#they initially staffed one person for this event and i got asked the morning of to come help out
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i hate that if i complain abt the culture of the company i work for (staffing one or two people for incredibly busy events that they had months to plan ahead for and then expecting/pressuring employees not to take their legally mandated break during those shifts) the only person who would get in trouble is the low level manager who was running the shift that night. they stick us in impossible situations so they can scapegoat us when anything goes wrong
#worked a rly hellish shift last night#didnt stop scooping for 3 hours while customers harassed us and shouted at us. like 5 and a half hours total of not sitting down at all#my arm is bruised today#they initially staffed one person for this event and i got asked the morning of to come help out#tickets for the event were sold MONTHS ago and the company knew that there would be thousands of people there#last month they staffed one person for a sold out [famous old punk band] concert#we're one of two food stands inside this concert space.
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A few weeks ago, working out a plan for the 3 weeks when we would be understaffed (and doubly understaffed for one of those weeks), I told me coworker/manager that I would feel ok taking on one particular project IF a solid first draft or two had been done by the time I had to take it over. What I meant was "I need the fucking team to fucking review and mark it up because I know these people and I do Not want to deal with Yet Another emergency rush during the last 2 days before the deadline" but I didn't put it like that.
Anyway, due to other work and technical problems that didn't happen. She did get a good first draft put together but it didn't get out for review until she'd been gone a couple days. Which in a sane workplace wouldn't matter. But the team didn't look at it for a couple days and then we got ANOTHER short-deadline project that they had to focus on and when I asked the project principal when I could expect markup he was like "we are super swamped I am sorry but I'll get you something by Monday morning." Spoiler alert: he didn't. No one is shocked at this turn of events.
Anyway! It is due on Tuesday! It's been 3 weeks since the initial kickoff meeting and while I did get a big chunk of missing text a week ago, there has still been no full review/markup! There are other decisions they need to make!
In a sane world, the project principal would review it and provide feedback on only the truly most vital elements, and just not bother adding extra pictures and fine-tuning things that are actually just fine, but history tells me that if I expect that my expectations will most like be crushed. So I expect a boatload of edits knowing there's a small chance I'll be pleasantly surprised.
We went over some of the status in the morning staff meeting and the other proposal person said we should set up a check-in meeting with the principal, "looks like you can do that Monday at 4." "I'm sorry, did you say 4 o'clock on Monday is his first free time?!" " . . . Yeah." Like we can really wait until then to get work done when it's due mid-afternoon on Tuesday.
So it looks like we're heading to the situation I feared, because asking for work to be done on a reasonable timeline is just fucking unreasonable. They won't touch the damn thing early in the process and then when new shit comes up out of nowhere well now there's really no time.
The good news is that on Monday we will again be fully staffed and I 100% hope to hand this fucking thing back to the person who started it. She'll probably be unhappy about some of the changes I made, but you know I was pretty unhappy with some of the ways she set it up (a manually typed table of contents??? In MY InDesign file??????? I think fucking not (I know why it was set up like that. I disagree that it is necessary) ) so I adjusted things to minimize the work I needed to do.
If for some reason I get stuck with this shit I may have to have a very blunt conversation about how very little physical tolerance I have for this kind of thing, and would they prefer me to call out sick pre-emptively for day so someone else -has to- do it, or risk having me run into the ground and then calling out sick for 1 to 3 days. Or would they rather have someone else do it?
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Before MSA +1: The Surprise Pepper
Lewis’ first memory was following a dead man down a street. He didn’t know how he knew the man was dead. He just knew, but he also knew that the dead man wasn’t dangerous. It was incredibly confusing to his young mind.
The dead man took him over to a house porch. “This is a good family. They’ll help you.”
“Okay…?”
The dead man left. Lewis watched him leave, suddenly feeling scared. He had no idea who that was, but he had been the only person Lewis had known in his very brief life. What was Lewis supposed to do now?
Lewis decided he was tired and curled up on the welcome mat to go to sleep.
Several hours later, Mr. Friggitello ‘Frig’ Pepper opened the door to get the morning paper and nearly tripped over Lewis. He stared, mouth open in shock for several moments. “Savina?”
“Hm?”
“There is a child sleeping on our welcome mat.”
“What?” Mrs. Savina Pepper walked over to the front door and got a good look at Lewis. “…Is that blood?”
“Urm…” Frig took a closer look. “I, uh, I think it is.” He swallowed. “Why does he have blood on his clothes?”
“Let’s ask him.” Savina knelt down and shook the boy. “Hey, wake up, you can’t be comfortable.”
Lewis made a sound that indicated that he didn’t want to wake up, but he did open his eyes after Mrs. Pepper shook him for a couple of moments. He blinked up at the Peppers with sleepy eyes. “Good morning?”
“Good morning,” greeted Savina. “Who are you and why are you sleeping on our doormat?”
“I’m Lewis. It’s softer than the wood,” said Lewis as that made perfect sense to him.
“It’s nice to meet you Lewis,” said Frigg. “I’m Frigg, and this is Savina.”
“Were you separated from your parents?” asked Savina as she looked around for anyone who might look like Lewis.
Lewis thought. He had parents. He wasn’t sure where they were…or who they were. He decided to settle for a shrug.
“Should we call the police?” asked Frigg.
A jolt of fear shot through Lewis. “Did I do something wrong?”
Frigg shook his head. “No, no, no! I just…You’re in trouble, and police help people who are in trouble.” He looked to Savina. “But I guess maybe we don’t have to?”
Savina made a considering sound. “Maybe if we can find Lewis’ parents ourselves. What’s your last name?”
“I don’t know,” Lewis said slowly. That struck him as being rather odd.
Mr. and Mrs. Pepper frowned. “Where did this blood come from?” asked Frigg. “You don’t seem to be injured.”
Lewis looked own at his clothes in surprise. He’d honestly forgotten about the blood. “I don’t hurt…”
“I’d still like to take you to the hospital. Or at least a clinic,” said Frigg.
Savina suddenly thought of something. “Lewis, why did you decide to rest at our hourse?”
Lewis tilted his head. “Huh?”
“There’s a cemetery behind our house. The nearby church seems more preferable,” explained Savina.
Lewis lit up. “Oh, is that where the nice dead man came from?”
Mr. and Mrs. Pepper stared. “Nice dead man?”
Lewis nodded. “Yeah. He brought me here. He said you were nice.”
While Mr. and Mrs. Pepper were rational adults and initially thought that Lewis might have imagined ‘the nice dead man’, they’d seen enough weird stuff in their house to consider that there really had been a dead man, especially since Lewis didn’t seem bothered by the idea.
Then again he was still pretty young. Maybe he didn’t completely understand what death meant.
“I’ll call the restaurant and let them know we’re taking the day off,” decided Savina. “I’ll grab something for Lewis to eat too.”
Lewis’ stomach growled at the promise of food. Frigg chuckled a bit as Savina walked back inside their home. “I hope you like spicy food. There’s not a lot in our house that isn’t.”
“I’m too hungry to care,” Lewis said.
“I can believe that,” said Frigg. He studied Lewis for a moment. “Hey, how old would you say you are?”
Lewis thought for a moment before shrugging.
Frigg sighed. “Don’t know that either, huh? What do you remember?”
“Um…The nice dead man brought me here.”
“And?”
“And, uh, the nice dead man brought me here,” repeated Lewis, looking very confused.
Oh, this was starting to look bad. “Do you know where you’re from?” Lewis shook his head. “Do you have any pets?” A shrug. “Brothers or sisters?” A shrug. “Where you got these clothes?”
Lewis glanced down as his simple green t-shirt and pants. Nothing special besides the blood on them. He shrugged again.
Frigg bit his lip. Did Lewis have amnesia? Before he could try and figure out a way to tell, Savina returned with a plate of toast that she’d put some jam on. “Here you go.”
Lewis lit up. “Thank you!” he immediately dug in.
Savina turned to Frigg. “I called the restaurant to let them know we probably won’t be coming in today. Let’s get Lewis to the hospital.”
“All right.” Frigg wasn’t sure he should tell Savina about Lewis’ possible amnesia in front of Lewis. Lewis was calm now, and Frigg wanted him to stay that way as long as possible.
It took around 15 minutes to get to the hospital. Lewis had finished his toast by then, so they wiped off some of the jam with a towel so he wouldn’t be too sticky when they went in. The emergency department had a few other people present, but the counter was free when they got up to it. “Ah, hello?”
The nurse on duty looked up with a tired smile. “Yes? I can help you?”
“My wife and I found this boy,” explained Frigg as Savina picked up Lewis and put him on her hip. “He says his name is Lewis. He doesn’t know who his parents are.”
That got a startled look from Savina and a concerned look from the nurse. “I see. Uh, Lewis, are you hurt?” She’d noticed the blood by then.
Lewis shook his head. “Nope.”
“Do you know any adults I can contact?” asked the nurse. Lewis shook his head. “If that’s the case, I’ll have to contact child services and the police.”
“We understand,” said Savina. “Do we wait or is there an open bay?”
“Well, we’re a bit short-staffed, and Lewis doesn’t seem to be in any danger, so I’ll have to ask you to wait.”
So the three sat in a group of chairs not too far from the counter. Lewis occasionally saw people in hospital gowns walking out of the doors. No one else seemed to notice them, much to his confusion.
After a little while, a man in a police uniform came in. His eyes swept across the room before landing on the Peppers. He made his way over to them. “Hello, I got a call about a missing child being found.”
“Is he missing?” asked Frigg.
“Well, I haven’t heard of any missing children matching Lewis’ description, but if you found him he must have been missing at some point,” reasoned the officer, who clearly had some odd logic going on.
Frigg sweatdropped. “Uh, I see…”
The officer took out a notebook. “So, would you mind telling me the events leading up to your trip to the hospital?”
The story was told mostly by Mr. and Mrs. Pepper with occasional input from Lewis. Unfortunately, this meant he mentioned the nice dead man. Fortunately, the officer seemed to think this was a living person and asked Lewis to describe him up until Lewis mentioned that part of his neck was missing. Then he figured this was someone Lewis saw die or something along those lines.
“Excuse me, but what is going to happen to Lewis?” asked Frigg.
The officer closed his notebook. “Lewis will be taken into the care of child services until his legal guardians are found. If they cannot be found, I suppose he’ll be placed in a foster family, maybe adopted.”
“Can’t I stay with Mr. Frigg and Mrs. Savina?” asked Lewis. “They’re nice, and I like them!”
“You’ll have to ask the child services representative. They’ll know more about that than I do.” The officer frowned. “Actually, I’m surprised they haven’t shown up yet. I wonder if they’re having a busy day. And these two will have to be okay with it of course.”
Lewis turned and looked at the Peppers with big, hopeful eyes. It reminded Frigg of the time he found a box of abandoned kittens that he took in even though he was allergic. Savina simply had bad experiences with the foster system. “We have room. He could stay,” she said.
“Ye-yeah! I know this isn’t exactly how we were planning on having kids, but this feels…important? Special? I just feel like this was meant to be and we should do this,” agreed Frigg.
“Well, that would depend on us not finding Lewis’ family,” said the officer. “You seem like a nice couple though. Oh, hey, I think that’s the child services officer.”
The person he was talking about was a tired looking, middle-aged woman. She caught sight of them and hurried over, putting on a smile. “Hello there. I’m sorry I took so long. There was an…incident that I had to take care of.” She knelt down so she was at the same level as Lewis. “Hello Lewis. I’m Catherine. How are you today?”
“Hungry,” Lewis answered promptly. “I ate all the toast.”
“I see. Maybe we can go get you something to eat once the doctors have looked you over,” suggested Catherine. “But can you tell me where your parents are first?”
“I don’t know,” said Lewis, starting to get annoyed at how the grown ups were asking him questions he just didn’t know the answer to. “I don’t know who they are.”
“I see. I’m sorry. Can you tell me who you were staying with?”
“I don’t know.”
The police officer cleared his throat. “Lewis may have some sort of amnesia,” he whispered.
Catherine winced. “Oh dear. Well, what can you tell me about yourself?”
“My name is Lewis. I like Mr. Frigg and Mrs. Savina! And toast with jam!” Lewis tried to think of something else to say.
“Can you tell me how old you are?” prodded Catherine.
“No.” Lewis wasn’t trying to be difficult, but he was certainly making it difficult.
“Peppers?” called a nurse.
They moved to a hospital bay where a doctor started taking some vitals. “A bit dehydrated, but I don’t think we need to put him on an IV,” said the doctor. “Maybe get him some juice.” The doctor started feeling around Lewis’ head.
“Ow!”
“Looks like you’ve got a pretty bad bump on your head.”
“Is that why he’s having trouble remembering things?” asked Frigg.
“Probably not. Amnesia caused by head injuries is pretty rare, at least to this extent. It’s much more likely to be psychological,” explained the doctor. “He might remember. He might not. You might have results if he sees a child psychologist. However, all in all, I’d say he’s a healthy boy. I can’t say for sure how old Lewis is, but I’d his development would be in the range of 5-6 years old.” He paused. “I’d say 6 given your size.”
“Oh…” Lewis made a note. It felt a bit better to know how old he was.
“There are no signs of abuse?” asked Catherine.
The doctor shook his head. “No, his parents took care of him, whoever they are.”
Lewis suddenly wondered who his Mom and Dad were.
“Now, I understand you two were interested in looking after Lewis?” Mr. and Mrs. Pepper nodded. “That’s excellent! But as we may be able to locate his parents, you won’t be able to adopt him at first. Also, I will have to do a house check, and I’ll need to know who will be taking care of Lewis while you’re at work.”
“I think we can hire a babysitter until Lewis can go to school. Then we can take turns taking weekends off to stay with him,” suggested Frigg.
Savina nodded. “It might require hiring another chef or sous chef, but I think it could work. Perhaps if he makes some friends at school, he can spend time with them.”
“I wanna make friends!” agreed Lewis.
Catherine nodded. “Good, good. I’ll check on you three weekly for the first month, and after that we can stick to monthly visits until it an adoption is possible.”
As the small group started to walk out of the hospital, Lewis happily grabbed Mr. and Mrs. Pepper’s hands. Despite only knowing them for a few hours, Lewis felt safe and happy around them.
Lewis hoped he’d be able to stay with them.
#Mystery Skulls animated#technically a crossover but the other series isn't present yet#Lewis Pepper#Mr. Pepper#Mrs. Pepper#I have no idea what their first names are#Child in trouble#Fluff#First meetings
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In which my sheer ignorance brings in to question complicated security.
Story time!
So. My career is somewhere in the bracket of "Theatre Technician". That's live theatre, not film house theatre. With that said, the same union governs hands for stage, concerts, television, and film sets. You ever sit all the way through the movie credits and see a sort of five armed star with letters in the arms? IATSE, that's us.
So in the wide field of our abilities and skills, often we're hired as workers to set up and tear down concerts. Sometimes it's a global tour, sometimes it's a festival one-off. I had a call of the latter type on the morning of the 31st. The job was taking apart a set that had been constructed for a ball room Halloween event at one of the nearby casinos in Niagara Falls. Show up, knock it down, bin the garbage, shove the keepers in a transport truck, call it a day.
Reminder I'm a motorcyclist.
Now, I'd never taken a gig at this particular venue before, and that's what initiated the amusing chain of events. Typically I'll show up somewhere and scout around for employee parking or bike racks or a security guard to ask, and 95% of the time people point me to an alcove or some bike racks or beside a dumpster. "Just tuck it over there," they say, "it's so small we don't mind." Saves me the hassle of walking twenty blocks in my space suit at two in the morning, which is both exhausting and stressful.
I left early to give myself plenty of time to find out where I could park. I showed up at the building, and it is huge. Not just a casino, but a hotel, a food court, a mall, multiple stages, huge. So instantly I know there HAS to be employee parking for the several hundred staff that keep something of that size working... I just had to find it.
So I pull in the main drive and see "park yourself 5$" and "valet park 10$". Perfect, I'll just ask a valet attendant. Except it's 7:30am and there's no one around. Shoot. Okay.
So I double back and drive down the curving ramp to "Park Yourself". And this was where it got fun.
Unless you're a rider, or know a rider who has bitched about this, you might not be aware that typically the sensors that have to do with gate arms at things like parking lots are not sensitive enough to detect motorcycles. That "No bikes or pedestrians" sign is basically because the technology isn't good enough to tell there's a rider there, and it's cheaper to put up an elitist sign than update your system. (The same is true for intersections at 3am, Glendale Ave and 406 South exit ramp I'm looking at YOU.) We don't trigger the weight/mass/metal or whatever the hell is needed to alert the system to change. So if you ever pull up to a stop light with a forlorn biker who starts beckoning you to drive forward, they're trying to get you to trip the light detector so you can both go.
Back to parking! So things like this are one of the many reasons it's easier NOT to "Just go to the lot like the rest of us" on a motorcycle. So there I was, pulled up to the parking entrance gate, and the automated ticket dispenser is having none of my shit. It won't even turn on. I poke the big green HELP button and nothing happens.
Now I'm stuck, because option one is turning around and drive back UP the curving IN ramp and hoping there isn't a car coming, or option two, which any good biker hooligan would resort to - driving around the gate.
So I drive around the gate.
Now I'm inside the underground parking with no pass and still have no idea where to park. So I head for the exit before security comes screaming after me for cheating their gate system. The exit has a staffed booth! Perfect!
I pull up to the attendant and explain "Hello, I've never been here before, I'm supposed to be doing a set tear down for (company) in (room name) and I'm not sure where to put my bike. I couldn't trigger the gate arm so I don't have the parking pass." The attendant nodded sagely, replying "yah, bikes don't, I have to manually hold the gate open for them to leave. Let me make a call."
So the attendant scoops up a phone and buzzes someone and repeats my story. Biker here to work, where should they go. Person on the other side of the phone says "ask valet". Attendant calls valet. Biker here to work, where should they go. Person on the other side of the phone says "come back around to the front and someone will show them". Perfect! They hold the gate so I can leave and I exit and loop around the block back to where I started.
Except there's no one there. A limo. Some taxis. No staff... Oh wait there's a person standing at the curb with a red staff shirt. I putter over and say "Hello! Were you the one waiting for me?" His confusion was evident. I continued "I was just at the underground parking attendant, I'm here for a work call and trying to find out where I can park my bike." His confusion deepened. "Why didn't you park it there," he asked, perplexed. "The sensor arm doesn't let bikes in," I calmly responded. The gears turned, and rather observantly he asked "wait so then how did you get to the attendant?" "Oh. I jumped the curb," I responded matter-of-factly, because I am a motorcycle, and do things like that. This stymies him for a moment, but he looks around and asks "How long are you gonna be?" "The call said until one," I answered; It did, but that ended up being a dirty lie on the part of the company and we all almost missed Halloween. He waved down the laneway ahead of us. "See that sedan? Just leave it in front of that, as close to the fence as you can."
This is exactly what I'd hoped for. I thank him for his time and scoot over to the indicated location, mindful not to block the "No parking or you'll be towed" sign affixed to the fence. First hurdle complete.
Strolling in through the front doors I scan the lobby for some indication of where I needed to be. None of the signage indicated my destination, and that's when I spotted security at the inner doors to the casino proper. Taking a moment to remove my full face helmet to look a TINY bit less like a hired thug from a Mission Impossible movie here to pull a heist, I approached the guard and presented my story. "Here to do a tear down in (room), never been here before, where go." He amiably points to another hall, directing me down to the end, take a left.
I wandered off through the mall concourse, down to the food court, and there on the left was the signage I needed. Down another, much posher hallway until I found the room full of road cases and scissor lifts, took my gear off, met the crew chief, proceeded to work.
Some hours later...
I jokingly mention my ordeal in the parking lot to one of the other members on the call with me. "Why didn't you just go to the contractor's parking?" they asked me, confused. "The what now?" I respond, equally confused. "Contractor parking. It's around back. And it's free." Well here's the thing. I didn't park in the 'contractor's parking' because none of the three separate employees (Not counting the two more over the phone from the lot attendant) told me 'just go to the contractor's parking.' Five people who all presumably knew the building and its features and no one said "workers park around back" when I said "I'm here to work." But that's fine, because everyone was lovely and helped me and parking beside a fence is free too.
"Well then how did you get in?" my brother member inquired. "Through the front door?" I responded hesitantly, because that seemed a sensible answer. "Did you stop by security?" he continued. "No?" I answered, feeling a nagging unease. "Then how did you get your access lanyard?" he asked.
At this point I start looking around and realize that every other person there has a white plastic permit on a lanyard around their neck.
"I didn't?" I stated flatly. Because I didn't know I was supposed to. Because none of the employees told me. Because none of my coworkers told me. Shit.
"Oh man, well, they'll chase you down later. This is a Casino. Security is really tight here. You aren't allowed in this part without a lanyard."
Except I very much was. In that part. Without a lanyard. Oh well. At that point I wasn't about to wander off from tearing the set down to get lost in the labyrinthine underbelly of access hallways, nor was I going to waste another crew members time making them show me where to go. I'd just fess up when security finally got around to chasing me down. I'd go fill out the paperwork. I'd trade my drivers license for a work permit, and continue with the call.
Another few hours into the gig and two security guards walk up to me. 'This is it,' I think to myself. 'They're going to scold me for not having a lanyard.' One guard points to me. Or rather, the flat beside me. "Hey, we were wondering. If that's getting thrown out, can we have it?" My brain skips a gear as it tries to readjust. It was being saved for the company since it was a 'good' 4x8 flat with no damage. "Shoot. Any idea where we can get something like that?" They were referring to the brick texture later afixed to the front of the flat. I confessed I didn't personally know (I asked the crew head, apparently lumber supply stores). They thanked me for my time and wandered off. And there I stood. Lanyardless. But hey it wasn't so bad because I was obviously working, in this one room, with other workers.
And then we started taking materials to the loading dock, which meant winding through the access hallways, bland beige concrete and motivational posters on cork boards and warehouses of alcohol and kitchen supplies. Surely. SURELY NOW. Passing by facility workers and supervisors and maintenance staff. Surely someone will point at me and glare and say "You can't be down here without a pass!" And I'll flail and blurt out "I'm sorry! I didn't know!"
But no one did.
Not by 1pm. Not by 6:30pm when the damn miserable call finally ended. Not after the call when I put on all my gear, including my helmet, and walked back up through the concourse, just to test my luck, as people shot furtive glances at what must be a terrorist come to rob their winnings. Not when I wandered back through the front doors and got on my bike parked beside the 'No Parking' sign next to high-roller shuttles and executive limos.
And that's how my sheer lack of knowledge of facility protocol basically invalidated everyone else's strict adherence to the system.
Because if I could just wander in and wander around. Couldn't anyone? What good is everyone turning in their photo ID to keep the building locked down if one person -doesn't-. Not maliciously, mind you. A bit experimentally, perhaps. Wondering how long I could pull it off.
It just goes to prove the old adage that if you look like you belong where you are, most people won't question you, but in today's high tension, terrorism alert climate, I'm not certain that's a good thing.
And next time I'll park in the contractor parking.
*Locations have been intentionally omitted because I don't want to get anyone in trouble.
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The Chase Files Daily Newscap 2/17/2019
Good MORNING #realdreamchasers! Here is The Chase Files Daily News Cap for Sunday 17th February 2019. Remember you can read full articles for FREE via Barbados Today (BT) or Barbados Government Information Services (BGIS) OR by purchasing by purchasing a Sunday Sun Nation Newspaper (SS).
ONE DEAD, ONE INJURED IN NEW ORLEANS SHOOTING – The stillness of a lazy Saturday afternoon was abruptly interrupted yesterday when the sound of gunshots rang out in New Orleans, St. Michael. The incident left 31-year-old Lorenzo Joseph, of Chapman Lane, St Michael and Goodland Park, Christ Church, with injuries to his body and a second victim, 25-year-old Rio Walkes, of Sobers Lane, St. Michael, was also shot. Both male victims were transported to the Queen Elizabeth Hospital by private ambulance. Police confirmed that prior to his arrival at QEH Joseph succumbed to his injuries however, Walkes’ condition was still unknown. An adult male is assisting police with the on-going investigations. (SS)
NEW ORLEANS VICTIM IDENTIFIED; SECOND MAN INJURED – Lorenzo Joseph, of 3rd Avenue, Chapman Lane, St Michael and No.35 Goodland Park, Christ Church is this island’s 12th murder victim for the year. The 31-year-old was shot and killed around 5:20p.m. on Saturday, February 16 following a shooting incident between 5th and 6th Avenue, New Orleans, St Michael. Joseph was reportedly liming among a group of men in the area when a lone gunman approached and opened fire, striking him about body. Another man was also injured. He transported by private vehicle to the Queen Elizabeth Hospital (QEH) where he succumbed to his injuries. The deceased was a former Empire Club footballer who also represented the City of Bridgetown in the David Thompson Memorial Football Classic. The second man, 25-year-old Rio Walkes, of Sobers Lane, St Michael was taken to the QEH by private transport. However, police say his condition is unknown at this time. A man is currently assisting lawmen with their investigations into this incident. (BT)
POLICE RELEASE NAME OF ST GEORGE VICTIM – Police have released the name of the man whose lifeless body was found “lying on the road in a pool of blood” following reports of a shooting at Rock Hall, St George near Taitt Hill this morning. He is 22-year-old Graham Norville, of No.14 Lemgreene Development, Lemon Arbour, St John. Investigations are continuing into this island’s 11th murder which occurred today, February 16 around 11:52 a.m. Police are asking anyone with information that can assist with their investigations to call emergency number 211, Crime Stoppers at 1 800 TIPS(8477) or any police station. (BT)
LOCAL CAST MOURNS FOR MURDERED ACTOR – The quiet of the Rock Hall, St George community was shattered just before noon today when gunshots rang out. When the dust had settled, 22-year-old Graham Norville lay in the road dead. The father of two, of No.14 Lemgreene, Lemon Arbour, St John is the island’s 11th murder victim for 2019. His lifeless body was found “lying on the road in a pool of blood” following a shooting at Rock Hall, near Taitt Hill around 11:52 a.m. Saturday, February 16. Norville is known for his role as Short Boss on the Barbadian web video series Badness. Dwayne Harris, director and lead actor in the popular series told Barbados TODAY that the cast was devastated by the news of Norville’s murder. He said the deceased who was seeking to further his career in the local film industry had “great potential”. “He was a very great individual. He had some things about to happen for him in the film industry. It is just sad that he had to pass so early,” Harris said, while adding that he hoped the content of the web series would not be aligned with the circumstances surrounding Norville’s death. Prominent youth activist and facilitator of the Nature Fun Ranch, Corey Lane, who has also acted in the web series, shared that Norville was also a songwriter, singer and an artiste. The activist issued a call for early intervention of the nation’s youth so they would not fall victim to crime and violence. “If we could only facilitate our young men . . . within the society . . . we could really put a dent in the fatalities, the murders and even everyday crime and violence in the society,” said Lane. He went on to suggest that the public use Norville’s death as a motivation to rescue the island’s youth so the cycle of violence would not repeat itself. “The saddest comment that I have heard thus far is that these guys live by the gun and therefore they will die by the gun and while it maybe a fact, I think there is much more we can do as a society to be proactive as opposed to reactive. One of the other things that is very important is prevention and reaching our teenagers, of young teenage age, to prevent them from having to walk down this road because it is much easier as the saying goes to bend a boy than break a man. “His death does not have to be in vain. His death can be a rallying call for all of us to double down and save our youth and save our society,” he said. (BT)
COW ITCH CLEARED FROM NEAR BLACKMAN AND GOLLOP – The clean-up of cow itch infested lands to the east of the Blackman and Gollop Primary School got underway this morning. It took place under the supervision of the Ministry of the Environment and the owner of Staple Grove estates who refused to be identified. Also on hand were members of the executive of the Blackman and Gollop Parent-Teachers Association and Minister of Environment Trevor Prescod. (SS)
24 HOUR POLYCLINIC SERVICE COMING JUNE 1 – The 24-hour health care service, to be introduced at two of the island’s polyclinics, will be officially launched on June 1. From that date, patients will be able to access medical care on a continuous basis, Monday through Sunday, at the Winston Scott Polyclinic, Jemmotts Lane, St Michael, and the David Thompson Health and Social Services Complex, Glebe Land, St John. According to the Ministry of Health and Wellness, the initiative is aimed at cutting down on the time patients currently wait to be seen at the Accident and Emergency Department of the Queen Elizabeth Hospital by offering them round-the-clock service at alternative venues. Services offered will include urgent care, which refers to illnesses and injuries which require immediate care but are not life-threatening, as well as routine care, which may include follow-up care for chronic conditions and health checks. In a statement, the Ministry revealed that it would be meeting with the major trade unions and workers’ representatives in early March to provide an update on the initiative. The meeting will report on the actions taken to address security concerns and human resource issues raised at earlier stakeholder meetings. The organizations involved are the National Union of Public Workers, the Barbados Workers’ Union, the Unity Workers Union, the Barbados Association of Medical Practitioners and the Barbados Nurses’ Association. With the introduction of the 24-hour polyclinic service, the public will be encouraged to visit the Accident and Emergency Department of the QEH primarily for emergency care, which is defined as life-threatening conditions or conditions which need an emergency response. For all other medical issues, they are encouraged to utilize the polyclinic services which will be fully staffed and equipped to meet their needs. (BGIS)
LAUNCH OF VISION 2020: WE GATHERIN’ NEXT FRIDAY – Hundreds of Barbadians are expected to converge in Bridgetown next Friday, February 22, for the launch of Vision 2020: We Gatherin’. It will be held in Parliament’s Courtyard and two screens will be set up so members of the public may view the ceremony on Broad Street or by the Palmetto Square Market. Vision 2020: We Gatherin’ is a 12-month global celebration of Barbadian excellence and a recommitment to this country’s successful future and core values that have defined us as a people. 2020 has been designated as the year for Barbadians and those who love this country to come home, reconnect with family and friends, and invest in the rebuilding and development of Barbados. Purposeful Pursuit of Barbadian Excellence is the theme of the year-long celebrations, which is an initiative of Prime Minister Mia Amor Mottley. It is designed to reinforce Government’s mantra of building the best Barbados together. Vision 2020: We Gatherin’ will comprise structured events at the national level, which will be coordinated by Government with input from its social partners. However, community groups, churches, educational institutions, entrepreneurs, and regional and international persons with Barbadian connections, among others, will be encouraged to produce other events. The initiative will begin in the north of the island in January 2020, and move southward every month, allowing each designated parish to showcase its icons, social life and the food for which it is renowned. The parish celebrations will culminate in St Michael in November, and Vision 2020: We Gatherin’ will climax in December with a Christmas extravaganza for all Barbadians – at home and abroad. (BGIS)
DIGICEL PLEASED WITH PERFORMANCE - After more than a decade of operating in Barbados and despite continued economic challenges, telecommunications company Digicel (Barbados) Limited, says it is pleased with its performance so far. Acting Chief Executive Officer Katherine Payne said the company’s 15 years of operations here have been fruitful for customers, the country and the company, adding that Digicel would continue to expand its offerings and grow its operations in order to capture a bigger piece of the pie. Opting not to give details Payne said: “LTE was one of our largest investments of late and our technical team and business strategy team are always looking at what is the next best thing in terms of not just the company but the country. While I have nothing to announce right now you can look out for things in the future.” She was speaking to members of the media on Friday night at the Barbados Hilton Resort where the company awarded about a dozen winners with cash prizes, cellular phones, free months of service, plane tickets and a home entertainment system for taking part in its Christmas 2018 promotion. She said the response for the competition was a positive one and that there was “nothing that we regretted with our Christmas promotion. It was very, very well received.” Barbados Community College employee Vercia Webb walked away with the grand prize of a brand-new Suzuki Swift. Other top prize winners were Debbie Brathwaite, a Liberty Store employee, who walked away with $20,000, and Barbados TODAY employee Maria Bascombe, who received two LIAT plane tickets. Digicel customers had the opportunity to win once they top up, purchase a handset or SIM card, pay a bill on time or sign up for a new service. Speaking on the progress of the company over the past 15 years, Payne said Digicel had played an important role in the development of the information and communication technology (ICT) sector here by breaking the monopoly. “What this basically means is that as a country the average citizen can afford to have access to varying levels of communication, so it is not just about mobile anymore. Digicel is a full-service provider, we service not just mobile customers but home and entertainment. We provide now fixed line and TV services to our customers, and then full ICT solutions for our business segment. So it really has provided an opportunity where the country as a whole can expand when it comes to telecommunications,” Payne explained. She said while the company did not yet have 100 per cent coverage of the island, she was satisfied that “the coverage is good” and was continuously improving. “We have increase bandwidth from a home and entertainment perspective. For our corporate customers as well, we have one of the largest customer bases in the country. In fact, for most of the Digicel offices across the region we have been expending not just from a corporate space but into government as well. We have signed deals over the last eight to nine months in Dominica and other Caribbean islands,” she revealed. “So Digicel is not just about providing mobile but about growing the telecommunications infrastructure of the country,” Payne added. During the brief award ceremony on Friday night, Director of Consumer Sales Dionne Emtage delivered remarks on behalf of the company’s board director Ralph Bizzy Williams. In that speech, Emtage said Digicel had played an exceptional role in Barbados and the region in providing “well-paid jobs for hundreds of people”. “The impact on the economy of the island has been tremendous all because Digicel aimed to break the monopoly of a single operator to bring the price of communication down drastically,” she said. Emtage also pointed out that Williams Industries benefited from the company as a result of partnerships. (BT)
HARRIS PAINTS PARTNERS WITH UNFPA IN PROACTIVE HURRICANE RESPONSE - By partnering with the United Nations Population Fund (UNFPA), Harris Paints is joining a proactive effort to help women and young girls in the region – should a natural disaster strike. The Caribbean paint company has provided space in its main Barbados warehouse for the UNFPA to store 1264 “dignity kits.” This storage allows the UNFPA to respond rapidly to the needs of affected populations in case of an emergency. In 2017 Harris Paints worked to ship water and supplies, provided by the company, staff and the wider public, for the hurricane ravaged islands of Barbuda and Dominica. This included the distribution of several dignity kits provided by the UNFPA. This current collaboration allows the UNFPA to be even better positioned in advance of a potential disaster. Randy Warner, Programme Clerk with the UNFPA, explained, “that during natural disasters many women and adolescent girls become more vulnerable to sexual exploitation and lack basic human necessities and protection. Left unattended, it is a situation that becomes progressively more acute. Dignity kits help women and girls maintain their dignity during humanitarian crises. Preserving dignity is essential to maintaining self-esteem and confidence, which is important to cope in stressful and potentially overwhelming humanitarian situations. Supporting women’s self-esteem and confidence also assists them in providing care and protection to their children.” These kits help mitigate some of these issues and contain toiletries like soap and toothpaste, sanitary supplies and clean undergarments to provide basic hygiene. In other humanitarian efforts UNFPA also works with ministries of health in the region to provide reproductive health kits during emergencies that include items to support clean delivery, rape treatment, the treatment of sexually transmitted infections and other essential drugs, basic equipment and supplies. “This storage space from Harris Paints allowed us to create and store more dignity kits to facilitate better pre-positioning of emergency supplies should any Caribbean nation face a natural disaster,” said Warner. Some of the kits will be stored locally but the majority will be sent to the National Office of Disaster Services (NODS) in Antigua and Barbuda where they can be distributed throughout the region. Tracy Johnson, Product and Trade Marketing Manager, welcomed the effort. “It’s great to partner with an organization like UNFPA who work to support women and adolescent girls when they are at their most vulnerable. We were happy to be able to provide a staging post in their efforts and to assist, should the need arise, in making sure these supplies are available and can get to those that need them as quickly as possible.” (BT)
WEST INDIES BRACING FOR STRONG CHALLENGE - With the odds yet again firmly stacked against West Indies in the upcoming One-Day International series, marquee batsman Shai Hope says the Caribbean are bracing for a strong challenge from England but also plan to counter with firepower of their own. West Indies are ranked ninth in the ICC one-day rankings and face a number one-ranked England side, already pencilled in as firm favourites to win the World Cup at home later this year. However, Hope said while the Wes Indies were cognisant of the challenge, they were not intimidated and would be looking to spring a surprise, similar to what occurred in the preceding three-Test series. “We’re an international team, we’ve come here to play cricket and we just view it as a challenge. We know they’re going to come at us hard and we’ve got to do the same – fight fire with fire,” Hope said here Saturday. “It’s a lot to look forward to, very exciting times especially leading up to the World Cup so I’m sure the guys are ready and raring to go. We’re just coming off a Test series win so it’s important for us to continue in that vein and try to get the series win as well.” He added: “We can use this as a good gauge for us going into the World Cup. We’re still looking at some plans [in terms of] what is the best fit and [team] combination but it’s a good challenge for us and we’ve got some work to do.” The two teams clash in the opening ODI at Kensington Oval here, with the hosts seeking their first series win over their opponents in 12 years. They will be motivated by their performance in the Test series, however, where they tore up the form books to crush the English in the opening two Tests, and regain the Wisden Trophy or the first time in a decade. (BT)
BAJAN SKIS INTO 2ND PLACE – Barbadian free skier Victor White placed second today in the Europa Cup in Poland. His win saw him receive an outpouring of congratulatory messages, including one from Minister of Sports, John King. (SS)
TAMIS WILL BE OFFLINE FOR MAINTENANCE ON SUNDAY –The public is asked to note that the Tax Administration Management Information System (TAMIS) will be offline on Sunday February 17, 2019 from 1 p.m. until 9 p.m. for scheduled maintenance. As a result, TAMIS registration as well as corporate and business tax filing will be unavailable during that time. We regret any inconvenience and look forward to your understanding. (BT)
GIVE IT A HIGHER PLACE – While praising music teachers for the tremendous job they have been doing in schools with limited resources available to them, Minister of Education Santia Bradshaw is saying it is time music be placed as a priority on the curriculum. Bradshaw said it is impossible to change attitudes towards music, or to build a vibrant local music industry, if education is not included in the process. Speaking at the media launch of The School’s Music Festival, at the Ministry’s Elsie Payne Complex, Constitution Road Office this morning, Bradshaw said it is time a conversation is started about how important the arts are within education. She said some Barbadians have been fortunate to attain success in the entertainment industry, however, at the same time, she firmly believes that there was significant room and need for more persons to make a living out of entertainment. “I don’t want to underscore the role education plays in so many different facets of everyday life. But particularly relation to the creative arts, we have to start with the foundation. “And the foundation is when students go into primary school, and they play a recorder, we have to make sure that the teachers are skilled, that they are trained, that they understand the basics and the fundamentals of music. It is there that it starts in terms of being able to create a vibrant music industry,” Bradshaw said. The Minister said she agreed that students who are upcoming musicians must be prepared for competition, but should also be taught a certain level of confidence that would enable them to hone their craft. “It doesn’t make them feel as though one person is better than the other. But rather that they develop a certain camaraderie to be able to come back on another occasion. That is the spirit with which I believe education has to move forward in relation to the arts. We have to be able to overcome some of the challenges in terms of resources,” she said. The Schools’ Music Festival was established to provide participants at both the primary and secondary level, with the opportunity to develop their musical performance environment. While the festival climaxes with two distinct primary and secondary showcase events, the aim is to provide structures for the ongoing development of outstanding and promising participants, while also exposing them to the business elements of the music industry. This year, the two audition rounds scheduled to be held on February 21 and 22, at the Prince Cave Hall, District ‘A’ Police Station, would be closed. The Grand showcase events would be held on Saturday, March 23 for the primary schools, and Sunday, March 24 for the secondary students, at the Garfield Sobers Gymnasium. Deputy Chief Education Officer (Planning) Dr Roderick Rudder said one of the fundamental changes that underpins this year’s music festival is that there would be no competition, just a showcase. Dr Rudder said the decision to move away from the competitive element was made to ensure that students have the opportunity to demonstrate their true potential without having to face the fear of competing. “Now, one of the fundamental changes that we really want to drive home this year, is the collaborative partnership between the teachers in our schools, the students who would be performing, and the practitioners from the industry who would be assisting with the development of the skills and the talents to be identified by the panel that will be assessing talented students who would be participating in this year’s Schools Music Festival. Additionally, there would also be the provision of a framework for ongoing artiste development in the long term,” he said. (BT)
For daily or breaking news reports follow us on Instagram, Tumblr, Twitter & Facebook. That’s all for today folks. There are 318 days left in the year. Shalom! #thechasefilesdailynewscap #thechasefiles# dailynewscapsbythechasefiles
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American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy
By HANS DUVEFELT, MD
Swedish Healthcare seemed competent but a bit uninspired and rigid to me but my medical school class trip to the Soviet Union showed me a healthcare system and a culture I could never have fully imagined in a country that had the brain power and resources to have already landed space probes on Mars and Venus by the time my classmates and I arrived in Moscow in the cold winter of 1977.
The first time we sat down for breakfast at two big tables in the restaurant of the big Россия hotel near the Red Square, our two male waiters asked if we wanted coffee or tea and people started stating their preferences. The waiters shook their heads and put their hands up in the air. No, they couldn’t split the beverage order, they explained. We had to all decide on one beverage with no substitutions.
The restaurant obviously had both coffee and tea, and as far as I know, they cost about the same. The only thing standing between the tea drinkers and their favorite morning beverage (the coffe crowd won the popular vote) was convention and attitude. I don’t know if this was a policy set by the hotel management or a complete lack of service-mindedness by he staff, but my classmates and I felt as if we, the customers, did not matter.
(Writing this piece, I came across the news item that the Hotel Rossiya, once the biggest hotel in the world, was demolished in 2006.)
From that first morning on, everything I encountered felt dim, dark and repressive. I saw with my own eyes that Sweden’s degree of uniformity was nothing compared to the Soviet Union’s, which some of my classmates, communists and former Viet Cong supporters, had spoken well of before we got there.
During our stay I saw dilapidated hospital wards and surgical suites with antiquated medical instruments in scarce supply, which we couldn’t even all see because of a lack of scrubs and booties. We saw bare-bones ambulances staffed with underpaid specialist physicians, neurologists for stroke victims, for example. I thought being a doctor in the Soviet Union seemed like one of the most depressing things you could end up doing for a living.
I yearned for the freedom and optimism I had seen back in 1971, when as an exchange student I fell in love with America and a girl I met in my high school sociology class.
During my high school year here, I got the impression that almost everybody in America had a personal ambition, like making music, writing a book or starting a business. I saw a service mindedness I had not seen in Sweden, where years later I saw the epitome of that in a restaurant near the Arctic Circle that closed for lunch (for the staff) from 12 to 1 pm every day.
In America I also got the impression that the rules of society were not exactly cut in stone the way there were in Sweden. Due dates seemed a little flexible, rules seemed to have countless exceptions; even spelling of the American language seemed to offer a few individual choices.
Doctors in America were mostly in private practice. I didn’t see much of American healthcare that year, except the afternoon reruns of Marcus Welby, MD that I devoured. It ran from 1969 to 1976 and it solidified my vision of being a primary care doctor in America.
Fast forward twenty years, to 1991, the year the Soviet Union collapsed. The Planned Economy proved itself to be an unsustainable daydream of the social engineers of communism.
That year I had lived in this country for a decade. My work in a Federally Qualified Health Center, part of a safety net that offered subsidized or free care to people without health insurance, had shown me the inequalities and health hazards of “the other half” of American society. I felt proud to be part of such a clinic, providing equal access to everyone.
During the ensuing two decades, the Federal agencies that paid our grants and provided our preferred reimbursement rates started to micromanage what we did and how we structured our work. My original liberated experience of American healthcare turned into a sense that the bureaucrats mistrusted doctors and administrators of FQHCs so deeply that they had to structure our work for us.
The crowning event was when we all more or less had to earn recognition as “Patient Centered Medical Homes”, which at first sounded like we needed to make our practices Marcus Welby-like. Instead, PCMH was not really about nimbly meeting your patients needs but about creating rigid protocols that in fact made it hard to improvise. This was followed by many other initiatives that to a small or larger degree lacked firm anchoring in the reality of front line medicine and became virtual shackles for medical practices.
This hampering of improvisation in how you meet individual patients needs felt strangely familiar, and brought back memories of that cold December morning in Moscow:
Tea or Coffee, but not both.
Save one same day slot and qualify for easy access recognition, double book freely and fail the access parameter (no “protocol”).
And then when Uncle Sam wanted our “data”, presumably for better central planning some day, we were given grants to computerize our patient records with numerous qualifiers about how to use these computers. “Meaningful Use” broadly sounded like a good idea, except the technology was immature.
One example: Patient information about their medical condition, if generated by the EMR software, often amateurish and rudimentary, gives us Meaningful Use brownie points, but high quality handouts from sources like Up to Date, Harvard or the Mayo Clinic don’t count.
Another Federal shackle: Uncle Sam wants us to deliver comprehensive care, which includes screening for a growing list of clinical and societal issues, like depression, alcohol use, domestic violence, sexual orientation, food insecurity and so forth. If we don’t do all this, we lose brownie points. Consequently, we hesitate fitting infrequent visitors into our clinic schedules, because you can’t possibly do all that in a single visit for a sore throat, so we look better if that patient goes to a walk-in clinic – one ding on the Access parameter instead of numerous dings for all the other ambitious comprehensiveness requirements
I am sorry to report that the well meaning bureaucrats of the Central Planning Office are making American Primary Care feel more and more like the Soviet Union of Lenin and Marx where people mattered as populations, perhaps, but not as individuals. That is not the way Americans think. They don’t want to be told what to drink with their breakfast and they don’t want to be told what the agenda is for their next doctor’s visit.
Collapse or profound disruption seems inevitable.
Hans Duvefelt is a Swedish-born rural Family Physician in Maine. This post originally appeared on his blog, A Country Doctor Writes, here.
The post American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy appeared first on The Health Care Blog.
American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy published first on https://wittooth.tumblr.com/
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American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy
By HANS DUVEFELT, MD
Swedish Healthcare seemed competent but a bit uninspired and rigid to me but my medical school class trip to the Soviet Union showed me a healthcare system and a culture I could never have fully imagined in a country that had the brain power and resources to have already landed space probes on Mars and Venus by the time my classmates and I arrived in Moscow in the cold winter of 1977.
The first time we sat down for breakfast at two big tables in the restaurant of the big Россия hotel near the Red Square, our two male waiters asked if we wanted coffee or tea and people started stating their preferences. The waiters shook their heads and put their hands up in the air. No, they couldn’t split the beverage order, they explained. We had to all decide on one beverage with no substitutions.
The restaurant obviously had both coffee and tea, and as far as I know, they cost about the same. The only thing standing between the tea drinkers and their favorite morning beverage (the coffe crowd won the popular vote) was convention and attitude. I don’t know if this was a policy set by the hotel management or a complete lack of service-mindedness by he staff, but my classmates and I felt as if we, the customers, did not matter.
(Writing this piece, I came across the news item that the Hotel Rossiya, once the biggest hotel in the world, was demolished in 2006.)
From that first morning on, everything I encountered felt dim, dark and repressive. I saw with my own eyes that Sweden’s degree of uniformity was nothing compared to the Soviet Union’s, which some of my classmates, communists and former Viet Cong supporters, had spoken well of before we got there.
During our stay I saw dilapidated hospital wards and surgical suites with antiquated medical instruments in scarce supply, which we couldn’t even all see because of a lack of scrubs and booties. We saw bare-bones ambulances staffed with underpaid specialist physicians, neurologists for stroke victims, for example. I thought being a doctor in the Soviet Union seemed like one of the most depressing things you could end up doing for a living.
I yearned for the freedom and optimism I had seen back in 1971, when as an exchange student I fell in love with America and a girl I met in my high school sociology class.
During my high school year here, I got the impression that almost everybody in America had a personal ambition, like making music, writing a book or starting a business. I saw a service mindedness I had not seen in Sweden, where years later I saw the epitome of that in a restaurant near the Arctic Circle that closed for lunch (for the staff) from 12 to 1 pm every day.
In America I also got the impression that the rules of society were not exactly cut in stone the way there were in Sweden. Due dates seemed a little flexible, rules seemed to have countless exceptions; even spelling of the American language seemed to offer a few individual choices.
Doctors in America were mostly in private practice. I didn’t see much of American healthcare that year, except the afternoon reruns of Marcus Welby, MD that I devoured. It ran from 1969 to 1976 and it solidified my vision of being a primary care doctor in America.
Fast forward twenty years, to 1991, the year the Soviet Union collapsed. The Planned Economy proved itself to be an unsustainable daydream of the social engineers of communism.
That year I had lived in this country for a decade. My work in a Federally Qualified Health Center, part of a safety net that offered subsidized or free care to people without health insurance, had shown me the inequalities and health hazards of “the other half” of American society. I felt proud to be part of such a clinic, providing equal access to everyone.
During the ensuing two decades, the Federal agencies that paid our grants and provided our preferred reimbursement rates started to micromanage what we did and how we structured our work. My original liberated experience of American healthcare turned into a sense that the bureaucrats mistrusted doctors and administrators of FQHCs so deeply that they had to structure our work for us.
The crowning event was when we all more or less had to earn recognition as “Patient Centered Medical Homes”, which at first sounded like we needed to make our practices Marcus Welby-like. Instead, PCMH was not really about nimbly meeting your patients needs but about creating rigid protocols that in fact made it hard to improvise. This was followed by many other initiatives that to a small or larger degree lacked firm anchoring in the reality of front line medicine and became virtual shackles for medical practices.
This hampering of improvisation in how you meet individual patients needs felt strangely familiar, and brought back memories of that cold December morning in Moscow:
Tea or Coffee, but not both.
Save one same day slot and qualify for easy access recognition, double book freely and fail the access parameter (no “protocol”).
And then when Uncle Sam wanted our “data”, presumably for better central planning some day, we were given grants to computerize our patient records with numerous qualifiers about how to use these computers. “Meaningful Use” broadly sounded like a good idea, except the technology was immature.
One example: Patient information about their medical condition, if generated by the EMR software, often amateurish and rudimentary, gives us Meaningful Use brownie points, but high quality handouts from sources like Up to Date, Harvard or the Mayo Clinic don’t count.
Another Federal shackle: Uncle Sam wants us to deliver comprehensive care, which includes screening for a growing list of clinical and societal issues, like depression, alcohol use, domestic violence, sexual orientation, food insecurity and so forth. If we don’t do all this, we lose brownie points. Consequently, we hesitate fitting infrequent visitors into our clinic schedules, because you can’t possibly do all that in a single visit for a sore throat, so we look better if that patient goes to a walk-in clinic – one ding on the Access parameter instead of numerous dings for all the other ambitious comprehensiveness requirements
I am sorry to report that the well meaning bureaucrats of the Central Planning Office are making American Primary Care feel more and more like the Soviet Union of Lenin and Marx where people mattered as populations, perhaps, but not as individuals. That is not the way Americans think. They don’t want to be told what to drink with their breakfast and they don’t want to be told what the agenda is for their next doctor’s visit.
Collapse or profound disruption seems inevitable.
Hans Duvefelt is a Swedish-born rural Family Physician in Maine. This post originally appeared on his blog, A Country Doctor Writes, here.
The post American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy appeared first on The Health Care Blog.
American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy published first on https://venabeahan.tumblr.com
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Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre
Hotel ibis Amsterdam Centre
Who doesn’t love Amsterdam? This walkable city was meant to be explored and I love visiting it as often as I can. There are many Amsterdam hotels to choose from, but if you want to stay in central Amsterdam and near Centraal Station, there’s no better place to stay than Hotel ibis Amsterdam Centre.
ibis Hotels logo
If you’re unfamiliar with the ibis Hotels brand, ibis is owned by AccorHotels and was founded in 1974. With 1800 hotels worldwide, ibis offers affordably priced accommodations throughout Europe, Africa, Asia and the Pacific, the Middle East, and the Americas.
How I Chose One of the Many Amsterdam Hotels
Hotel ibis Amsterdam Centre
Choosing one hotel from so many Amsterdam hotels isn’t easy. However, my hotel of choice for my latest stay in Amsterdam was the Hotel ibis Amsterdam Centre. After Danielle and I got off the DFDS ferry from Newcastle to IJmuiden, we took a coach to Centraal Station. A few minutes later we were at the front door of Hotel ibis Amsterdam Centre.
Location, Location, Location
Hotel ibis Amsterdam Centre
I’ve stayed in several different areas in Amsterdam and a few different Amsterdam hotels when I’ve visited and a central location is key.
Location of Hotel ibis Amsterdam Centre
You literally can’t get any closer to Amsterdam Centraal Station as it’s 0.1km/0.06mi from the hotel. Other nearby points of interest include:
Anne Frank House: 1.21km/0.75mi
Dam Square: 0.8km/0.5mi
Rijksmuseum Amsterdam: 2.8km/1.74mi
Van Gogh Museum: 3.2km/1.99mi
Fast and Easy Check In
Lobby area
With a fast and easy check in process, it takes only a few moments to get checked in at Hotel ibis Amsterdam Centre, 100% non-smoking hotel. Check in is at 2 pm and check out is at noon.
Front desk
The front desk is always staffed with friendly and helpful employees to help you not only check in and out, but to answer any questions you might have. We found our room to be excessively hot and we were provided with not one, but two fans from the front desk.
Super Easy DIY Luggage Storage
Lobby area by luggage storage
If you arrive early, like we did, usually you have to leave your bags in a manned luggage storage area. But Hotel ibis Amsterdam Centre does it a little different. You’ll get a coin from the front desk to put in the turnstyle that lets you pass through to the Luggage Storage room.
Luggage storage area
Wheel your bag down the ramp or walk down the stairs and put your bags to the left while you pass through the turnstyle.
Luggage storage room
Then the front desk person will buzz you into the room where you can safely store your luggage. There’s even small safes inside in case you want to store valuables separately. I initially was hesitant about how safe this is, but the room is supervised by the front desk staff and also monitored on CCTV.
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. Click To Tweet
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. That helped because I didn’t need to find a luggage locker at the train station. It saved me money and time, two things I never seem to have enough of as always.
On Site Restaurant and Bar
Lobby area
Don’t feel like going out for dinner? Walk down to the lobby and over to the International ibis Kitchen Restaurant, which is open for dinner daily from 6pm until 10:30 pm. The bar just to the right in this pic is also open daily.
Awesome Public Spaces
Lobby area
Whether you’re waiting to meet someone or killing time, the lobby at Hotel ibis Amsterdam Centre is welcoming and inviting.
Seating in lobby
There’s a table and chairs if you want to eat something, use your laptop, or read.
Business center
As well as a small business center with two desktop computers and two printers. Handy if you need to print out tickets for attractions or your flight.
Amenities in lobby
If you didn’t make it to breakfast on time, go to the Fresh & Ready Take Away section of the lobby and pick up a few things. There’s even fresh squeezed orange juice. You can also find sandwiches and beverages like coffee and water, too.
Elevators to rooms
To the left of the Fresh & Ready Take Away area are the elevators to the hotel rooms. You’ll need your card key to access the elevators, which adds a nice extra layer of security.
Signage in elevator
I love this little poster inside the elevator with so many great Amsterdam facts. Did you know any of them?
Heineken machine in hotel
Where else might you ever see a Heineken beer dispensing machine sandwiched between a soda machine and a water machine? In Amsterdam, of course.
Clean and Comfortable Rooms
Room 773
When time came for us to get to our room, we collected our bags and headed to our room on the 7th floor. Room 773 was a clean and comfortable room with two twin beds. The new Sweet Beds are super comfortable although small. We called down and asked for extra pillows, but other than that, the room was adequately sized for two people.
Room 773
There’s also a desk, a safe, a small wardrobe and shelves, a TV with international channels, and of course, free WIFI.
TSG Tip: I’ve read online where some people say the hotel is loud because of the noise from the trains coming and going. While I could see them and hear them if I tried hard, it wasn’t enough to disturb my sleep. If you’re a light sleeper, ask for a higher floor and that should help.
Bathroom in room 773
The bathroom features a large shower, which is bigger than some other hotels, including Amsterdam hotels, I’ve stayed at in the past.
TSG Tip: I always bring my own toiletries to avoid shampoo, conditioner, and shower gel surprises. ibis hangs a shower gel in the shower and over the sink and I think it can be used as a shampoo, too.
Great Views
View from room 773
This was the view from our room looking out over the tracks and toward the water toward the EYE Filmmuseum.
View from hotel toward Centraal Station
This was the view from the fifth floor bridge overlooking Centraal Station on a sunny day. It felt like you could see so far into Amsterdam from here.
View from hotel toward Centraal Station
When you see views like this, it reminds you that you’re here to get out and about in Amsterdam and not to spend all of your time in a hotel room.
All You Can Eat Breakfast Buffet
Breakfast area
A hotel stay is only made better with an all-you-can eat breakfast buffet. When you book your stay with Hotel ibis Amsterdam Centre, look for the Bed & Breakfast rate for slightly more to enjoy a hot breakfast each morning of your stay.
TSG Tip: Not all Amsterdam hotels offer breakfast so why not choose one with breakfast? You’ll start your day off on the right foot and you won’t have search for food all around the city.
Breakfast
The ibis buffet breakfast features hot foods like scrambled eggs with bacon and sausages as well as freshly ground coffee, fruit juices, and various breads. There’s also a new seasonal special offered every two months.
Breakfast
Why do the carbs always call to me? The croissants looked so flaky and buttery, but I was good and resisted.
Coffee cup in breakfast area
All I could ever want is coffee in the morning. Couldn’t help but take a pic of the ibis coffee cup. So true ibis. So true.
Breakfast area
The breakfast area is huge with tons of seating throughout the entire restaurant. While breakfast is offered until noon daily, try to avoid peak times to avoid crowds.
View from in front of Hotel ibis Amsterdam Centre
Add up all these great reasons to stay at Hotel ibis Amsterdam Centre and why would you want to stay anywhere else? Whether it’s your first visit to Amsterdam or you want to be near Centraal Station, it’s so close to everything that it’s an obvious choice.
When it comes time for you to choose from among the many Amsterdam hotels that are out there, take some of these thoughts into consideration for a great stay in Amsterdam.
Hotel ibis Amsterdam Centre Stationsplein 49, 1012 AB AMSTERDAM, NETHERLANDS
On my new SPONTANEOUS TRAVEL SCALE of 1-5, with 1 being super easy and spontaneous and 5 being you better plan far in advance, this is a 1. Unless there’s some huge event happening, I think it would be fairly easy to get a last minute reservation at one of the closest hotels to Centraal Station and that definitely means a huge thumbs up as far as spontaneous travel goes.
While I was generously provided accommodations from Hotel ibis Amsterdam Centre, as always all opinions and photographs, unless otherwise noted, are my own.
The post Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre appeared first on Travel Shop Girl.
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Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre
Hotel ibis Amsterdam Centre
Who doesn’t love Amsterdam? This walkable city was meant to be explored and I love visiting it as often as I can. There are many Amsterdam hotels to choose from, but if you want to stay in central Amsterdam and near Centraal Station, there’s no better place to stay than Hotel ibis Amsterdam Centre.
ibis Hotels logo
If you’re unfamiliar with the ibis Hotels brand, ibis is owned by AccorHotels and was founded in 1974. With 1800 hotels worldwide, ibis offers affordably priced accommodations throughout Europe, Africa, Asia and the Pacific, the Middle East, and the Americas.
How I Chose One of the Many Amsterdam Hotels
Hotel ibis Amsterdam Centre
Choosing one hotel from so many Amsterdam hotels isn’t easy. However, my hotel of choice for my latest stay in Amsterdam was the Hotel ibis Amsterdam Centre. After Danielle and I got off the DFDS ferry from Newcastle to IJmuiden, we took a coach to Centraal Station. A few minutes later we were at the front door of Hotel ibis Amsterdam Centre.
Location, Location, Location
Hotel ibis Amsterdam Centre
I’ve stayed in several different areas in Amsterdam and a few different Amsterdam hotels when I’ve visited and a central location is key.
Location of Hotel ibis Amsterdam Centre
You literally can’t get any closer to Amsterdam Centraal Station as it’s 0.1km/0.06mi from the hotel. Other nearby points of interest include:
Anne Frank House: 1.21km/0.75mi
Dam Square: 0.8km/0.5mi
Rijksmuseum Amsterdam: 2.8km/1.74mi
Van Gogh Museum: 3.2km/1.99mi
Fast and Easy Check In
Lobby area
With a fast and easy check in process, it takes only a few moments to get checked in at Hotel ibis Amsterdam Centre, 100% non-smoking hotel. Check in is at 2 pm and check out is at noon.
Front desk
The front desk is always staffed with friendly and helpful employees to help you not only check in and out, but to answer any questions you might have. We found our room to be excessively hot and we were provided with not one, but two fans from the front desk.
Super Easy DIY Luggage Storage
Lobby area by luggage storage
If you arrive early, like we did, usually you have to leave your bags in a manned luggage storage area. But Hotel ibis Amsterdam Centre does it a little different. You’ll get a coin from the front desk to put in the turnstyle that lets you pass through to the Luggage Storage room.
Luggage storage area
Wheel your bag down the ramp or walk down the stairs and put your bags to the left while you pass through the turnstyle.
Luggage storage room
Then the front desk person will buzz you into the room where you can safely store your luggage. There’s even small safes inside in case you want to store valuables separately. I initially was hesitant about how safe this is, but the room is supervised by the front desk staff and also monitored on CCTV.
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. Click To Tweet
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. That helped because I didn’t need to find a luggage locker at the train station. It saved me money and time, two things I never seem to have enough of as always.
On Site Restaurant and Bar
Lobby area
Don’t feel like going out for dinner? Walk down to the lobby and over to the International ibis Kitchen Restaurant, which is open for dinner daily from 6pm until 10:30 pm. The bar just to the right in this pic is also open daily.
Awesome Public Spaces
Lobby area
Whether you’re waiting to meet someone or killing time, the lobby at Hotel ibis Amsterdam Centre is welcoming and inviting.
Seating in lobby
There’s a table and chairs if you want to eat something, use your laptop, or read.
Business center
As well as a small business center with two desktop computers and two printers. Handy if you need to print out tickets for attractions or your flight.
Amenities in lobby
If you didn’t make it to breakfast on time, go to the Fresh & Ready Take Away section of the lobby and pick up a few things. There’s even fresh squeezed orange juice. You can also find sandwiches and beverages like coffee and water, too.
Elevators to rooms
To the left of the Fresh & Ready Take Away area are the elevators to the hotel rooms. You’ll need your card key to access the elevators, which adds a nice extra layer of security.
Signage in elevator
I love this little poster inside the elevator with so many great Amsterdam facts. Did you know any of them?
Heineken machine in hotel
Where else might you ever see a Heineken beer dispensing machine sandwiched between a soda machine and a water machine? In Amsterdam, of course.
Clean and Comfortable Rooms
Room 773
When time came for us to get to our room, we collected our bags and headed to our room on the 7th floor. Room 773 was a clean and comfortable room with two twin beds. The new Sweet Beds are super comfortable although small. We called down and asked for extra pillows, but other than that, the room was adequately sized for two people.
Room 773
There’s also a desk, a safe, a small wardrobe and shelves, a TV with international channels, and of course, free WIFI.
TSG Tip: I’ve read online where some people say the hotel is loud because of the noise from the trains coming and going. While I could see them and hear them if I tried hard, it wasn’t enough to disturb my sleep. If you’re a light sleeper, ask for a higher floor and that should help.
Bathroom in room 773
The bathroom features a large shower, which is bigger than some other hotels, including Amsterdam hotels, I’ve stayed at in the past.
TSG Tip: I always bring my own toiletries to avoid shampoo, conditioner, and shower gel surprises. ibis hangs a shower gel in the shower and over the sink and I think it can be used as a shampoo, too.
Great Views
View from room 773
This was the view from our room looking out over the tracks and toward the water toward the EYE Filmmuseum.
View from hotel toward Centraal Station
This was the view from the fifth floor bridge overlooking Centraal Station on a sunny day. It felt like you could see so far into Amsterdam from here.
View from hotel toward Centraal Station
When you see views like this, it reminds you that you’re here to get out and about in Amsterdam and not to spend all of your time in a hotel room.
All You Can Eat Breakfast Buffet
Breakfast area
A hotel stay is only made better with an all-you-can eat breakfast buffet. When you book your stay with Hotel ibis Amsterdam Centre, look for the Bed & Breakfast rate for slightly more to enjoy a hot breakfast each morning of your stay.
TSG Tip: Not all Amsterdam hotels offer breakfast so why not choose one with breakfast? You’ll start your day off on the right foot and you won’t have search for food all around the city.
Breakfast
The ibis buffet breakfast features hot foods like scrambled eggs with bacon and sausages as well as freshly ground coffee, fruit juices, and various breads. There’s also a new seasonal special offered every two months.
Breakfast
Why do the carbs always call to me? The croissants looked so flaky and buttery, but I was good and resisted.
Coffee cup in breakfast area
All I could ever want is coffee in the morning. Couldn’t help but take a pic of the ibis coffee cup. So true ibis. So true.
Breakfast area
The breakfast area is huge with tons of seating throughout the entire restaurant. While breakfast is offered until noon daily, try to avoid peak times to avoid crowds.
View from in front of Hotel ibis Amsterdam Centre
Add up all these great reasons to stay at Hotel ibis Amsterdam Centre and why would you want to stay anywhere else? Whether it’s your first visit to Amsterdam or you want to be near Centraal Station, it’s so close to everything that it’s an obvious choice.
When it comes time for you to choose from among the many Amsterdam hotels that are out there, take some of these thoughts into consideration for a great stay in Amsterdam.
Hotel ibis Amsterdam Centre Stationsplein 49, 1012 AB AMSTERDAM, NETHERLANDS
On my new SPONTANEOUS TRAVEL SCALE of 1-5, with 1 being super easy and spontaneous and 5 being you better plan far in advance, this is a 1. Unless there’s some huge event happening, I think it would be fairly easy to get a last minute reservation at one of the closest hotels to Centraal Station and that definitely means a huge thumbs up as far as spontaneous travel goes.
While I was generously provided accommodations from Hotel ibis Amsterdam Centre, as always all opinions and photographs, unless otherwise noted, are my own.
The post Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre appeared first on Travel Shop Girl.
Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre published first on http://ift.tt/2uCE2ez
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Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre
Hotel ibis Amsterdam Centre
Who doesn’t love Amsterdam? This walkable city was meant to be explored and I love visiting it as often as I can. There are many Amsterdam hotels to choose from, but if you want to stay in central Amsterdam and near Centraal Station, there’s no better place to stay than Hotel ibis Amsterdam Centre.
ibis Hotels logo
If you’re unfamiliar with the ibis Hotels brand, ibis is owned by AccorHotels and was founded in 1974. With 1800 hotels worldwide, ibis offers affordably priced accommodations throughout Europe, Africa, Asia and the Pacific, the Middle East, and the Americas.
How I Chose One of the Many Amsterdam Hotels
Hotel ibis Amsterdam Centre
Choosing one hotel from so many Amsterdam hotels isn’t easy. However, my hotel of choice for my latest stay in Amsterdam was the Hotel ibis Amsterdam Centre. After Danielle and I got off the DFDS ferry from Newcastle to IJmuiden, we took a coach to Centraal Station. A few minutes later we were at the front door of Hotel ibis Amsterdam Centre.
Location, Location, Location
Hotel ibis Amsterdam Centre
I’ve stayed in several different areas in Amsterdam and a few different Amsterdam hotels when I’ve visited and a central location is key.
Location of Hotel ibis Amsterdam Centre
You literally can’t get any closer to Amsterdam Centraal Station as it’s 0.1km/0.06mi from the hotel. Other nearby points of interest include:
Anne Frank House: 1.21km/0.75mi
Dam Square: 0.8km/0.5mi
Rijksmuseum Amsterdam: 2.8km/1.74mi
Van Gogh Museum: 3.2km/1.99mi
Fast and Easy Check In
Lobby area
With a fast and easy check in process, it takes only a few moments to get checked in at Hotel ibis Amsterdam Centre, 100% non-smoking hotel. Check in is at 2 pm and check out is at noon.
Front desk
The front desk is always staffed with friendly and helpful employees to help you not only check in and out, but to answer any questions you might have. We found our room to be excessively hot and we were provided with not one, but two fans from the front desk.
Super Easy DIY Luggage Storage
Lobby area by luggage storage
If you arrive early, like we did, usually you have to leave your bags in a manned luggage storage area. But Hotel ibis Amsterdam Centre does it a little different. You’ll get a coin from the front desk to put in the turnstyle that lets you pass through to the Luggage Storage room.
Luggage storage area
Wheel your bag down the ramp or walk down the stairs and put your bags to the left while you pass through the turnstyle.
Luggage storage room
Then the front desk person will buzz you into the room where you can safely store your luggage. There’s even small safes inside in case you want to store valuables separately. I initially was hesitant about how safe this is, but the room is supervised by the front desk staff and also monitored on CCTV.
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. Click To Tweet
I especially liked being able to leave my luggage here after I checked out of the hotel, but before getting my train to Schiphol Airport. That helped because I didn’t need to find a luggage locker at the train station. It saved me money and time, two things I never seem to have enough of as always.
On Site Restaurant and Bar
Lobby area
Don’t feel like going out for dinner? Walk down to the lobby and over to the International ibis Kitchen Restaurant, which is open for dinner daily from 6pm until 10:30 pm. The bar just to the right in this pic is also open daily.
Awesome Public Spaces
Lobby area
Whether you’re waiting to meet someone or killing time, the lobby at Hotel ibis Amsterdam Centre is welcoming and inviting.
Seating in lobby
There’s a table and chairs if you want to eat something, use your laptop, or read.
Business center
As well as a small business center with two desktop computers and two printers. Handy if you need to print out tickets for attractions or your flight.
Amenities in lobby
If you didn’t make it to breakfast on time, go to the Fresh & Ready Take Away section of the lobby and pick up a few things. There’s even fresh squeezed orange juice. You can also find sandwiches and beverages like coffee and water, too.
Elevators to rooms
To the left of the Fresh & Ready Take Away area are the elevators to the hotel rooms. You’ll need your card key to access the elevators, which adds a nice extra layer of security.
Signage in elevator
I love this little poster inside the elevator with so many great Amsterdam facts. Did you know any of them?
Heineken machine in hotel
Where else might you ever see a Heineken beer dispensing machine sandwiched between a soda machine and a water machine? In Amsterdam, of course.
Clean and Comfortable Rooms
Room 773
When time came for us to get to our room, we collected our bags and headed to our room on the 7th floor. Room 773 was a clean and comfortable room with two twin beds. The new Sweet Beds are super comfortable although small. We called down and asked for extra pillows, but other than that, the room was adequately sized for two people.
Room 773
There’s also a desk, a safe, a small wardrobe and shelves, a TV with international channels, and of course, free WIFI.
TSG Tip: I’ve read online where some people say the hotel is loud because of the noise from the trains coming and going. While I could see them and hear them if I tried hard, it wasn’t enough to disturb my sleep. If you’re a light sleeper, ask for a higher floor and that should help.
Bathroom in room 773
The bathroom features a large shower, which is bigger than some other hotels, including Amsterdam hotels, I’ve stayed at in the past.
TSG Tip: I always bring my own toiletries to avoid shampoo, conditioner, and shower gel surprises. ibis hangs a shower gel in the shower and over the sink and I think it can be used as a shampoo, too.
Great Views
View from room 773
This was the view from our room looking out over the tracks and toward the water toward the EYE Filmmuseum.
View from hotel toward Centraal Station
This was the view from the fifth floor bridge overlooking Centraal Station on a sunny day. It felt like you could see so far into Amsterdam from here.
View from hotel toward Centraal Station
When you see views like this, it reminds you that you’re here to get out and about in Amsterdam and not to spend all of your time in a hotel room.
All You Can Eat Breakfast Buffet
Breakfast area
A hotel stay is only made better with an all-you-can eat breakfast buffet. When you book your stay with Hotel ibis Amsterdam Centre, look for the Bed & Breakfast rate for slightly more to enjoy a hot breakfast each morning of your stay.
TSG Tip: Not all Amsterdam hotels offer breakfast so why not choose one with breakfast? You’ll start your day off on the right foot and you won’t have search for food all around the city.
Breakfast
The ibis buffet breakfast features hot foods like scrambled eggs with bacon and sausages as well as freshly ground coffee, fruit juices, and various breads. There’s also a new seasonal special offered every two months.
Breakfast
Why do the carbs always call to me? The croissants looked so flaky and buttery, but I was good and resisted.
Coffee cup in breakfast area
All I could ever want is coffee in the morning. Couldn’t help but take a pic of the ibis coffee cup. So true ibis. So true.
Breakfast area
The breakfast area is huge with tons of seating throughout the entire restaurant. While breakfast is offered until noon daily, try to avoid peak times to avoid crowds.
View from in front of Hotel ibis Amsterdam Centre
Add up all these great reasons to stay at Hotel ibis Amsterdam Centre and why would you want to stay anywhere else? Whether it’s your first visit to Amsterdam or you want to be near Centraal Station, it’s so close to everything that it’s an obvious choice.
When it comes time for you to choose from among the many Amsterdam hotels that are out there, take some of these thoughts into consideration for a great stay in Amsterdam.
Hotel ibis Amsterdam Centre Stationsplein 49, 1012 AB AMSTERDAM, NETHERLANDS
On my new SPONTANEOUS TRAVEL SCALE of 1-5, with 1 being super easy and spontaneous and 5 being you better plan far in advance, this is a 1. Unless there’s some huge event happening, I think it would be fairly easy to get a last minute reservation at one of the closest hotels to Centraal Station and that definitely means a huge thumbs up as far as spontaneous travel goes.
While I was generously provided accommodations from Hotel ibis Amsterdam Centre, as always all opinions and photographs, unless otherwise noted, are my own.
The post Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre appeared first on Travel Shop Girl.
Amsterdam Hotels: 8 Reasons to Love Hotel ibis Amsterdam Centre published first on http://ift.tt/2vy5Wr0
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10 Wonderful Moments From World Of Coffee Budapest
For three days in mid-June, the World of Coffee Budapest 2017 filled and fueled the Hungexpo fair center. Coffeemeisters and coffeelings from around the world united, celebrating the drink in ways old and new, traditional and millennial, literal and sartorial. Here are 10 of my very favorite highlights from a memorable event.
Starsky & Hutch
You may recognize the Loveramics Egg as the official cup of the World Latte Art Championship, though this year marked the brand’s first on the expo floor. Debuted was the brand’s new Starsky & Hutch series, evoking a “mid-century design” and “American diner-style,” according to sales manager Jenny Cheung. Like their eponymous plainclothes detectives, the cups appear pretty ordinary, albeit colorful and with a body “so thick and strong,” as per Cheung, they can take on high-pressure situations (like direct AeroPressing, microwaves, dishwashers, and who knows, perhaps bashing an escaping crook over the head).
etzMAX
“Your caw, caw, caw-ffee can still be good!” Etzinger’s crow logo seemed to be calling. The Liechtenstein-based burr manufacturer (say that three times fast) premiered a prototype of its on-demand grinder designed specifically with short-staffed restaurants in mind. “We wanted to reduce it all to the essentials and make it as small as possible, as simple as possible, so even if you’re not a barista you can get a good shot,” said Andrea Schoech, who works for the company and is married to its founder, Christian Etzinger (also the engineer behind Baratza’s Sette burr technology). Expect the etzMAX—with its 32-millimeter conical burrs, digital control panel, and removable 1000-gram hopper—to be available by yearend.
Black Sheep
No need to clutch your pearls: that pristine white Giesen W1 was not vandalized. The graffito is part of recent rebranding by Black Sheep, one of at least 16 Hungarian micro-roasters represented at the World of Coffee. Black Sheep senior roaster Gábor Tóth explained that his Debrecen-based business recently updated its “old-fashioned” logo to coincide with the opening of a second cafe and roastery. The venue will house the little lamb of a Giesen along with a similarly customized black W15, helping fulfill a corporate mission to provide “a bridge between the new wave of fruity coffees and the classic, darker roasts.”
Prêt-à-pour-over
New Zealand’s Nara Lee may not have won the 2017 World Brewers Cup—that honor went to Chad Wang of Taiwan—but the contestant still wore a fitting crown. Off the competition floor, her copper dripper-turned-cocktail hat glistened in the Hungarian sun. See the beaded wiring details captured on camera and proudly shared by Lee’s home cafe, Black and Gold Coffee/Eatery in Auckland.
Brewista Artisan
If Punky Brewster bought a kettle, surely it would be this rainbow Brewista Artisan. The limited-edition 600-milliliter gooseneck brewer with variable temperature is already available in most of Asia and will follow in August for Europe and the US. Other new hues include rose gold, flash black, and pearl white. And speaking of pale pleasures, Brewista’s potentially game-changing NutraMilk nut milk machine will be launched in October, said Carolyn Chen, marketing director at parent company Smartco.
Ironheart
Comandante’s C40 Ironheart first showed off its silvery tattooed cylinder this past spring in Seattle. But in Budapest, the Munich manufacturers started selling their handmade manual grinder with a carbon steel burr set. It is ideal for fine-grinding Turkish coffee (while leaving Comandante’s C40 nitro blade for espresso). As company co-founder Raphael Braune noted: “Carbon steel has a 66 Rockwell hardness, so that’s basically like a Japanese sword.”
Ethiopian Women in Coffee
In a separate building, out of earshot from competition roars and arena anthem interludes, the World of Coffee gave space to slower-paced, more intimate gatherings. In this spirit, 10 representatives of the Ethiopian Women in Coffee association held two cuppings of 28 washed and natural coffees. The event was sponsored by SheTrades, an initiative “providing market competitiveness training and services to benefit women in coffee,” as host Andrew Hetzel of Coffee Strategies put it. I personally attended this event, a highlight within my list of highlights from the show—if you get a chance to check out this programming at upcoming coffee events worldwide, do it.
Coffee Socks
Uri Wollner’s main job is running Cophi cafe in Warsaw, but his side-hosiery-hustle gained some traction in Budapest. “You get up in the morning, put your feet down, you see this,” he said of the coffeehouse quips and barista flair stitched onto his Coffee Socks. “Start the day positive and remember what you’re here to do, which is spreading love.” Your opinion on a barista’s goodwill ambassador role notwithstanding, you can design your own socks and order 100 to be produced on a six-yarn “old-school machine” in Lodz, Poland’s historical textile town, where Wollner has family roots.
BOB Coffee Lab
The BOB Coffee Lab stand presaged the same-named cafe and roastery due to open this summer in Bucharest. Behind it are Romanian triple Coffee in Good Spirits champion Paul Ungureanu, 2016 World Coffee Roasting champion Alexandru Niculae, and two other co-founders. But what about Bob, you ask? “Bob is a man who one day woke up as a dog,” offered Ungureanu, referring to their corporate mascot: a Kafka-reading shaggy canine. Meanwhile, said Niculae: “‘Bob’ in Romanian means ‘bean,’ like a coffee bean… But it can be anything. You could be Bob if you wanted to.”
Arcade Attire
These Pac-Man screen-patterned trousers were worn by multi-title-holding coffee champ Davide Berti as he judged the Cezve/Ibrik Championship. Perhaps they got the famously fashion-forward Berti (cf. Sprudge Sunday Magazine’s Edizione Italiana) in a gaming spirit. Regardless, Pac-Man was an apt sartorial metaphor for the World of Coffee, which can leave a visitor feeling like a mouth-led head consuming its way through a life-strengthening maze and occasionally reaching that especially fruity bonus.
Karina Hof is a Sprudge staff writer based in Amsterdam. Read more Karina Hof on Sprudge.
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Women's Hockey Notebook: Meghan Duggan Q&A; USWNT news; Men's team boycott?
Courtesy of Women’s Hockey Life
Puck Daddy had the opportunity to interview US Women’s National Team (USWNT) captain Meghan Duggan on the team’s boycott of the upcoming World Championship.
The Q&A with Duggan goes through a majority of the topics to come to light in the past week and a half.
We’re going to do something a bit different.
There has been an amazing amount of reporting on the negotiations. At the end of most of Duggan’s answers, we’ve added links to further reading on the subject covered. It doesn’t encompass everything written but it hits on a lot.
PUCK DADDY: How are you? What’s the last week and a half been like for you?
MEGHAN DUGGAN: I’m good, I’m good. It’s certainly been busy as everyone has been seeing and following in the media. Definitely a lot going on on our end, but I’m confident. Proud of my team and everyone that’s been involved.
It’s been a united group and a really strong group from the start, and that’s the only reason why we’ve been able to, I think, take this stand. It’s because we’re all in this together and been leaning on each other throughout the entire thing and communicating very well and so, yeah, it’s good.
• U.S. women, USA Hockey talks: Where things stand. [ESPN] • USA Hockey takes negotiations public, USWNT issues charged response. [Puck Daddy]
The team did a social media blast on Friday morning (see above). Why did you choose ‘limitless’ as your word?
DUGGAN: I love the word. I think it means a lot internally to us as players, our team and our program. I think that, in this day and age, everyone, regardless of gender, or anything else, it shouldn’t put limits on themselves, and that’s what we’re doing right now.
There shouldn’t be limits on women in terms of their equitable support in relation to men in any organization or any employment opportunity. We talk a lot about being ‘limitless’ in our program in terms of types of things we’re trying to achieve as players, and I think this falls right into that category.
• U.S. women’s hockey team member share bold messages on social media. [USA Today] • U.S. women’s hockey players tweet inspiring photos amid wage dispute with USA Hockey. [Excelle Sports]
Our interview with USWNT hockey player Monique Lamoreux re: the battle with USA Hockey // DiCaro & Hedger Show https://t.co/OHoMWucSsr
— Julie DiCaro (@JulieDiCaro) March 26, 2017
Can you give readers what life like for a post-college women’s hockey player who is in the National Team system?
DUGGAN: It’s different for everyone, obviously, and how they choose to balance their life and their financial needs and outside career path with their training and preparation for the National Team.
First of all, to stay with the National Team, to keep making that roster, to keep getting invited to those training camps and major [International Ice Hockey Federation] tournaments and to be a part of a team is a 365 day a year job without question. The National Team in all of our eyes, how passionate we are about it and what it takes to remain on that team. It dictates where we live, what we do every day, what we eat, how much sleep we get, who we interact with, and exactly what our days are like every day. And that’s just what it takes to stay on that team.
Everyone on our team does something else at this point, as a post-grad player, to help support themselves financially.
A lot of girls balance a full-time job. I, myself, the last two seasons had a coaching job in the NCAA. That was full-time in addition to my training. This year I stepped away from that job just solely to focus one hundred more on my training because it was certainly a lot to juggle in those other two years.
But even with myself stepping away from that job, and any of the other girls that don’t have full-time jobs, there’s tons of part-time things we have to pick up; whether it’s private lessons or speaking events, pretty much doing everything we can to supplement and to help us out from a financial basis.
There’s a lot of girls that rely on their parents for certain things; rely on their spouses or significant others for certain things, but there’s not one overall path that everyone once they graduate college, but you’ve got to start thinking about other things and how to make ends meet once you leave that glorious NCAA blanket.
• Women’s U.S. hockey players want to sit in business class, not coach (terrible headline, but informative read). [CNN Money]
The initial comparison is what the US team has versus Hockey Canada. They get a lot of government funding, though. How did the National Team formulate their demands?
DUGGAN: We did a lot of research in a lot of different areas before we went into this. It isn’t something we came to overnight. There was a lot conversations and fact checking and things like that, and we understand and know some of the elements and things that go along with Hockey Canada and how they run their program, but to be honest, I think we’re just focused on us.
This and our communication with each other and how we understand it, and what we think is important as American women. This fight and this battle doesn’t have anything to do with the Hockey Canada girls. For us I think we feel like what we have asked for is certainly appropriate for American players, female American players in this program.
• For more on how Hockey Canada pays it’s players, read ‘Elite athlete funding in the U.S. and Canada: How national team players get paid.’ [The Ice Garden]
She said she wanted to be just like me, I told her, “be better.” Taking a stand today for a their tomorrow #BeBoldForChange pic.twitter.com/l4JwDeTlSz
— Brianna Decker (@Bdecker14) March 25, 2017
The negotiations have been going on for the past year and half. Why announce your stance and the boycott two and a half weeks before Worlds?
DUGGAN: I wish a year and a half or a year ago we were able to come to an agreement on these terms. But in all the meetings that we had and the back and forth with USA Hockey we weren’t making any progress. Negotiations were at a standstill, and we got to the point last week where we felt that we had to take the next step, and it was a crucial next step.
The last thing that we would ever want to do is sacrifice a world championship, a defense of a gold medal on home soil, and I don’t think that people realize, maybe, how difficult it is for us to put that on the line. We’ve trained for it all year, but, at the same time, I think it shows how important this is to our program. How important this is to the future of USA Hockey on the women’s side and how passionate we are about it.
I think it’s the right time for a ton of reasons, and certainly proud to be doing it right now.
• How female athletes can help advance the fight for fair pay. [Time] • Women have already beaten USA Hockey at bargaining table. [USA Today] • US Women’s National Team demands better from USA Hockey. [Victory Press] • USA Hockey’s ignorant, misguided response to USWNT boycott. [Puck Daddy]
Can you explain why the boycott is about “more than just the money”?
DUGGAN: We’ve spoken from day one about how compensation is a piece of it. The other areas are in terms of programming and us wanting to play more games.
The comparison [used] is the [US National Development Team] program playing sixty game a season, where our team, in a non-Olympic year, plays nine. We want to play more games.
Then also just the marketing and PR and promotional aspects of our team. You saw the example of the jerseys before the 2014 Olympics. The women, from a marketing and PR and communications standpoint, are an afterthought, for lack of a better term.
One of the biggest parts of this movement is we, as women who have been involved in this program a long time, feel that it is necessary that the culture and mindset change within the USA Hockey higher-ups needs to change in regards to how they respect and treat and value the women in this program. That to me is more important than anything.
I think with all of those areas, the compensation piece, all the other proposed terms that we’ve talked about, in terms of injury and pregnancy and travel, staffing, meals, guest funds, things like that, they’ve really shown the women are an afterthought.
The biggest piece to me, and to the rest of the team, I think is getting across to them is that it’s 2017, and we’re not going to be underestimated anymore. We don’t want to be an afterthought. This is important for the young girls and the future of this program that these things change.
• Women’s boycott highlights opportunity for major change at USA Hockey. [ESPN] • Women’s Team’s fight sheds light on USA Hockey leadership. [NY Times] • USA Hockey takes another wrong turn in talks with women’s team. [ESPN] • Wrong message being sent in USA Hockey’s rigid stance on women’s team pay dispute. [Toronto Sun] • USA Hockey’s misleading claims on women’s hockey support. [Puck Daddy]
WATCH: NWHL players show support for #USWNT #BeBoldForChange pic.twitter.com/VF94cogxe5
— The Ice Garden (@TheIceGarden) March 25, 2017
In USA Hockey’s statement prior to in-person negotiations on Monday, they made special mention about childcare. Can you go into the request for maternity leave coverage and how having a child impacts a female professional athlete differently?
DUGGAN: There are some of us that have been around for ten years and are getting close to thirty. Jocelyne Lamoreux said it pretty well: time and time again we shouldn’t have to choose between between continuing and playing hockey, doing what we love and representing USA Hockey, and having a family.
There’s a lot of players on the team that, in their near future, are marriage and kids and things like that, but don’t want to feel like they have to give up hockey and our love for this game and representing our country at the Olympics for that. Men often don’t have to choose, when you look at it on that side.
I think for us, just having something in place, from a pregnancy standpoint within USA Hockey, it just hasn’t been something that’s been talked about. It hasn’t been a major issue in the past few years because we don’t have anyone on the team, aside from Jenny Potter 10 to 12 years ago that had a child while still playing, but it is something that I think we as players feel that, for the future of this program there needs to be a policy in place.
It was nothing like there needs to be a specific maternity leave, but we wanted to start the conversation with USA Hockey about should a player become pregnant, now what? What is USA Hockey’s obligation to that [player] if the player wants to continue playing, how do we deal with that financially? Is there a daycare and a nanny support after the player has the baby and now wants to come back?
It’s a lot of that stuff we wanted to start the conversation and have that talk with them about that.
Does that include holding a spot on the roster?
DUGGAN: That’s certainly a part of it. We talked about upon the players return she has the opportunity to, after medical clearance, have the opportunity to be invited back to the next one or two training camps.
Of course, within any national program, you still have to prove yourself. This is so that there’s no pregnancy discrimination and [players] are given an opportunity to come back once cleared medically. I think we put it at no less than two training camps.
She said she wanted to be just like me, I told her, “be better.” Taking a stand today for their tomorrow #BeBoldForChange pic.twitter.com/2fgOOMd0NB
— Meghan Duggan (@mduggan10) March 25, 2017
CNN Money reported USA Hockey doesn’t provide disability insurance. Is that correct?
DUGGAN: The insurance portion is a little bit difficult to understand. Those are some of the things we’re still currently discussing with them from an injury protection and worker’s compensation and all that standpoint.
It’s difficult to give an exact answer because USA Hockey doesn’t see us as employees. They’ve made that very clear. They don’t want to “employ” the players. So, in terms of disability and worker’s comp and a lot of that is kind of an interesting line there.
Has the IIHF, United States Olympic Committee (USOC), or International Olympic Committee (IOC) weighed in or spoken to the team at all?
DUGGAN: Not that I’m aware of.
• USA Hockey’s plan for replacements raises questions about anti-doping protocols. [USA Today]
You’re featured in a Dunkin’ Donuts commercial wearing a Team USA jersey. Have you or anyone on the team heard from sponsors?
DUGGAN: Not that I’m aware of, but people I’ve been involved with, that I know from a sponsorship standpoint, I would not be surprised if they are reaching out to USA Hockey and putting the pressure on them a little bit.
I would love to think that they are. There’s a lot of unbelievable people who sponsor women’s hockey, and put money into it because they believe in the product and so do we.
I think ultimately this is about wanting the higher-ups at USA Hockey to believe in this product. I would hope that they are. I haven’t heard any specifics as of late.
• After our interview with Duggan, Dunkin’ Donuts issued a statement: ‘U.S. Women’s National Hockey Team receiving major support in USA Hockey dispute.’ [USA Today] • David Nectow, the president of Total Hockey (a USA Hockey sponsor) released a statement:
#BeBoldForChange @JocelyneUSA17 @moniquelam7 pic.twitter.com/nmi1vAIYK3
— Travis Gray ™ (@travisgray21) March 17, 2017
You’re ‘Captain America.’ Do you feel added responsibility to be out front for this movement?
DUGGAN: Our entire group is unified. We’ve had discussions with the whole Worlds team, the [USA Hockey] player pool, the U-18 team. We’ve been working through this together.
As captain, and as one of the veteran players, it’s important to me. I’m passionate about speaking up. I’m proud to be leading the charge alongside all of my teammates.
Our core leadership group has been absolutely fantastic. In the initial press release that went out last Wednesday, there were five names: myself, Hilary [Knight], the Lamoureux twins [Jocelyn and Monique], and Kacey Bellamy who were going to be available for press and media and comments and things like that. Everyone has heard our voices more than the rest of the team, but I can say with one hundred percent confidence that we’re in communication with our team all the time.
Everything we say is on behalf of team, and the communication piece has been the biggest part of why this is going to be successful. We constantly ask the girls ‘is there anyone that feels they need to say anything for themselves? Do we want to continue with a few of us speaking on behalf of the team?’ And [the answers are] ‘we’re good with that, and we’re going to continue that way.’
Anything that comes out of any of our mouths is a clear indication of how the team feels.
Finally, if I were a little girl playing on an all boys team, what would you tell me about why the National Team is doing what they’re doing?
DUGGAN: I would say: this fight is for you. Women are amazing. Be proud to be one. Keep playing, stand up for yourself because this is for you.
We want to be the change and we want to make the change women’s sports in this country.
This is for you.
• Best perspective: Auston Matthews vs. Makenna Newkirk: The case against USA Hockey. [Pension Plan Puppets]
– – – – – – –
USA Hockey has made it clear they want to play Worlds with the initial roster named to the tournament. However, they’ve also indicated that they will be reaching out to other players in order to secure a roster to play.
At the time, we wrote this was a major tipping point for women who play hockey and are within the USA Hockey grasp. Any player that crossed the picket line would draw a serious blow to the movement and their future career.
According to Puck Daddy’s Greg Wyshynski, it’s not going well.
Source close to USWNT tells me that USA Hockey is now “contacting D3 and HS players” as Plan B for women’s worlds.
— Greg Wyshynski (@wyshynski) March 25, 2017
Yes, USA Hockey is so desperate that they’re reaching out to HIGH SCHOOL PLAYERS to go against the likes of Marie-Philip Poulin and Team Canada.
Not only is this desperate, it’s incredibly dangerous. If Duggan is correct and the players aren’t fully insured as is, the risk goes up significantly when putting kids on the ice against the best women’s hockey players in the world.
On Twitter, those approached to play are posting tweets with a modified Jerry Rice quote to show they’ve turned down the offer. The list continues to grow each day.
[View the story “‘Plan B’ players declining USA Hockey” on Storify]
More on USA Hockey’s decision to search for replacement players:
• Saying no to USAH: Q&A with University of Minnesota’s Cara Piazza. [The Ice Garden] • USA Hockey is trying to ice a team of scabs for the Women’s World Championship. [Vice Sports] • ‘Women’s players declining inquiries from USA Hockey to serve as replacements.’ [espnW] • ‘USA Hockey tries, fails to find World Championship replacement players as Women’s National Team boycotts.’ [Deadspin] • USA Hockey rebuffed as replacements stand in support of women’s boycott. [The Guardian] • Several women’s players spurn worlds inquiry from USA Hockey. [AP]
– – – – – – –
One last bombshell…
From NHL Player Agent Allan Walsh:
Word circulating among NHL players that American players will refuse to play in men’s World Championships in solidarity with the women.
— Allan Walsh (@walsha) March 26, 2017
HUGE IF TRUE.
Player support from the Men’s National Team and other NHL’ers has been welcomed but hardly groundbreaking.
None of the statements issued by players thus far have included any sort threat (for lack of a better term) to USA Hockey. Support, yes. Something that would make USA Hockey get super serious, super fast? No.
Allies in this fight are welcomed in any way. A movement of this magnitude by the Men’s Team means far more than any 140 character post.
Side note: One group you will definitely not see get involved is the NHL. They do give money to USA Hockey for grassroots growth, but don’t stipulate how USA Hockey should use the money. It’s all part of the collective bargaining agreement.
– – – – – – –
Jen Neale is an editor for Puck Daddy on Yahoo Sports. Have a tip? Email her at [email protected] or follow her on Twitter! Follow @MsJenNeale_PD.
#hockey#_revsp:21d636bb-8aa8-4731-9147-93a932d2b27a#nhl#_uuid:04beb760-04bc-3d48-8fab-901b616edab9#_author:Jen Neale#IIHF Women's World Championship#_lmsid:a077000000CFoGyAAL#women's hockey#usa hockey#USWNT#meghan duggan
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American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy
By HANS DUVEFELT, MD
Swedish Healthcare seemed competent but a bit uninspired and rigid to me but my medical school class trip to the Soviet Union showed me a healthcare system and a culture I could never have fully imagined in a country that had the brain power and resources to have already landed space probes on Mars and Venus by the time my classmates and I arrived in Moscow in the cold winter of 1977.
The first time we sat down for breakfast at two big tables in the restaurant of the big Россия hotel near the Red Square, our two male waiters asked if we wanted coffee or tea and people started stating their preferences. The waiters shook their heads and put their hands up in the air. No, they couldn’t split the beverage order, they explained. We had to all decide on one beverage with no substitutions.
The restaurant obviously had both coffee and tea, and as far as I know, they cost about the same. The only thing standing between the tea drinkers and their favorite morning beverage (the coffe crowd won the popular vote) was convention and attitude. I don’t know if this was a policy set by the hotel management or a complete lack of service-mindedness by he staff, but my classmates and I felt as if we, the customers, did not matter.
(Writing this piece, I came across the news item that the Hotel Rossiya, once the biggest hotel in the world, was demolished in 2006.)
From that first morning on, everything I encountered felt dim, dark and repressive. I saw with my own eyes that Sweden’s degree of uniformity was nothing compared to the Soviet Union’s, which some of my classmates, communists and former Viet Cong supporters, had spoken well of before we got there.
During our stay I saw dilapidated hospital wards and surgical suites with antiquated medical instruments in scarce supply, which we couldn’t even all see because of a lack of scrubs and booties. We saw bare-bones ambulances staffed with underpaid specialist physicians, neurologists for stroke victims, for example. I thought being a doctor in the Soviet Union seemed like one of the most depressing things you could end up doing for a living.
I yearned for the freedom and optimism I had seen back in 1971, when as an exchange student I fell in love with America and a girl I met in my high school sociology class.
During my high school year here, I got the impression that almost everybody in America had a personal ambition, like making music, writing a book or starting a business. I saw a service mindedness I had not seen in Sweden, where years later I saw the epitome of that in a restaurant near the Arctic Circle that closed for lunch (for the staff) from 12 to 1 pm every day.
In America I also got the impression that the rules of society were not exactly cut in stone the way there were in Sweden. Due dates seemed a little flexible, rules seemed to have countless exceptions; even spelling of the American language seemed to offer a few individual choices.
Doctors in America were mostly in private practice. I didn’t see much of American healthcare that year, except the afternoon reruns of Marcus Welby, MD that I devoured. It ran from 1969 to 1976 and it solidified my vision of being a primary care doctor in America.
Fast forward twenty years, to 1991, the year the Soviet Union collapsed. The Planned Economy proved itself to be an unsustainable daydream of the social engineers of communism.
That year I had lived in this country for a decade. My work in a Federally Qualified Health Center, part of a safety net that offered subsidized or free care to people without health insurance, had shown me the inequalities and health hazards of “the other half” of American society. I felt proud to be part of such a clinic, providing equal access to everyone.
During the ensuing two decades, the Federal agencies that paid our grants and provided our preferred reimbursement rates started to micromanage what we did and how we structured our work. My original liberated experience of American healthcare turned into a sense that the bureaucrats mistrusted doctors and administrators of FQHCs so deeply that they had to structure our work for us.
The crowning event was when we all more or less had to earn recognition as “Patient Centered Medical Homes”, which at first sounded like we needed to make our practices Marcus Welby-like. Instead, PCMH was not really about nimbly meeting your patients needs but about creating rigid protocols that in fact made it hard to improvise. This was followed by many other initiatives that to a small or larger degree lacked firm anchoring in the reality of front line medicine and became virtual shackles for medical practices.
This hampering of improvisation in how you meet individual patients needs felt strangely familiar, and brought back memories of that cold December morning in Moscow:
Tea or Coffee, but not both.
Save one same day slot and qualify for easy access recognition, double book freely and fail the access parameter (no “protocol”).
And then when Uncle Sam wanted our “data”, presumably for better central planning some day, we were given grants to computerize our patient records with numerous qualifiers about how to use these computers. “Meaningful Use” broadly sounded like a good idea, except the technology was immature.
One example: Patient information about their medical condition, if generated by the EMR software, often amateurish and rudimentary, gives us Meaningful Use brownie points, but high quality handouts from sources like Up to Date, Harvard or the Mayo Clinic don’t count.
Another Federal shackle: Uncle Sam wants us to deliver comprehensive care, which includes screening for a growing list of clinical and societal issues, like depression, alcohol use, domestic violence, sexual orientation, food insecurity and so forth. If we don’t do all this, we lose brownie points. Consequently, we hesitate fitting infrequent visitors into our clinic schedules, because you can’t possibly do all that in a single visit for a sore throat, so we look better if that patient goes to a walk-in clinic – one ding on the Access parameter instead of numerous dings for all the other ambitious comprehensiveness requirements
I am sorry to report that the well meaning bureaucrats of the Central Planning Office are making American Primary Care feel more and more like the Soviet Union of Lenin and Marx where people mattered as populations, perhaps, but not as individuals. That is not the way Americans think. They don’t want to be told what to drink with their breakfast and they don’t want to be told what the agenda is for their next doctor’s visit.
Collapse or profound disruption seems inevitable.
Hans Duvefelt is a Swedish-born rural Family Physician in Maine. This post originally appeared on his blog, A Country Doctor Writes, here.
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