We have just enjoyed The Intern. The contrast between De Niro as an old school businessman and the modern nerds was… painful. Don’t shave, but do groom. Adam has good hints.

Polls are bunk. Bunk. David Farrar, who works as a pollster, says that there is a systematic error. So does Mike Williams. I would add this: there are many people in NZ who don’t fit within any of the current four parties in parliament, and want to throw all the bastards out.

Last night, Newshub and 1News published conflicting political poll results, leaving people scratching their heads.
The National Party rose in the 1News Colmar Brunton poll to 44 per cent and ahead of Labour, which dropped to 42 per cent – down 6 per cent from the April poll.
But according the Newshub Reid Research poll Labour would have enough to govern alone, skyrocketing to 50.8 per cent with National diving to 37.4 per cent.
Former Labour Party head Mike Williams told Newstalk ZB the results show polls should be managed in different ways to uncover people’s preferences.
“The problem is the market research industry is in crisis at the moment … polls have not been confirmed by actual results,” he said.
He pointed out international polling results have been wrong recently, from the Brexit referendum in Britain to the Australian federal election last month.
“It’s difficult that landlines are dying out, it’s hard to get hold of cellphone numbers, some of these people are now doing online polling,” Williams said.
“The only [solution] I can think of, and it’s really expensive, is to actually go back to face-to-face polling, going back 30 to 40 years of the Heylen poll.”

Otago Daily Times.
Creepy. From Gab.

One of my friends led me to this link. About burnout, and about professional ethics being… hacked. I don’t think this applies only to doctors and nurses. I know that accountants, lawyers and teachers take work home. I know academics can’t do the job well in the time they have. But there is no elasticity left in many jobs, and people are not cogs in a machine. They break. EMR is “electronic medical record”. Administrative creep is often mandated by parliament who are told “it is just another five minutes”. But those minutes are now adding up. Burnout is endemic within NZ as well.

The E.M.R. is now “conveniently available” to log into from home. Many of my colleagues devote their weekends and evenings to the spillover work. They feel they can’t sign off until they’ve documented all the critical details of their patients’ complex medical histories, followed up on all the test results, sorted out all the medication inconsistencies, and responded to all the calls and messages from patients. This does not even include the hours of compliance modules, annual mandates and administrative requirements that they are expected to complete “between patients.”
For most doctors and nurses, it is unthinkable to walk away without completing your work because dropping the ball could endanger your patients. I stop short of accusing the system of drawing up a premeditated business plan to manipulate medical professionalism into free labor. Rather, I see it as a result of administrative creep. One additional task after another is piled onto the clinical staff members, who can’t — and won’t — say no. Patients keep getting their medications and their surgeries and their office visits. From an administrative perspective, all seems to be purring along just fine.
But it’s not fine. This month the World Health Organization recognized the serious effects of burnout from chronic workplace stress. Burnout levels among doctors are at new highs, far worse than among the general population, and increasing relentlessly. Burnout among nurses is similarly rising and is highest among those on the front line of patient careDoctors and nurses commit suicide at higher rates than in almost any other profession. Higher levels of burnout are also associated with more medical errors and compromised patient safety.
This status quo is not sustainable — not for medical professionals and not for our patients.
Mission statements for health care systems and hospitals are replete with terms like “excellence,” “high-quality” and “commitment.” While these may sound like Madison Avenue buzzwords on a slick brochure, they represent the core values of the people who labor in these institutions. Health care is by no means perfect, but what good exists is because of individuals who strive to do the right thing.
It is this very ethic that is being exploited every day to keep the enterprise afloat.

Danielle Ofri, New York Times.

Again, one of my friends posted this, commenting on a meme about “Dr Google”. I don’t link to Facebook.

Second, medical providers have licenses and credentials which they are constantly at risk of losing. They are required to use sound medical rationale documented in the record to justify every decision they make, in case there is a bad outcome. When you walk into a doctors office with your “research” claiming that you have already diagnosed yourself and demanding a particular treatment protocol, you are not going to get it.
The doctor does not see himself as the equivalent of a bathroom tampon dispenser. He assumes you are there for his expert opinion.
I have never been reported to a credentialing body, but I have sat in on a few of the committees that review bad outcomes. Every little decision the provider makes in the lead up to it is scrutinized like an invasive rectal exam. If the decision algorithm used by the provider does not justify a course of action to a reasonable degree of medical certainty, he will possibly lose his credentials (at that hospital), be reported to the national registry and could lose his license. Knowing that this is possible causes doctors to be very thorough and precise in what they do.
But hey! The internet and stuff!
Third, not once, on any medical treatment team have I ever met a provider who was incentivized by “big pharma” or whatever. Every one of them, to a person, is there to use the collective knowledge and experience of the team to help the patient feel better.
Its not a customer/business relationship. If you think that way, you have failed to understand the entire context of what is happening when you walk into a doctors office. And anyway, if that is your position, why go at all? You already know what is wrong and what to do about it. My guess is, you still recognize the value of medical expertise and are wanting to confirm what you already believe.
About 99% of the time when a patient comes to see me and says “I think I have X” 1. they are wrong. and 2. I have to spend an enormous amount of time explaining to them how differential diagnosis works. I realize that people have to live with whatever ails them, but conceptualizing mental disorders and being able to differentiate one from another takes more than reading diagnostic criteria from the DSM and applying it yourself. Quite a bit more, actually.
I don’t have a “god complex” either. I have about 12 years of training and another 20 years of experience studying human behavior.
When the tradesmen come to my ranch, building my house, excavating, pouring concrete, laying pipe and so on, I am an awe at what they can do.
I want to be able to go to a physician and have them say, “based on all your personal risk factors, medical history, symptoms, clinical picture, your diet, your genetic factors, your age, your sex, etc, the probability of having a heart attack in the next 20 minutes is X” and then let me decide what to do. If you ask them for this kind of raw data, they will give it to you.
I would, but nobody ever comes in asks me questions like that.

Scott, Facebook.

Any week that a university loses a suit because they accused a bakery of racism because students shoplifted is a good week. In the same week, Israel Folau is taking Rugby Australia to court because they restricted his right to practice his religion. To get the context of what Adam nominated as the long read of the week, you need to know that Huffman founded Reddit.

Over the years, Huffman has become increasingly concerned about basic American political stability and the risk of large-scale unrest. He said, “Some sort of institutional collapse, then you just lose shipping—that sort of stuff.” (Prepper blogs call such a scenario W.R.O.L., “without rule of law.”) Huffman has come to believe that contemporary life rests on a fragile consensus. “I think, to some degree, we all collectively take it on faith that our country works, that our currency is valuable, the peaceful transfer of power—that all of these things that we hold dear work because we believe they work. While I do believe they’re quite resilient, and we’ve been through a lot, certainly we’re going to go through a lot more.”
In building Reddit, a community of thousands of discussion threads, into one of the most frequently visited sites in the world, Huffman has grown aware of the way that technology alters our relations with one another, for better and for worse. He has witnessed how social media can magnify public fear. “It’s easier for people to panic when they’re together,” he said, pointing out that “the Internet has made it easier for people to be together,” yet it also alerts people to emerging risks. Long before the financial crisis became front-page news, early signs appeared in user comments on Reddit. “People were starting to whisper about mortgages. They were worried about student debt. They were worried about debt in general. There was a lot of, ‘This is too good to be true. This doesn’t smell right.’ ” He added, “There’s probably some false positives in there as well, but, in general, I think we’re a pretty good gauge of public sentiment. When we’re talking about a faith-based collapse, you’re going to start to see the chips in the foundation on social media first.”

Use social media as an intelligence source. There are many who indicate what they think there. But… I dumped twitter six months ago, and recently took Facebook off my phone, leaving messenger lite for the family to get hold of me. I’m calmer and more productive.

Too much of the discourse in mass media is rhetoric, designed to make us feel a certain way. Virtuous, disgusted, righteous, angry — or sad, depressed, and hungry. The media cares not a whit. It cares only for your attention. But they are but feelings, and as fencing bear reminds us, feelings don’t make you happy. (Read the whole thing).

Again, they are just feelings. They can make you miserable, but they cannot make you happy. What can? As Mihaly Csikszentmihalyi has argued, skill. More particularly, skill exercised under the appropriate conditions of difficulty, such that you are neither anxious or bored. “Flow,” he calls it, as if it is easy. Which it is–but only in concept, almost never in execution. (I, Fencing Bear, am living proof.) Why? Because real happiness comes not from doing things we find easy–or, worse, from following our “passion”–but from confronting challenges and rising to them. Here, competition is our friend because it gives us opportunities in which to exercise our skills, but even more importantly, because it provides real opportunities for failure. We learn nothing when we win, except that our skills were adequate to the task. We learn–and learn big, if having learned to sit with our feelings, we can ignore them and pay attention to what we need to change in our practice.

This, to my mind, as both Fencing Bear and Professor of History, is the real scandal afflicting our university and college campuses today. Not that the students are feeling triggered by the feelings that they experience when confronting ideas or assignments that they do not know how to address, but that we, their teachers, have failed to give them proper challenges because we (and, no, I don’t really include myself in this group, but as a teacher, I know I always have room to improve) have become so obsessed with making sure that they never feel bad.

Fencing Bear at Prayer.

Meanwhile, pray for our brothers in Ontario. It appears that preaching there is hate speech.