America’s Futile War on Drugs

by Mark Harvey

Sometimes our American ideas about social problems and how to fix them are downright medieval, ineffective, and harmful. And even when our methods are ineffective and harmful, we are likely to stick to them if there is some moralistic taint to the issue. We are the children of Puritans, those refugees who came to America in the 17th century to escape King Charles.

To say Puritans had strong beliefs is as understated as saying Genghis Khan enjoyed a little pillaging and conquering out on the Asian steppes. The Puritans were believers like no believers before them. And in general, they weren’t a lot of fun. As if religious services aren’t serious enough, the Puritans eliminated choral music and musical instruments from their churches because those touches were a little too much like the papistry of the Catholic Church. Puritans in Massachusetts even banned Christmas for a spell as they thought the holiday had a pagan origin and therefore embraced idolatry.

The journalist H.L. Menken put it well when he said, “Puritanism is the haunting fear that someone, somewhere, may be happy.”

So when you forge a nation with some strong puritan roots along with some marvelous practicality, such as the United States, sometimes you get pretty mixed up results. The prime example is our colossally counter-productive “War on Drugs,” now 50 years in the works. Read more »

Open Your Mouth, Stick Out Your Tongue, and Say “Five”

by Carol A. Westbrook

6a00d8341c562c53ef01b8d1c5ba95970c“What should I do with this?” my husband asked, as he handed me the letter. It was a Press Ganey survey asking him to evaluate a recent visit to his doctor.

In case you have never seen one, a Press Ganey survey is a multi-page questionnaire in which you asked to rate your experiences during a hospital or outpatient clinic visit, from 0 (bad) to 5 (best). The completed questionnaire is mailed to Press Ganey, which compiles and analyzes the data, and reports the results to the hospital or health care system that ordered the survey.

The survey asks questions like, “Did you have to wait long to see your doctor? Was the staff pleasant? Was the waiting room clean? Did your doctor take enough time to explain things to you? Did your doctor smile and shake your hand? Did the valet parker return your car promptly?” It also does not ask questions that the health care organization does not want to hear, for example, “Was your doctor given enough time with you? Did you actually get to see the doctor instead of the nurse practitioner? “Press Ganey has been called an Angels' List for clinics and hospitals.

That is why administrators love Press Ganey surveys–because they know that good scores will bring in more business. They also have the side benefit of providing an outlet for unsatisfied or angry patients who otherwise would be pounding on their door. Giving a doctor a “0” makes a disgruntled customer feel that he is addressing a problem, without the manager ever having to do anything about it!

Most importantly, though, patient satisfaction scores provide “objective” data that can be used to manipulate physicians by lowering their salaries or even firing them if they do not maintain a high score.

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