Archive for the ‘Unintended Consequences’ Category

Service of Noses Out of Joint: Are Online Reviews by Patients on the Line?

Monday, September 25th, 2017

 

Photo: youtube.com

Plastic surgeon Dr. Bahman Guyoron’s patient wasn’t pleased with the job he did on her nose to “alleviate nasal congestion,” according to Wall Street Journal reporter Joe Palazzolo, and while at it, he was to cosmetically tweak her beak. So she shared her thoughts about the outcome on a range of online review sites from RealSelf, Yelp to RateMDs.com, and Dr. Guyoron sued her.

The patient said she now must sleep with a breathing aid because her nostril collapses and that her nose is wider than it was before surgery. A second surgery by the same doctor didn’t fix the problems.

Photo: earth.com

Her lawyer said “her reviews were ‘substantially true or were her opinion,’” and that they didn’t harm the doctor’s reputation.

Palazzolo explained that the doctor would have to prove they were false and that he was damaged. “If the jury deemed him a public figure, he would have to show that [the patient] knew the information was false or showed reckless disregard for the truth.”

In email correspondence with the newspaper the patient wrote that her purpose was to inform others and that she didn’t expect to face financial ruin as a result. According to lawyers who handle such cases, wrote Palazzolo, “a negative comment can diminish a doctor’s business in short order.” And because doctors’ hands are tied due to privacy laws to discuss details of procedures, to get patients to erase such reviews some opt to sue.

Photo: petwave.com

“‘Given how few defamation cases go to trial—and cases involving doctors are even more rare—any trial would be an important signpost for future litigation,’ said Sara Kropf, a lawyer in Washington, D.C., who provides legal advice to doctors regarding patient reviews.” This trial is scheduled for February.

Photo: catster.com

At first Dr. Guyoron wanted the patient to remove the reviews and pay him $700,000, which she said she didn’t have. He now wants $1.8 million.

Knowing the risk to your wallet, would you think many times before posting online a negative review about any doctor? Doctors aren’t infallible: they make mistakes as we all do. Should review sites investigate/vet patient complaints before posting them? What are other effective ways to warn other patients about a doctor you’ve found faulty?

Photo: haririlaw.com

Service of Questions

Monday, February 1st, 2016

questions 5

I have two questions that Google doesn’t answer and a third that you might not find on Google for good reason but it’s something you might like to know.

Henny Penny

I can’t remember ice falling from skyscrapers after a storm when I grew up in NYC but that might be because I didn’t live or go to school in neighborhoods with very high buildings. Or maybe I blocked it out.

Henny PennyMy question is: How come architects building structures in NYC today can’t come up with a way to stop this from happening? My office building had staff remove snow from the roof after the recent storm so nobody would get hurt. On the Sunday after 27-inches of snow fell on NYC we took a walk and were surprised by chunks of ice crashing on to sidewalks throughout midtown. This isn’t the first time yet many of the buildings we passed have been built in the last 10 years.

Partnerships

I [and thousands of others] had the looniest time getting on and off NYC busses three days after snowstorm Jonah. On Third Avenue between 43rd and 42nd Streets, ice several feet high lined the curb. Passengers jumped off the bus into deep slush and sloshed from 43rd  to 42nd in the street while oncoming traffic splashed them with icy mire. We couldn’t mount the sidewalk until we reached 42nd and turned the corner. It was as messy as it was dangerous.

Snow January 2016 004I was horrified on my walk home that night to see people with two choices to reach the steps of a bus. They could drench their feet to above their ankles in an icy soup or walk away from the bus, up the sidewalk to the corner and wobble through foot-high ice with a few footprints made by previous pedestrians and then quickly negotiate a tricky walk down the slippery street, in the dark, to the bus’s door. I realized what was happening when I approached the stop and saw an elderly woman, with a cane, who was attempting the latter option. Thankfully she’d made it by the time I got there.

Six days after the storm I came upon a dozen workers with shovels and a giant snowplow on a little used street. Most of the workers were hanging out [see photo below]. Clearly the city isn’t up to the task.

My question is: Why doesn’t the Metropolitan Transit Authority, with the city’s cooperation,** enroll the help of businesses or landlords to get them to clear/maintain three foot slits in snow/ice at bus stops that are in front of their property and keep it free of slush? **The city would compensate cooperating businesses through tax rebates.

Unintended Consequences

Santa gave my husband a Uniglo Heattech tee-shirt for Christmas to keep him warm. According to the Uniglo website, “The moisture-wicking fabric retains heat and also features anti-odor properties to keep you feeling fresh even when you sweat.”

Heattech T Shirt

Heattech T Shirt

But for him, Heattech, launched in Japan some 13 years ago, does something else that the company cannot promote on Google.

My husband suffers from a rash on his shoulders which itches all the time. A cream called Sarna works for about an hour but then the itching returns. However, when he wears his Heattech shirt, he doesn’t itch all day.

I read that the fabric also contains Camellia oil which according to an article on majoritymagazine.com, stays in the fabric up to 30 washes. This oil is said to help retain moisture. His dermatologist, who had not encountered Uniglo Heattech before, has suggested that if the textile retains moisture, that’s what alleviates the dry skin condition which causes the itch.

According to the magazine, “Due to Japan’s pharmaceutical laws, Unglo can’t officially claim that the presence of Camellia oil helps to retain moisture.” Uniglo probably can’t promote this wonderful health benefit here for the same reason: it would have to put the fabric through excruciating tests to prove and therefore promote such a claim.

Do you have questions that even Google hasn’t answered or surprise benefits of products you like?

NYC snow cleanup team.

NYC snow cleanup team.

 

Service of Unintended Consequences II

Thursday, December 10th, 2015

Unintended Consequences 2

Have you wondered how the shrinking moderate presence in Washington occurred; how the country has an increasing number of citizens from third world countries and how ISIS happened? Homer Byington, my husband, shares his theories.

In 1965, as part of his “Great Society” Civil Rights initiative, President Lyndon Baines Johnson signed into law the Voting Rights Act of 1965, passed by Congress despite the strong opposition of the Southern wing of the Democrat Party, but with the overwhelming support of the Republican minority. Its intent was to give black citizens the same voting rights as white citizens and a proportionate share of representation in legislative bodies such as Congress. It and subsequent court decisions, especially since the 1990s, have led to the re-drawing of State Congressional district lines to create a number of new “black majority districts.” Doing this, obviously, has led to the remaining districts in each state becoming far whiter than they had previously been.

The unintended, and unforeseen, consequence of this was that while there are now far more black and Hispanic congressmen and women than ever before, the number of “safe” seats controlled by extremist white conservatives has also increased even more dramatically. The number of moderates of any political stripe has declined just as dramatically.

President Lyndon B. Johnson

President Lyndon B. Johnson

That same year, again as part of his “Great Society” Civil Rights initiative, President Johnson signed into law the Immigration and Nationality Act of 1965, which was enacted by Congress, despite the strong opposition of the Southern wing of the Democrat Party, but again with the overwhelming support of the Republican minority. Its intent was to replace the existing law, which was discriminatory because it based visa eligibility on the national origin of the immigrant, with a policy that united families. There was no limitation on the number of immediate family members of American citizens that could be admitted.

donkey and elephantThe unintended, and unforeseen, consequence of this has been that the demographic makeup of the country has changed dramatically. Neither President Johnson, nor most others in his administration, and especially the mid-western Republicans, wanted or expected this to happen. They assumed that the vast bulk of immigrants would be family members of existing citizens and, therefore, would continue to be European. Instead, prosperity and declining birthrates there led to, if anything, reverse immigration to, rather than from, particularly Western Europe. Instead, a flood of Third World migrants, taking advantage of a variety of preference categories under the statute on a worldwide quota basis, compounded by the admission of their relatives and, in turn, their relatives, have poured into the country over the past 50 years.

In 2004, the United States invaded Iraq supposedly to fight terrorism and quickly overthrew Saddam Hussein, a Sunni, his Ba’ath Party and army. Perhaps following the example of what the Allies did in Post-war Germany with the Nazis, Hussein was eventually executed, the first tier of Ba’athists and military were prosecuted or jailed and the lower ranks were fired and disenfranchised. The latter, according to Michael Weiss, co-author of ISIS – Inside the Army Of Terror, became the pool of unemployed, unhappy, educated, technologically inclined, skilled Sunni labor from which ISIS sourced the relatively sophisticated team that now staffs its middle and upper-middle management. (Based upon my own experience with Iraqis, I’m inclined to believe Weiss.)

President George W. Bush

President George W. Bush

The unintended, and unforeseen, consequence of this occupation policy was that we and others now have a massive problem dealing with a variety of terrorist attacks by diverse ISIS agents and recruits around the world. President George W. Bush and his advisors may have invaded Iraq with the intention of weakening, and eventually defeating, al-Qaeda and Osama bin Laden, (although I was not then, and am still not now sure anybody in the government really understood what he was doing at the time), but they certainly did not intend to spawn a new breed of yet more sophisticated Wahhabi Sunni terrorists. However, that seems to be what has happened.

Homer asks: Do you think that there is any way in which we can undo these past unintended consequences? If so, how would you go about fixing what has happened? And, can you think of any actions our leaders are now taking which will unintentionally result in regrettable consequences for all of us?  

 Tangle of yarn

Service of Unintended Consequences II

Thursday, June 27th, 2013

Unintended consequences

Let’s Face it

Facebook sent printed invitations to media, delivered by messenger, for a product launch. Hmmmm. Is social media already passé?

Fertilize New York

CompostWe learn on wnyc.org: “Mayor Michael Bloomberg proposed expanding a successful pilot program recycling food scraps to more single-family homes, high rise buildings and schools. Within three years, the Bloomberg Administration says, the hope is that recycling food scraps will be mandatory and as much of a routine as recycling glass, metal and plastic.”

While I love the concept of a food scrap composting initiative, I think the Mayor needs to first address the way city food is sold and the space constraints of millions of residents. We buy much of our meat, fish, fruit and vegetables packaged on Styrofoam trays covered in plastic wrap so off the bat we need two kitchen trash receptacles.

New Yorkers’ microscopic kitchens—especially those in Manhattan–are the brunt of jokes and jibes. In mine there’s barely room for one tiny garbage can which works as we put out garbage daily in the morning and it’s picked up in front of the door. We keep empty bottles on a counter and put them out for pickup separately. A second can to capture just food scraps will be a challenge for space. Devoting more countertop to hold garbage is more than unsightly, it’s a health hazard and potential rodent attractant.

In giant apartment houses with hundreds of tenants, renters send garbage to the basement via a shoot. Color coded bags–blue for compost, white for paper, green for bottles, pink for plastic and yellow for other garbage–would solve the one-shoot-in-tall-buildings issue if tenants could be bothered to buy them, keep them straight and comply.

Only in New York

Bike sharingSome New Yorkers are using the bike sharing Citibikes for exercise in the fresh air. Seems they pedal in place without anyone having to slip in a credit card or join the rental system. That’s a New York kind of moxy that makes me smile.

What’s in a Name?

The “Borghese v Borghese: Battle for a Royal Name” story in The New York Times seemed different from the usual intellectual property fights. In her article Christine Haughney cited a law professor who mentioned examples that I thought only underscored the dissimilarity. One was Chick-fil-A, known for the slogan “Eat More Chicken,” that sued a folk artist who tried to trademark “Eat More Kale.” 

Princess Marcella Borghese. Photo: Wikipedia

Princess Marcella Borghese. Photo: Wikipedia

While I think that example is a stretch, an even bigger one is to ask a family to drop its name and heritage.

Revlon bought the Borghese cosmetics brand, according to Haughney, along with “the words and phrases BORGHESE, MARCELLA BORGHESE and PRINCESS MARCELLA BORGHESE” and subsequently sold the Borghese Company, now in private hands.

The first problem occurred as a result of a press release about one of Princess Marcella Borghese’s grandchildren. He was to appear in a TV program. His grandmother was mentioned as well as the fact that she “started the famed self-named cosmetics line, Borghese Inc.” The grandchild was warned against “causing any false impression in the marketplace that there is a connection or relationship between yourself and Borghese Inc. and our cosmetics products.” The next hiccup between the Princess’s descendants and the company came when the grandson applied for a trademark for pet shampoo and conditioner—La Dolce Vita by Prince Lorenzo Borghese–to be sold by PetSmart. The Company sued.

Am I reading too much into the symbolism of a social media giant choosing a traditional form of communication? Should tiny NYC kitchens and the way food is sold and tossed in giant apartment buildings stall a compost program? Do you know of other typical out-of-the-box takes on services like NYC bikers using parked vehicles for exercise? Should a family member be forbidden to sell his/her name and others prohibited to use that last name in business forever?

Tiny nyc kitchen

Service of Unintended Consequences

Monday, May 6th, 2013

Transparent backpack

One business will get a jolt as a result of the Boston Marathon bombings because it appears that backpacks won’t be allowed at future ones there or in NYC either. Not every one of the some 45,000 runners who finish the NY Marathon depends on them but enough do. Add the smaller events here and elsewhere and the numbers add up. Fanny packs are allowed and will take their place. Perhaps transparent backpacks will eventually be allowed.

pickpocketThe increased incidence of pickpocketing in Europe will fatten the wallets of manufacturers of money belts and other contrivances to keep tourist cash and credit cards safe. Pilfering got so bad at the Louvre that guards went on strike. Security felt that the Paris police were too easy on the children who perpetrated countless daily thefts. [Why children? They get into the museum free.] On a recent “Travel Show,” Arthur Frommer noted that Paris isn’t the only European city to report record theft and suggested his listeners take care.

Airline limits on luggage have impacted that industry and orthopedic surgeon and audiologist waiting rooms flourish from the fashion for platform heels and ear pods on portable music devices.

Matchlighting candleHave you scrambled for matches to light candles on your dinner table or to add calming fragrance to the atmosphere? So few restaurants use matches to promote their businesses.

Finger nails are out for Android and iPhone users who expect to type on screens. Look around: There are fewer claws than in the past.The technique for those who use voice-to-text systems harkens back to the dark ages when executives had secretaries and typing pools. They chatted into Dictaphones with letter or memo copy and secretaries typed what they heard. As in days of yore, you can also ask your phone to add a comma and a period. There was no wink symbol then.

BicylesNew Yorkers are split about what to expect from the 10,000 cycles in the bicycle share program again about to launch: Increased lines in ERs perhaps? I’d written about the initiative last summer in “Service of Exercise” when we first expected it and haven’t changed my mind: Thumbs down and I’d like to be wrong.

I saw an able-bodied 50-something man walking briskly across Third Avenue at 43rd Street last week. Suddenly he fell flat on his back. He hadn’t seen a deep hole surrounding a manhole cover and lost his balance and his footing. We’re putting thousands of bicycles on these unsound streets?

New York drivers are unforgiving and rushed. If you’re crossing where they want to go—what’s a green light?–there’s a 70-30 chance they’ll stop. Maybe the unintended consequence the Mayor anticipates is a more cordial driving attitude. That would be nice.

Do you have examples of good and bad unintended consequences or some that are yet to be determined?

 courteous taxi

 

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