Bicyclist Fatalities in AZ 2009

On Dec 4, 1:15*pm, SMS wrote:
On 12/4/2010 11:19 AM, DirtRoadie wrote:

Thanks so much for your "IGNORance"
As they say, ignorance is bliss.
DR

Reminds me of the scene from the movie _Network_...

Ernie Merriman: (sarcastically) It must be nice to always believe you
know better, to always think you're the smartest person in the room.
Jane: (seriously) NO, it's not, it's awful!!

Not familiar with the scene but, absolutely, that's Frank Krygowski
all over.
http://bit.ly/gxQP3l

I know an individual (and even have a more-or-less cordial
relationship with this person) who is a pathological liar. This
person (gender indeterminate) is actually quite skilled in a number of
areas and is otherwise reasonably intelligent. But he/she, despite his/
her skills lies constantly. This assessment is based upon false claims
which are independently and objectively verifiable. Accordingly, it is
difficult to know what is true and what is not in what he/she says and
trusting him/her is out of the question.

Frank strikes me the same way. An almost (for the sake of politeness)
pathological obsession with justifying HIS position. He changes
whatever needs to be changed. Facts, figure and words are all fair
game. He makes up people and their opinions, inaccurately describes
"studies" and treats EVERYONE with condescension.

DR

On 12/5/2010 6:39 PM, DirtRoadie wrote:
On Dec 4, 1:15 pm, wrote:
On 12/4/2010 11:19 AM, DirtRoadie wrote:

Thanks so much for your "IGNORance"
As they say, ignorance is bliss.
DR

Reminds me of the scene from the movie _Network_...

Ernie Merriman: (sarcastically) It must be nice to always believe you
know better, to always think you're the smartest person in the room.
Jane: (seriously) NO, it's not, it's awful!!

Not familiar with the scene but, absolutely, that's Frank Krygowski
all over.

Actually it's from Broadcast News with William Hurt and Holly Hunter,
not Network.

On Dec 5, 9:55*pm, SMS wrote:
On 12/5/2010 6:39 PM, DirtRoadie wrote:

On Dec 4, 1:15 pm, *wrote:
On 12/4/2010 11:19 AM, DirtRoadie wrote:

Thanks so much for your "IGNORance"
As they say, ignorance is bliss.
DR

Reminds me of the scene from the movie _Network_...

Ernie Merriman: (sarcastically) It must be nice to always believe you
know better, to always think you're the smartest person in the room.
Jane: (seriously) NO, it's not, it's awful!!

Not familiar with the scene but, absolutely, that's Frank Krygowski
all over.

Actually it's from Broadcast News with William Hurt and Holly Hunter,
not Network.

Nonetheless, Francis R. Krygowski, RBT's mascot nutcase to a T.
DR

On Dec 5, 4:15*pm, Frank Krygowski wrote:
On Dec 5, 12:37*pm, Jay Beattie wrote:

On Dec 4, 8:50*pm, Frank Krygowski wrote:

And BTW, crunching their numbers shows one "traumatic event" (i.e. any
injury at all) every 6,667 miles. *It shows one "serious injury" (i..e.
not _really_ serious, but some medical person looked at it, whethert
needed or not) every 25,600 miles. *That pretty well corroborates
Moritz's data, showing that LAB bike commuters rode 32,000 miles
between crashes that cost $50 or more.

I don't let any study worry or console me because I am well aware of
the risk of cycling to me. *Being on warfarin following my last ski
injury and surgery/DVT/PE, any bleeding injury can be serious. But
with that said, I still ride almost every day -- with a day off for
skiing, which is far riskier than bicycling.

I was on warfarin for a while, and when I first started it, I asked my
doctor about any restrictions on my activities. *He knows about my
cycling, of course, and told me I had absolutely no activity
restrictions. *He considers cycling to be acceptably safe.

My doctors freak out when I say I ride to work everyday and ride on
the weekends when I am not skiing. I picked a hematologist who is a
cyclist just so I wouldn't have to listen to the concern and terror --
and he was one of the worst. Everyone has told me to wear a helmet
for biking and skiing, since a brain bleed could kill me. Yes, helmets
are just foam hats, but I have been prescribed a foam hat. Fine with
me. My ski helmet keeps my ears warm., and I wear a bike helmet
anyway since I ride on some pretty bad roads -- not because of cars
but because of steep uneven and wet pavement. -- Jay Beattie.

On 12/6/2010 3:18 AM, Jym Dyer wrote:
Tom Sherman writes:
... when people boast about kill-filing me, then I might
as well nym-shift to make them re-do their filters.

=x= Moronic to do, simply pathetic to brag about it.
_Jym_

As pathetic as Jym Dyer's little trick of setting followup-to:
"alt.shut.the.hell.up.geek"?

I am sorry that Jym Dyer fails to see the inherent moral imperative not
to comment on others posts if one has them kill-filed.

--
Tºm Shermªn - 42.435731,-83.985007
I am a vehicular cyclist.

On 12/5/2010 8:39 PM, DirtRoadie WHO? ANONYMOUSLY SNIPES:
On Dec 4, 1:15 pm, wrote:
On 12/4/2010 11:19 AM, DirtRoadie wrote:

Thanks so much for your "IGNORance"
As they say, ignorance is bliss.
DR

Reminds me of the scene from the movie _Network_...

Ernie Merriman: (sarcastically) It must be nice to always believe you
know better, to always think you're the smartest person in the room.
Jane: (seriously) NO, it's not, it's awful!!

Not familiar with the scene but, absolutely, that's Frank Krygowski
all over.
http://bit.ly/gxQP3l

I know an individual (and even have a more-or-less cordial
relationship with this person) who is a pathological liar. This
person (gender indeterminate) is actually quite skilled in a number of
areas and is otherwise reasonably intelligent. But he/she, despite his/
her skills lies constantly. This assessment is based upon false claims
which are independently and objectively verifiable. Accordingly, it is
difficult to know what is true and what is not in what he/she says and
trusting him/her is out of the question.

Frank strikes me the same way. An almost (for the sake of politeness)
pathological obsession with justifying HIS position. He changes
whatever needs to be changed. Facts, figure and words are all fair
game. He makes up people and their opinions, inaccurately describes
"studies" and treats EVERYONE with condescension.

DR

This is rich coming from a known liar [1].

[1] Google has preserved the evidence of "DirtRoadie" lying by
falsifying quotations.

--
Tºm Shermªn - 42.435731,-83.985007
I am a vehicular cyclist.

"Tºm Shermªn™ °_°" " wrote in
message ...
On 12/6/2010 3:18 AM, Jym Dyer wrote:
Tom Sherman writes:
... when people boast about kill-filing me, then I might
as well nym-shift to make them re-do their filters.

=x= Moronic to do, simply pathetic to brag about it.
_Jym_

As pathetic as Jym Dyer's little trick of setting followup-to:
"alt.shut.the.hell.up.geek"?

I am sorry that Jym Dyer fails to see the inherent moral imperative not to
comment on others posts if one has them kill-filed.

And pray tell, why does this jerk spell his name with y's in it?

Regards,

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

On 12/5/2010 3:16 PM, Tim McNamara wrote:
In ,
Peter wrote:

As I explained before, very few processes convert directly to
computers with any degree of efficiency.

Hence the problem with EMRs. Typing narratives is something that works
very very well on computers. Spreadsheets, ditto. Three dimensional
modeling, yup. In medicine, imaging software is excellent and a
critically important tool- no computers, no MRIs for example. Lots of
other examples possible.

The problem is pretty specifically with clinical documentation. It
takes much longer to enter and much longer to read. I can get through a
paper chart in half the time as it takes on an EMR. My last physical
(2009) took more than twice as long as normal because of the EMR. Time
loss is a very serious issue and increases rather than decreases the
costs of health care.

The data does not seem to support your anecdotes.

http://www.nejm.org/doi/pdf/10.1056/NEJMsa0900592

"Results
On the basis of responses from 63.1% of hospitals surveyed, only 1.5% of
U.S. hospitals have a comprehensive electronic-records system (i.e.,
present in all clinical units), and an additional 7.6% have a basic
system (i.e., present in at least one clinical unit). Computerized
provider-order entry for medications has been implemented in
only 17% of hospitals. Larger hospitals, those located in urban areas,
and teaching hospitals were more likely to have electronic-records
systems. Respondents cited capital requirements and high maintenance
costs as the primary barriers to implementation, although hospitals with
electronic-records systems were less likely to cite these barriers than
hospitals without such systems."


http://www.ncbi.nlm.nih.gov/pubmed/12773650

"CONCLUSIONS: The quality of care in the VA health care system
substantially improved after the implementation of a systemwide
reengineering and, during the period from 1997 through 2000, was
significantly better than that in the Medicare fee-for-service program.
These data suggest that the quality-improvement initiatives adopted by
the VA in the mid-1990s were effective."

http://www.ncbi.nlm.nih.gov/pubmed/1...,f1000m,isrctn

"Since 1995, the Veterans Health Administration (VHA) has had an ongoing
process of systems improvement that has led to dramatic improvement in
the quality of care delivered. A major component of the redesign of the
VHA has been the creation of a fully developed enterprise-wide
Electronic Health Record (EHR). VHA's Health Information Technology was
developed in a collaborative fashion between local clinical champions
and central software engineers. Successful national EHR implementation
was achieved by 1999, since when the VHA has been able to increase its
productivity by nearly 6 per cent per year."

The data to date suggests that EMR implementation in the US is pretty
minimal, and where it has been extensively implemented (e.g. VA), it has
significantly improved care and lowered costs.

Let's put it this way: I'm the customer, the product doesn't meet my
needs and therefore I don't want to buy it. This wouldn't be my problem
except for potentially being mandated to buy a product which doesn't
meet my needs *and* interferes with my productivity. How'd this happen?
The vendors of the product convinced legislators to force a market for
the product when the product itself could not create its own market.

And you call me arrogant. As far as I'm concerned, as a patient, I am
the final customer and beneficiary. My primary care provider and the
affiliated hospitals have EMR implemented and I have been quite pleased
with the benefits. Then again, my medical facilities are urban, large,
and affiliated with medical schools, where EMR's are most prevalent in
this country. I'm impressed by the level of coordination between primary
care, emergency care, various specialist services and diagnostic
facilities, etc. Unfortunately, I've had the need to use them all.


This is why EMRs suck, man.

"In UK veterinary practice, the replacement of paper recording
systems with electronic methods of storing animal patient
information escalated from the 1980s and the majority of clinics
now use electronic medical records. In a sample of 129 veterinary
practices, 89% used a Practice Management System (PMS) for data
recording "

Better to be a dog in the UK it seems.

More arrogance, since you are assuming that computerization =
better health care. When health care is done unerringly by
computers, that might work out to be true.

It seems to be true according to at least some major studies. The list
of benefits is long. Your objections seem to be centered on efficiency,
but there is evidence that has been substantially improved, also. If
efficiency was actually lowered, it would be rather unique across the
very wide range of computer assisted activities.

My point was that UK vets are more computerized than US human
hospitals& clinics. I doubt that the vets have been coerced into
purchasing such systems. I could be wrong.

Dunno. But there appeared to be an implied value judgment in your
statement that "computers = better care."

I think that's a given. The only thing that appears to be controversial
is the gains in efficiency and cost/benefit. I would expect that vets
are at least as concerned about costs and efficiency as human medics.

Why not design computers to capitalize on the characteristics and
economics of a highly sophisticated, well-developed pre-existing
documentation system?

To fully take advantage of the benefits of computerization data must be
standardized and encoded. This allows both easy data exchange between
systems and automated data processing. Those two benefits are enormous.
As medical facilities, by necessity, become more distributed and
specialized, the need to coordinate and share becomes proportionally
greater. Virtually all commercial activities undergo continuous
transformation via technological innovation. That's what drives
productivity, and has for millennia. That medicine is somehow immune to
this is naive.

Oddly enough we don't have widespread moral outrage over Bill Gates
making millions a year (although for some reason there is moral outrage
over Steve Jobs making millions a year). But we seem to have moral
outrage over a physician making $150,000-300,000 a year even though the
expertise and liability demanded of the physician is orders of magnitude
greater than is demanded of Jobs or Gates.

Medicine, in the US, via a number of mechanisms, is pretty much a
cartel. Among other things, it has done a poor job of improving
productivity and quality via technology. As a group, it's a foot
dragger, anecdotes aside, the overall numbers tell an unambiguous, and
damning, story. It's not all about HMO's and pharmaceutical companies.

No. "Death panels" will have to exist in one form or another. A price
tag will be (or already is) placed on the value of a human life, by
someone. Pragmatism requires that some costs will be spared.

This is generally incorrect because of regulatory limitations placed on
insurance companies to deny coverage of treatment (this is on a state by
state basis because that's where most insurance regulation happens under
the current commerce laws). Decisions are made by the patient and the
doctor as to what treatments are pursued (and thus as to the costs
incurred).

See Arizona organ transplants. It's the future.


So do lots of businesses that aren't considered health care. There
are a lot of life and death issues in the world. Toyota
accelerator pedals, for example. Proper installation of furnace
exhaust vents. Carbon fiber steerers and fork blades.

There is the matter of degree. Health care is principally involved
with serious physical and mental issues, other industries only
peripherally, hence the difference of degree in regulation.

There is a matter of degree. Thank you for realizing that nuance, which
was not evident in your earlier writings.

It's not a "nuance", it's the very core of the matter.


In the US, something like 60% of bankruptcies are related to health
problems. In much of the rest of the developed world, it is 0%. There
are really no valid economic arguments against universal insurance under
a robust public option. The arguments against it are primarily those of
political philosophy (e.g., the canard of "freedom"). The benefits are
massive- reduced total costs, elimination of bad debt for services
provided which in turn can reduce costs of care, removing the cost of
insurance from payrolls and putting US businesses on a more even footing
with businesses in other countries (benefitting small businesses as much
or more), etc. Funding can be diversified across large segments of the
economy (a combination of payroll taxes and broader taxes) which can
distribute the burden quite tolerably.

Even Medicare and Medicaid, with their low overheads, will break the
bank if efficiencies aren't achieved. The way forward is to improve
productivity in the same manner with which it has been improved in
virtually all other segments of both the service and product economies
-- with technology, mainly with computers.

What I am doing in this discussion is separating the components of
health care in a way that identifies where the problems are located
which makes them more addressable. Making the problems smaller makes it
easier to conceptualize solutions. There are problems attendant with
health care finance (mostly insurance companies) that IMHO are the
biggest problems that have to be addressed. While I favor the public
option for a lot of reasons, that is not the only possible way to
address the deficiencies (as models in other countries have shown).

Wringing out the overhead costs -- if there's ever the political will --
is only a one-time event. Once overhead is reasonably low, it's the
actual productivity of the providers that becomes the only issue.
Productivity that extends to both treatment and prevention in a
coordinated way.

The problems between health care provider and patient can also exist,
but these are much less systematic and are specific to those
relationships. In the past 20 years there has been a concerted effort
in health care to be more user-friendly, to provide better patient
education and to facilitate better treatment decisions. This is a
discussion that is held regularly at all hospitals and most clinics.

A kinder, gentler, more responsive, and less mistake-prone medical
system is all very nice. What is really needed is a much less expensive
system. A system that can both heal and prevent at much greater
efficiencies. The US medical system is still pretty much in the past
century despite the fancy gadgets.

On 12/4/2010 9:34 PM, DirtRoadie wrote:
On Dec 4, 6:57 pm, Jay wrote:
On Dec 3, 9:42 pm, Frank wrote:

I do so routinely. Every time I control a lane in front of a truck, I
prevent him from passing when he shouldn't. Anyone can learn to do
the same.

Gotta' love the authoritarian "when he shouldn't."

What I like is the idea that when a bicycle is in front
of a truck, the cyclist is controlling the truck.

The driver is controlling the truck and hopefully he's paying attention,
he sees the cyclist and the truck doesn't have any mechanical issues.

On Dec 6, 10:36*am, Duane Hébert wrote:


What I like is the idea that when a bicycle is in front
of a truck, the cyclist is controlling the truck.

The driver is controlling the truck and hopefully he's paying attention,
he sees the cyclist and the truck doesn't have any mechanical issues.

If you want to be pedantic, when the cyclist is properly in front of
the truck in a lane too narrow for safe passing, he is controlling the
use of the lane.

So Duane, when you're bicycling in a 10 foot lane with a truck that's
8' 6" wide coming up behind you, what exactly do you do?

- Frank Krygowski