Tuesday, April 15, 2008

One picture; two thoughts

DSC06240

Trafalgar Square

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We spent the day with our medical advisors today, pitching our ideas and getting their feedback for the best way to use our shiny new device. One of them cautioned against the moral hazard of medical innovations: if we take responsibility for patients, they will cease to take care of themselves. The specific topic concerned whether monitoring for disease progression would create a false sense of safety that enabled people to continue bad habits ("I can go on smoking if the monitor says I'm okay!").

I've known it myself with regard to cholesterol: diet and exercise didn't budge it, so I was put on Lipitor. Now, I admit, I'm less likely to quibble about having the occasional South Beach unsafe meal it the little pill keeps my TotChol at 130 regardless.

And now I'm sitting here wondering what the corresponding moral hazard is for Viagra...

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Over dinner, our mixed Dutch - American group got into a discussion about the US election, and a Dutch physician asked a colleague how she voted in the primary. She told him, but commented that Americans would never ask one another about how they voted. The Dutch were amazed: apparently that isn't a taboo topic in the Netherlands.

It launched a conversation about "What can't you ask?" The Americans have a long list, from salary to politics, religion to sex. The Dutch, apparently, only keep salaries secret from one another?

But even that has exceptions. I was trying to sort out salaries for my group, and consulted HR to get the employee COMPA ratios. These are numbers that tell what an employee makes relative to their market value: people are generally paid between 90 and 105% of COMPA. Along the way, I discovered that every employee here knows their COMPA, where this is a very deep secret in the US (leading to "Why do I only get 95% of market value?").

Similarly, when handing out a raise, I get an envelope from HR, which I hand out with a handshake, a smile, and a compliment. It turned out to be a serious breach here: we should have opened the envelope together, discussed the amount, and agreed on it's appropriateness (followed by a handshake, a smile, and a compliment).

'moral is, money matters are tough everywhere...

6 comments:

Nick said...

Belfast is a curious mixture when it comes to conversation topics. Some people are very strait-laced and will steer away from all the things you mentioned. Others will talk about virtually anything - with the exception of religion which is still too incendiary to raise casually. In the 5 plus years I was in my last job, nobody ever discovered my religion (Buddhism as it happens)!

Dave Hampton said...

I've always been interested in religions that were more philosophical than spiritual: buddhism seemed like one with that reflective flavor to it. I read part of the book (and discovered that I shared a birthday with the Buddha), but never took it beyond into the necessary study.

In this US election year, politcs are the first topic that the Dutch want to talk about. I've tried to keep up with current Netherlands debates as well so i can steer things a bit if table conversation starts to get rancorous.

Textual Healer said...

I think I have started to become a bit more Dutch in my attitudes to talking about money. Perhaps its to do with running my own business. Last month when discussing an insurance policy I openly asked a broker what his commission was. Something I would have never done a few years ago. He looked quite suprised that I asked (thinking it was an English thing perhaps).
Dave on your comment - did you hear about the Tibetan Buddhist monk who went to Belfast to give a course. At the airport he was aksed what religion he was and replied Buddhist - and the customs official looked back and said ay but are youse a catolic or a protestant buddhist?

Dave Hampton said...

I like that :)

Agreed; I run a seed business in England and it was a change for me to really nail down prices before contracting work. I always want to be a nice person, and haggling about money isn't. How are you at negotiating prices down?

AB said...

Interesting. Although I have to say I disagree about your comments regarding discussion of politics in America. Maybe it is a generational thing? No one I know would think twice about discussing politics amongst peers, although I don't see us asking anyone in our parents generation, I get a feeling of treading on taboo at the thought of asking one of my parents friends (unless I knew them REALLY well) who they support.

On the flip side, most of the people I know are Obama supporters, and on the rare occassion I come across a republican my age, I usually change the subject ASAP!!!!

Dave Hampton said...

Ab, I agree that people are willing to dicuss politics, but how many will tell you how they voted?

Maybe it's less of a thing now, but my parents always held to the "Privacy of the voting booth" philosophy, and never told us who they voted for.

The rumble that I hear back from the US is that people are gradually feeling less confident about Obama. I'm a longstanding not-Republican, and want to feel warmer about Obama...but he's oscillating between brilliance and rookie mistakes. He's going to have to ascend the learning curve more quickly, I'm afraid...