Quality Digest  |  05/03/2009

Letters

Stimulated Yet?

Thank you, Scott Paton, for telling it like it is (“Stimulated Yet?” Quality Curmudgeon, March 2009). The bonuses at AIG and continuing troubles at General Motors make it pretty clear that bailouts don’t work. It’s also time people start taking responsibility for their actions. The real enemy is greed and until we can control the reward system, bailouts, Sarbanes-Oxley, regulation, or any other government program, we will fail, adding even more expense to the problem.

Bill Osburn

 

Paton’s comments recommending that GM and Chrysler go into bankruptcy reflect a standardized, revisionist Calvin Coolidge/Herbert Hoover blather that the “free market” will heal things in due time. Unfortunately, this thinking pervaded the approach of the economists that surrounded Hoover, and the economy plunged into the Depression.

The auto industry actually responded to what many people in the so-called American “free market” wanted: large vehicles, liberal financing, and a demand that was unabated until speculation in the oil markets put a halt to purchasing, along with the complete freeze-up of credit markets.

He does not seem to understand that a large, capital-intensive organization like GM, with hundreds of thousands of employees, union contracts and debt obligations to satisfy, burgeoning health costs, etc., cannot simply be expected to turn this horrific situation around in a month.

—Christopher Hahin

 

It’s All About the People

Denise Robitaille’s article in the March 2009 issue (“The People, Yes”) was as inspired as it was inspiring. “The People, Yes” should be the type of article featured in every quality, business, and financial magazine every issue, every month, every year. I’ll buy the author a drink and toast the engine of all human endeavor—The People—next time she’s in the DC area.

Ann Casey

 

Health Care Bias?

S. Bala’s piece on emergency room triage (“Lean Triage for Hospital ERs,” March 2009) began by noting a report by the “nonpartisan” Commonwealth Fund. Although he may technically be correct (with regard to whether CF is aligned with a political party), the Commonwealth Fund seeks the socialization of American medicine. In addition, it has come under valid criticism for overstating, in one of its reports, the role of medical expenses as a cause of personal bankruptcies. I’m surprised that anyone still reads the CF’s reports anymore, and more surprised that they would be cited as a reference.

Robert P.N. Shearin, M.D.

 

S. Bala responds: The CF-commissioned survey of public satisfaction that I cited at the outset of the article was conducted by Harris Interactive. The methodology Harris used suggests that the sample, and manner in which it was collected, are statistically above reproach.

The other CF survey cited later, this time of health care professionals, was done in coordination with Modern Healthcare , a publication that boasts 29 awards for journalistic excellence, including six Gold awards from the American Society of Healthcare Publications Editors and the American Society of Healthcare Business Publication Editors.

 

It’s Not Our Fault, After All

“Methinks thou dost protest too much....” Blaming the recession on ineffective quality practitioners is like blaming the Titanic for not having an iceberg warning system (Dirk Dusharme, “Death Row Conversion,” First Word, March 2009). Every one of us worth our paychecks is looking constantly at process control and improvement, but likewise we are all faced with constant resource reductions. That we have to protest about unethical behavior on the part of executives (as evidenced almost weekly in the daily news) bespeaks a much deeper concern, the erosion of societal moral integrity. The Truth, folks, is still the Truth, regardless of “spin factors” to the contrary.

David K. Smith

 

Don’t Need Lead Underwear

I cringed when I turned to “Real-Time X-ray Inspection” (Gil Zwieg, March 2009). The picture, showing an operator X-raying an object, completely ignores radiation protection. The operator is standing in close proximity to and holding the object that is scattering the X-rays. X-ray scatter is contributing to both extremity and whole-body doses that, over a period of time, can be significant. At the very least this operator should be wearing a lead apron and wearing leaded gloves. She should also be wearing a dosimeter. I realize that the picture was probably staged for the article; however, basic radiation protection considerations should have been included to remind readers of personnel safety requirements.

Michael J. Leal, M.S.
Regional Radiological Health
Representative, Northeast Region
U.S. Food & Drug Administration

 

Gil Zweig responds: You’re right, attention should be paid to safe operating practices whenever ionizing radiation equipment is used. However, the source of the Glenbrook Technologies fluoroscopic camera discussed operates at 35 kV to 50 kV at 150 m A, and the X-ray beam is tightly coned to just fill the 50 mm field. There is zero scatter to the operator. Here is a link to a fluoroscopic video I made of my small finger in response to concerns about pediatric imaging (www.qualitydigest.com/product-demo/video/glenbrook-technologies-mxra-flouroscopic-camera.html ). The dose rate to my finger while making the video was 25 mR/hr or about 0.4 mR/min.

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