Dander Gathering Again: Terzo

It's hard these days to rid oneself of the rising dander. Dander Omnium Gatherum Patch Numero Terzo. To put it more simply, here are more tales from the DOG Patch. And a smattering of actual good (how's this possible?) news.

Double Back on Politics at the VA. There's a guy now installed under Secretary David Shulkin by the name of Darin Selnick. He carries the title of Senior Advisor, and also

Tales from the DOG Patch: Numero Deux

A tip of the hat to Dr. Roy Poses, who did a nice job summarizing the first blast from the DOG Patch. (For those who missed it, it's a distillate of all the dander we've mustered in recent health policy debates as they veer more and more toward the utterly surreal.) Dander omnium gatherum, hurled willy-nilly at the gentle readers of HCRenewal. Ready or not, another dispatch from the DOG Patch.

Top 10 Forex Sites (2018 edition)

Here is the list of the top 10 Forex sites ranked by Alexa for 2018. It is an update of my old post:

1. Investing.com - technical analysis and real-time data streaming for the Forex, commodities, major world indices and futures. Includes trading and investment tools.

2. Forex Factory - forum that includes market calendar and news

3. Trading Economics - view, download and compare thousands of economic indicators

4. DailyFX - foreign exchange analysis, currency news updates, FX forum, currency forecasts and charts

5. FXStreet - real-time exchange rates, currency charts, news, market forecasts, technical analysis and a currency converter

6. Babypips - simple easy to understand guide for teaching beginners how to trade

7. Mataf - forex trading tools, daily exchange rates and currency analysis

8. Dukascopy - a leading Forex ECN broker and a bank

9. FXCM - a leading Forex broker

10 Forex Peace Army - reviews of Forex services, resolves Forex scam incidents

The Case of the Brew Master's Plot - Was the Veterans Affairs Secretary's Travel Spending Scandalous, or Was He Framed in a Plot to Oust a Political Moderate?

"Come, Watson, come! The brew is afoot."

The Veterans Affairs Secretary's Apparently Scandalous Travel

On February 14, 2018, the Washington Post reported that the Department of Veterans Affairs (VA) Inspector General (IG) severely faulted travel arrangments made for a trip to Europe by the Department's Secretary, Dr David Shulkin.


Veterans Affairs Secretary David J. Shulkin�s chief of staff

Why do not people have financial independence?

Why do not people have financial independence?
What is your goal when starting to invest in the financial market? If you think it's just to earn "more granite" than paying the bills, you think you're small. Learning to invest is easier than you think and in a short time it is possible to become an effective investor.

Knowing where to correctly apply your money, you get enough back to stop working to earn money and work only if you feel like it, when your money is doing it for you. In this article I talk about why people do not have financial independence and that this information can help them discover what is preventing them from achieving their goals. Exit:
What is financial independence?

Financial independence means being able to live with an indefinite income. The idea is simple: to accumulate wealth, whether in real estate, in equities, in commerce or in another type of investment guaranteeing returns.

For example, you have 1 million reais in real estate that earns 8,000 reais a month and a cost of living less than 8,000 per month, ready: you are free! You can live more than 50 years to live the performance of your property, work when you want and if you want.

Everyone wants to have enough money to realize their dreams and goals, but why do not many people succeed?
What are the main difficulties?

Most people do not even take the opportunity to invest seriously. They are:

    Limit beliefs

Many people have beliefs that make it impossible to make investments. These are thoughts of the type: "Little gain"; "I have not had the opportunity to study enough to have a better career"; "I was not born with a gift to start a business and become rich", among other forms of self-sufficiency.

These beliefs are very strong in Brazil and in less developed countries. Many people think that financial independence is feasible only for those with special gifts or for those living in a country that offers more facilities, but that is not true. Anyone who has never invested in life can learn, after a few weeks of dedication to study, what are the best options for investing today.

    the fear

It is necessary to leave the comfort zone to achieve financial independence. To get there really, there is no way: you will have to learn to invest. Many people are scared because they imagine that making the investments in the right way is difficult to learn and very risky to try.

This fear paralyzes and she ends up not going behind the information and doing nothing. In fact, it's risky if you do not know the right method, but it's not so complicated to learn and it's worth it.

    No objective

What would you do with five, ten, twenty times more money a month? Is your dream to buy a property? A boat? Travel abroad every holiday? Take the family to a station twice a year? No matter what you choose, the key is to have a goal.

Once you have seen the benefits of your quality of life and it becomes a priority for you to be financially free, you will strive to reserve a percentage of your salary to make these investments.

Seeing a goal to achieve is much more palpable to undertake efforts to achieve it. Your motivation to learn, to save money, will make it happen.

    Lack of knowledge

It is precisely because of the lack of knowledge that people end up making investments that are not good and opt for solutions such as savings or private provision. In order to carry out risky operations, imagining that these investments are conservative and lose the opportunity to use their money in alternatives that guarantee a much greater financial return.

From the moment you learn methods, it is only to begin to follow that, little by little, improve your knowledge to obtain excellent results in the financial market.

   Lack of discipline

You do not necessarily need to invest every month, but it will be difficult to achieve your goal if you make a one-time contribution of R $ 500, for example. Calculate your short, medium and long-term potential and commit to these values.

Imagine that this amount is an account payable with interest, fine and monetary correction. In this way, you will give a way to make this payment, will not you?

From the moment it is a priority for you, to imagining what you will do with this financial freedom, by visualizing the benefits, it will be much easier to stay focused on that goal.

To want is to engage, and to commit is a power!

Welcome to the DOG Patch: first in a series?

Lately my dander is up so often and so copiously, over what's happening in health care and the world at large, I'm exhausted. Covered with nasty dander. Cowering under the sheets. Others seem to share this dysphoria. But I found if not a cure, at least a palliative. There's so much dander I can scrape it off with a great big shovel and toss as much as I can your way. Here's my first Dander Omnium

New article in J. of General Internal Medicine calls for simplifying EHRs

At my January 31, 2018 Healthcare Renewal blog post "The inevitable downgrading of burdensome, destructive EHRs back to paper & document imaging" at http://hcrenewal.blogspot.com/2018/01/the-inevitable-downgrading-of.html, I opined that the downgrading of the clinician-facing components of EHRs was essential and inevitable.

A new editorial in the Journal of General Internal Medicine makes

Are You With Us, Dr Gu? - Vanderbilt Suspended Surgical Resident Allegedly Due to Patient's Mother's Compaints About His "Taking a Knee" on Social Media

In the US, our political situation seems to be leading to new threats to free speech in academic medicine.

Background: Dr Gu's Activism

his story was first reported by The Chronicle at Duke University, and here it is in chronological order

Congressional Subpoena about Fetal Tissue Research

Dr Eugene Gu is a pediatric surgical resident at Vanderbilt University Medical Center (VUMC). He

Free Press? Don't Need No Stinkin' Free Press - Center for Medicare and Medicaid Services (CMS) Tries to Intimidate Modern Healthcare Journalist

Remember the good ol' days, when most US challenges to free speech or the free press in health care came from aggrieved corporate or academic managers? Now government health agencies have gotten into the act, never mind First Amendment guarantees of free speech and a free press.

CMS Attempted to Intimidate a Journalist for Modern Healthcare

This story first appeared on the blog of the

Fish gotta fly, birds gotta swim: more on the opiate crisis

At so many levels, the current opiate crisis, and the way in which various actors are seeking to cope with it, proves rich in intriguing detail.

For starters, it needs to be memorialized that there is a judge in Ohio--like Pennsylvania a fascinating political see-saw state--who's actually trying to do something about this crisis.

Daniel Polster, a Clinton appointee and approaching two decades

Disastrously conceived, managed, and implemented U.S. Coast Guard EHR leaves our Coast Guard heroes safer ... after reversion to paper records

Sometimes, the typical EHR mismanagement debacles that I have been writing about since at least 1999 leave patients safer. This is one such example.

I note that the contents of this blog, as well as my still-extant Drexel website "Contemporary Issues in Medical Informatics: Good Health IT, Bad Health IT, and Common Examples of Healthcare IT Difficulties" (http://cci.drexel.edu/faculty/