What I'm Reading (Oct. 18)

By Chuck Dinerstein, MD, MBA — Oct 18, 2019
Here's what's on tap: Is tackle football the "New Smoking?" ... Private equity investment + healthcare = SURPRISE Billing. ... Is there an evolutionary role for parasites? ... And time: Is it subjective, fleeting or agonizingly long? A look at the underlying neurobiology.
Painting by Jean-Baptiste Camille Corot [Public domain]

It is a prime time of the year for sports. The World Series is just about to get underway, and we are just about in the middle of football’s regular season. Perhaps, for that reason, a new public service announcement may have escaped your notice. Yes, tackle football is the new smoking, especially for players 14 and under. Helmets were brought into football to reduce head injuries, and over the years, those helmets have become increasingly sophisticated in how and what protection they provide. An article from the Conversation, “Could helmetless tackling training reduce football head injuries?” ponders whether all that safety has inadvertently made the game far more unsafe. 



When I use the term ambulance chasers, who comes to mind? 

Pencils down. 

While many of you may have answered “slip and fall” attorneys, and that is true, a more woke answer would be private equity firms like Kohlberg Kravis Roberts & Co. 

“Ambulance services used to be covered by local taxpayers, volunteers, or nonprofit hospitals, part of a suite of services akin to firefighting, which many people took for granted. This remained the status quo for emergency medical services for decades. Then, following the 2008 recession, private equity firms began to buy up ambulance companies. Quality has declined, and prices have shot up.”

From the American Prospect, Private Equity Chases Ambulances. And while it isn’t mentioned in the article, private equity firms have found another investment opportunity, emergency medical services. Many hospitals outsource their emergency care to these groups. And consider this, two sources of surprise billing in health, are the rides to the Emergency Department and the Emergency Department itself. Just saying.


About a month ago, I wrote about the hygiene hypothesis, that some of our chronic diseases are a result of our improved hygiene – we don’t get exposure to everything our immune system has evolved to protect us against. From Slate Star Codex, “a blog about science, medicine, philosophy, politics, and futurism,” another evolutionary hypothesis, “Maybe Your Zoloft Stopped Working Because A Liver Fluke Tried To Turn Your Nth-Great-Grandmother Into A Zombie.”


Finally, from Nautil.us, an article looking at those moments when we are “in the flow.” When we effortlessly and in a very subconscious way, do our thing, like improvisational music, or on some occasions, surgical care. What Time Feels Like When You’re Improvising is a look at the neurobiology of being in that flow. For the interested, the areas of the brain that appear involved are also the ones associated with advanced practitioners of meditation. You got to love it when East truly meets West. 



Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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