysis” to see how different weightings affect the outcomes.
  • WHO CHOICE (who.int/choice) – tools and methods for doing cost-effectiveness work.
  • When you combine cost-effectiveness assessment with equity, you care able to see the trade off you are making to achieve a more equitable situation (i.e., is this a prce you are willing to pay for more equity?) –> becomes a matter of judgement.
  • “Disinvestments” are seen as cuts and tend to be politically unpopular. (Again, losses hurt more than gains feel good).
  • Q methodology.

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Math It!

Quadratic solverMy managerial economics prof offered my class the option to have a math refresher evening to make sure we are up to speed on the math we need to understand to be able to do the work we need to do in managerial economics. So after spending the past three days at the health care priority setting conference, which was chalk full of health economics1, I spent two hours this evening going over solving systems of equations and taking partial derivatives.

Needless to say, my brain is fried. Very glad I went though, because I feel much better about my ability to do my managerial economics assignments. Starting tomorrow.

Image Credit: Posted by Irregular Shed on Flickr.

  1. And ethics. And a twist of patient engagement to boot. []

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Transit It!

Since the conference that I’ve been at this week is in Vancouver, I’ve been taking Skytrain. And I have to tell you, I so much prefer taking Skytrain to work instead of driving! I can read and drink my coffee and not have to worry about terrible drivers like I do when I’m driving!

Granted, it’s been beautiful and sunny these past two days, so it’s been great to walk between the Skytrain Station and the conference hotel – a little bit of exercise that fits nicely into my day! – and it wouldn’t be quite the same if it were cold and rainy. But still – better than driving. Also, the trip home this afternoon was in peak rush hour so I was sardined into the train so tightly I couldn’t even get my textbook out of my bag to read. But still – beats driving!

Tomorrow is the last day of the conference and since I have to go out to UBC afterwards, I’m driving instead of Skytraining it1. Driving into Vancouver during morning rush hour is craptacular, so I’ll probably go in extra early to avoid the traffic and work at a coffee shop until the conference starts. Because if I have to be sitting around, I’d rather sit around a coffee shop and get work done than sit in traffic!

But never fear, I have to go to Vancouver both on Thursday night and on Saturday, so my transit pass will continue to get a workout

  1. As getting home from UBC afterwards would take one million years if I were taking transit. []

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Prioritize It!

I am spending the next 3 days at Priorities 2012, the biennial conference of the International Society on Priorities in Health Care (ISPHC).

From the conference website:

The International Society on Priorities in Health Care was formed in 1996 to strengthen the theory and practice of priority setting in health care. It provides the leading international forum in which health researchers, clinicians and managers involved in priority setting come together to exchange ideas and experiences. We are proud to bring the Society’s 9th world congress to Vancouver this year.

The theme for Priorities 2012 is “Partnerships for Improving Health Systems” which will examine the interface between researchers, clinicians and managers, and how these key stakeholders can best work together to improve our health systems. The conference is a true international forum with strong participation from stakeholders from low- , middle- and high-income countries.

I’m super excited because this is a chance to meet people from all around the world who are working on similar things to what I do and to learn about some of the ground breaking work that is being done. I also foresee there being connections between what I’m learning in school and what I do for a living1. I always find I come away from conferences chalk full of new ideas and totally re-energized about my work.

If you are interested in the goings on at the conference, you can follow the tweets at #priorities2012!

  1. I have being making lots of connections already, but I feel like this conference will take it up to a whole new level! []