Link: http://blog.theentrepreneurschool.com/doctors-are-horrible-entrepreneurs-1054/comment-page-1#comment-464

Posting here a comment I left over at the Entrepreneur School Blog, where Jim Beach talks about the lack of business sense in doctors. If it sounds rant-ish, I apologize.

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There are good reasons doctors make for bad business people (and entrepreneurs). The healthcare system is set up where the customer is an insurance company (1) and (2) practicing medicine has turned into a matter of treating symptoms rather than proactive care. In other words, the doctors expect *you* to call them when you have a problem because on the front-end (the preventative end) they largely have nothing to offer.

Case in point: medical students only take maybe a semester’s worth of nutrition. Insane when you consider that diet (and lifestyle) choices are certainly the most likely causes of people’s health maladies — so really, when it comes to having the proper tools to help patients avoid getting ill in the first place, doctor’s aren’t equipped. They are proactively/preventatively neutered.

I won’t get into the insurance company angle, but that has an impact, too. The customer has been utterly divorced from the healthcare system when you’ve got so many layers between you and your care:

you -> employer’s HR department -> [the insurance company bureaucracy] -> [hospital bureaucracy that negotiates reimbursement amounts] -> doctors who code procedures and provide you care

Simply cutting out the employer side would immediately get the consumer more plugged in as you’d have 10s of thousands of more individuals interested in getting better rates/plans from insurers than the lackadaisical corporate HR departments. I digress.

And there’s a (3) here, too. That’s that the doctor’s go to school for longer than any other profession, which makes them prone to dogmatism/procedure instead of being creative or driven to trial/error and problem-solving.

All things considered, it’s a disaster of a system. It’s no surprise it’s only getting worse. The only surprise (to me) is that so few people are talking about these core, simple problems that are making for such a disastrous healthcare system.

Link: http://www.peopleandplace.net/perspectives/2009/1/26/collapse_and_renewal#

Found a lot of interesting things to think about in this article. Seems to get at how dynamic/complex/living systems (ecosystems, economies) evolve rapidly and then stagnate, which leads to collapse, and reboots the system (my simplification).

What I Have Learned
Change that is important is not gradual but is sudden and transformative. There is a common base cycle of change in individuals, in ecosystems, in business, in society. Increasing rigidity halts a long, slow period of growth and increasing efficiency. That begins a period of creative destruction and a fast period where uncertainty is great, where novelty emerges, and where new foundations are formed for a new cycle to begin. That is where we are now heading internationally.

In the United States, it is a time when the power of the state has achieved rigidity unseen since the triumphs of the falling of the Berlin Wall. Politicians have reacted to extreme disturbances, like the appalling terrorist attacks of 9/11, with powerful military response, a blind view of history and cultures, and a greedy desire for narrow benefit. Global economic expansion and dependence on peaking oil supplies, particularly in the Middle East, lock geopolitics into a self-destructive state from which transformation is extraordinarily difficult.

That is the time when change is most uncertain. We are living in it now. In this year we have simultaneously faced the sudden appearance of now reinforcing flips - sudden increases in the price of oil, increases in the costs of food, a financial collapse and the start of a recession, the retreat of Arctic ice sheets with climate warming, and accelerating loss of biodiversity. That is a lot to swallow and it reflects a process of human development and expansion since WWII.

But it is also the time when the individual has the greatest influence: when experiments determine the future; when the Internet opens opportunities for collaboration within and across nations; and when low cost mistakes are glorious because they trigger learning.

And these are the lessons I have learned that help in that process of dealing with turbulence:

1) Separate individual thought and work is essential but now, when integrative studies are the only way to reveal understanding, work with others is equally so. An individual’s knowledge can be combined with that of others to make the whole greater. In doing that we each recognize that we do not know everything but we do know, and know well, something. We learn with grace and humor and patience to work with others from different disciplines and backgrounds.

2) Complexity is in the mind of the beholder, in the patterns that are generated by causes that are simpler. Not as simple as once thought, but explained by a kind of “Rule of Hand", not by a “Rule of Thumb’. Quite simply, I found in case after case of ecosystem change that four to six sets of variables operating at a number of different scales, in a non-linear way, captured nature’s flipping behavior. It turns out that ecosystems are temporary assemblages, pausing for a few hundreds of centuries in a passing state of quasi-stability as part of evolutionary change. Think of that when we think of the reality of global climate change.

3) There are about three kinds of scientists - the consolidator, the technical expert, and the artist. Consolidators accumulate and solidify advances and are deeply skeptical of ill formed and initial, hesitant steps. That can have a great value at stages in a scientific cycle when rigorous efforts to establish the strength and value of an idea is central. Technical experts assess the methods of investigation. Both assume they search for the certainty of understanding.

In contrast, I love the initial hesitant steps of the “artist scientist” and like to see clusters of them. That is the kind of thing needed at the beginning of a cycle of scientific enquiry or even just before that. Such nascent, partially stumbling ideas, are the largely hidden source for the engine that eventually generates change in science. I love the nascent ideas, the sudden explosion of a new idea, the connections of the new idea with others. I love the development and testing of the idea till it gets to the point it is convincing, or is rejected. That needs persistence to the level of stubbornness and I eagerly invest in that persistence.

All types of scientists are necessary, but I would love it if we could encourage and include the innovative type of artist. At the least, enjoy rigor, but never inhibit the innovative artists.

4) I learned that the key to make effective designs was to identify large, unattainable goals that can be approached, but not achieved, ones that relate to fundamental values of free speech, freedom, equity, tolerance and education. And then to add a tough design for the first step, in a way that highlights or creates options to design, later, a second step - and then a third and so on. We found that the results were steps that rapidly covered more ground than could ever be designed at the start. At the heart, that is adaptive design, where the unknown is great, learning is continual and actions evolve.

5) I am prodigiously curious about nature, and that triggers initial ideas. I am also terribly persistent and stubborn about developing and testing an idea that grabs me; at those times I am totally and narrowly focused, driven by the potential. That is what eventually makes an idea useful. So I conclude that natures create the idea; stubbornness makes it useful! But I have had to learn how to see nature. It is curiosity, anecdotes, funny correlations, jokes and metaphors that start that. It is new emerging theory that completes it.

One has to learn to develop senses that help us listen to intriguing voices that are hidden amongst the noise. Owlish ways to hear the rustle of the mouse. Do that and the future will be fun and rewarding. We all might even help, at this time of great change and threat, to develop further a world of justice, understanding and equity.

Link: http://www.mindfully.org/Farm/2003/Everything-Is-Illegal1esp03.htm

Richard Nikoley pointed me to this excellent essay by Polyface Farm’s Joel Salatin. It is one of the best things I’ve read in quite some time – a complete indictment of government interference with just wanting to be free. Joel suggests that eventually the noose will tighten too much and a cycle will assert itself once more, throwing off these heinous chains to freedom, individuality, diversity and independence. I hope he is right.

Look, if I want to build a yurt of rabbit skins and go to the bathroom in a compost pile, why is it any of the government’s business? Bureaucrats bend over back-wards to accredit, tax credit, and offer money to people wanting to build pig city-factories or bigger airports. But let a guy go to his woods, cut down some trees, and build himself a home, and a plethora of regulatory tyrants descend on the project to complicate, obfuscate, irritate, frustrate, and virtually terminate. I think it’s time to eradicate some of these laws and the piranhas who administer them.

Link: http://www.zerohedge.com/article/martin-armstrongs-latest-real-dark-pools

Martin Armstrong continues writing his typewritten letters (from a detention center in New Jersey) regarding ongoing economic and political events. I’m no expert on Armstrong though if you’ve not heard of him, he was detained (imprisoned) for some seven years for contempt of court and only went to trial when the judge who had been detaining him was removed from the case by the NY Court of Appeals (source: wiki). There’s a pretty reasonable chance that Armstrong did nothing wrong other than crossing the State.

Oh and Armstrong had a number of models and forecasts he used to predict the market, some of which were apparently amazingly accurate. Who knows.

Armstrong’s latest letter is available on ZeroHedge, a finance-centered blog that has quickly become one of the most cited and popular finance blogs out there. Interestingly, the ZH writers are anonymous, taking on the names of various characters in Chuck Palahniuk’s Fight Club. Recently, ZH took their site off of blogspot.com and moved it to offshore servers to further protect their anonymity and the site’s often whistleblowing content.

Getting to the point. The letter is about Goldman Sachs and what Martin calls the “club” on Wall Street. The “club” is a group of extremely powerful individuals who are out to make massive amounts of money via the financial system. Importantly, the “club” attempts to do this not by making better bets (as in, speculating), but essentially by rigging the system and creating the perfect trades. The “club” accomplishes this goal by controlling inside information.

The letter is pretty lucid and provides an interesting glimpse into what goes on behind-the-curtains of Wall Street. What struck me most about the letter is that Armstrong works to dispel the notion that there is some conspiracy theory across all central banks to control the world. What’s really going on is that the central bankers are trying to do their jobs and maintain economic and monetary order. Unfortunately, they are clueless academics. Martin realized just how impotent and lost the powers-that-be were back during the 1989 crash:

It had dawned on me perhaps when there was the 19889 Crash. I had carried two cell phones many times when the model was reaching critical turning points as it did in 1989. The markets were going nuts, and my one cell phone ran[g] that was used primarily for very special clients. it was one of the G5 Central Banks asking me outright what the model was showing and did I think they needed to intervene? As I was explaining the focus was in Japan and that there would not be any abnormal correction and thus there should not be concern about intervention, my regular cell phone rang. It was another G5 member asking the same questions.

What became very clear to me, was they truly had no idea what was taking place any more than the rest of the world. Everyone was struggling to comprehend the new world that was emerging. Communism seemed defeated, markets were crashing, and the general expectation was - Should we be rejoicing?

Most of the central banks have a lot of PHDs, with no real world experience. They have read books, but have not been in the trench to “feel” what it is truly like. This is why government employees rarely have anything worthwhile that will ever contribute to society. …

Armstrong has seen behind the curtain and knows that the authorities (in this case the central banks) are clueless, self-interested, and incapable of working together to effect change. Often, outsiders see these authorities and point out their ineptitude, understanding they are clueless academics. And that’s where outsiders go from insightful to crazy – they go on to conjure up theories of impossibly coordinated efforts by the same incompetent authorities.

In other words, it’s just like the South Park episode – Mystery of the Urinal Deuce.

So what is going on when we see Goldman Sachs making money hand over fist? Simple: they’re doing what they do best, exploiting their inside information, political connections, and their current monopolistic status on Wall Street. Is it all that surprising?

This interview with Max Keiser is fantastic. Keiser doesn’t hold back with regard to how he views Goldman Sachs as “scum” that has “co-opted” the U.S. government. He even goes on to say they are financial terrorists that effectively held the U.S. hostage by claiming that the world would end if they weren’t bailed out (essentially, Keiser is equating the likes of Hank Paulson, who was head of the treasury when the massive bailout was orchestrated and is an ex-Goldman CEO was basically working for Goldman in his role at the Treasury). And yeah, Max is an outspoken guy, but I have to wonder how many others out there on Wall Street are thinking something very similar but keeping their mouths shut (out of fear of retribution or whatever).

Regardless, you have to wonder: something is extremely wrong when an investment bank squeaked out of implosion a year ago thanks to a massive government bailout only to be the last man standing to reap the benefits of underwriting tons of equity as a quasi-bank-quasi-hedge-fund-with-supreme-access-to-the-U.S.-government and then makes enough money to pay all of their employees $300K+ in salaries/bonuses.

If that isn’t confusing, if that doesn’t make you scratch your head and say, “huh?” then just start looking around. There are a few people like Max, Barry Ritholtz, and, of course, Matt Taibbi (See his RollingStone article if you haven’t already) who are spreading the word.

And this isn’t about envy over a company being profitable. It’s about a company that is succeeding because they have massive influence in D.C. and with the Fed and Treasury. That’s not right. It’s not capitalism. It’s not a free market.

Ok that’s enough from me.

Link: http://bit.ly/14TCLS

Note: I don’t normally get into celebrity deaths, but to say Michael Jackson was an icon would be an understatement. Despite any number of freak-things related to the King of Pop, he was still an amazingly talented individual who created some fantastic music. I can’t say he’ll be missed — he’s only missed insomuch as I could displace the good things about him from the bad. And that had become increasingly difficult if not impossible over the past ten years.

From Yahoo! Finance comes an article titled “Jackson lived like king but died awash in debt.” You probably already know the gist. Jackson created any number of fantasies, from his freak narcissim to Neverland Ranch. He lived a life of extravagance and died almost a half billion dollars in debt.

A few short descriptors that come to mind when I think about Michael Jackson:

• He was an amazing talent and produced a veritable catalog of pop masterpieces.
• His family was dysfunctional — often disturbingly so.
• He went from lavish wealth to huge debt. He got foreclosed on with Neverland Ranch.
• After things had started going downhill, MJ’s investment in the Beatles’ songs (owning the copyrights) kept him afloat. It has always struck me as odd that you could own someone else’s musical creation. Rent seeking off of intellectual property rights? Check.
• Jackson was freakishly narcissistic and/or had an extreme case of body dysmorphic disorder, engaging in all sorts of plastic surgery endeavors that ultimately made him look alien/gross/non-human.
• He had some serious demons with regard to his sexual identity. Whether he actually acted on these things or not, I don’t know — it doesn’t matter, really. He had problems and they related to his sexuality.
• MJ was one of most obsessed-over celebrities ever. And look how that turned out — he made his kids wear masks in public.
• He died young of a heart attack.

I submit that Michael Jackson’s life is one of the more disturbing examples of modern American culture. He was an extreme case, for sure, but his problems are not unique: too much debt, too much spending, rent-seeking off of other’s work, twisted narcissism, broken family, repressed sexuality, and dying young of a heart attack*, the end result of a life of stress and poor nutrition.

It makes me sad to make this connection, but it’s just too striking to ignore.

America, what have we become?

* I guess cause of death is yet to be officially ascertained, but we’ll roll with this for now.

Link: http://xkcd.com/592/

Love the latest xkcd comic:

In three frames xkcd indicts central planning with the single line that, “People are complicated!”

Why is this simple truth so hard to understand? If people are complicated, so are all systems of human interaction (i.e. markets, government, relationships, etc.). And it doesn’t stop there, of course: all dynamic systems are complicated.

It shouldn’t be a surprise that the simple-minded solutions of central planners fail to manage such unpredictable complexity. So why are they even trying?

Link: http://www.blog.sethroberts.net/2009/05/29/the-american-health-paradox-what-causes-it/

This bit by Seth Roberts reminds me all at once of Nassim Taleb’s work (Status quo, the fed turkey, works until it completely implodes), Seth Godin’s “This is Broken” idea, and the dinosaurs going extinct.

Who is flying this plane? Do they really know what they are doing? Does chance win over purpose?

Seth’s blog post is centered around the broken U.S. healthcare system — a system which suffers both from a burgeoning status quo as well as no means of introducing alternative solutions. In other words, it is entrenched.

And just like the dinos, when that entrenchment ultimately leads to social upheaval, the failure may be catastrophic.

A robust system must be dynamic.

Link: http://daviddfriedman.blogspot.com/2009/05/other-worlds-and-wasted-talents.html

When I read this latest from David Friedman, I couldn’t help but think of one word, “broken.” There are so many people, myself frequently included, who are wasting their lives doing things they loathe. Meanwhile, they engage in hobbies, “other worlds” where their talents and energies are spent doing things they enjoy.

What we have is a system that tries to make widgets out of human beings. When the human beings inevitably fail to enjoy their particular widget design, they resort to other activities to distract or make their corporate lives bearable. Everyone loses in this system because people are not deployed to their highest and best (and most fulfilling) use.

The system is broken.

I was reminded of this recently when someone I know in WoW as an unusually competent and charismatic leader, organizer, and player, mentioned the problem of “parental agro.” He is apparently a college student, possibly a graduate student, living with his parents. Older examples are friends in the SCA of whose abilities and energy I think highly, who made their living as school teachers or secretaries or the like—respectable jobs, but not particularly high status or high paying ones.

The pattern is not entirely surprising. It makes sense that an energetic individual who doesn’t find much outlet for his energies in his current career will direct them towards his hobbies. Adam Smith long ago observed that, in the British universities of the time, a professor got no benefit by doing a good job of teaching, since the professors were on salary rather than, as in at least some of the Scottish universities, paid by the students. He concluded that if the professor were naturally energetic, he would spend his energies doing something that might be of some benefit to him rather than doing his job, which would not. Nowadays we call it “consulting.”

Link: http://www.blog.sethroberts.net/2008/01/21/interview-with-gary-taubes-part-14-the-end/

I did a site search on Seth’s blog for “fructose” (On how to do these and improve your use of Google Search) as I was curious if Roberts had seen any negative impact to using fructose in his Shangri-La Diet. I wondered this because fructose is apparently sweeter than glucose, which per the SLD theory that flavor/calorie associations spur weight gain, might imply that ingesting fructose would actually cause weight gain (I was trying to tie this all together into Stephen at WHS’s recent post about sugar). Alas, apparently sugar-water using nothing but fructose works fine on SLD. I forgot that plain sugar water is tasteless regardless of the sugar used (I don’t understand how sugar is sweet, but sugar water is not, but it’s true)

Anyway, in a roundabout way I got to reading Roberts’ interview with Taubes (Only read the last two parts out of fourteen: need to find the time to read the rest!). It was at the end of this interview that Taubes made a fascinating comment about how people in the scientific community react to his research on insulin and carbohydrates. Specifically, these otherwise intelligent and reasoning folk tend to close their minds as soon as Taubes drops the “C word:” carbohydrates. One word shuts them down as they write off Taubes’ immense research by way of invoking the “Atkins diet” or any number of other “low-carb diets” that were all the rage a few years ago.

And I couldn’t help but think how this mental shutdown is what I’ve seen countless times with any person of religion — people who otherwise may agree with any number of points you make will completely shutdown on the invocation of certain words.

This is a fantastic example of rational people utterly failing to apply reason, and it is exemplified by scientists and people of faith, alike. Indeed, the common thread here is simply dogma. Interesting.

TAUBES I think that’s true, but there’s this contrary effect that happens. I said this in my lecture. The science I’m trying to get across can be accepted up until the point at which I say the the word carbohydrate, and then people shut down, and they think “Oh, it’s that Atkins stuff again.” Their minds close and they turn around and go back to their lives. Anyway, I look forward to seeing the interview and getting your book and reading it. I enjoyed this. Again, I like nothing better than talking about this stuff.