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Comment by Wbrom (Wbrom42@gmail.com) on Dentistry, Oral Surgeons, and the Inefficiency of Small Markets · 2024-11-01T17:46:49.966Z · LW · GW
  1. VCs are already doing this. They have offered to buy both the oral surgery practice and the dental practice I use in town.

  2. The care they provide turns worse and worse because the model you envision turns a professional (someone who should have a fiduciary responsibility to the patient's best interest above their own) into an employee of a non-professional corporation. All of the pre-and postoperative care that you envision being done by less highly paid individuals in order to free up the surgeon to "generate profit" gets done cheaply and more slapdash resulting in worse and worse patient care. Either the oral surgeon fights back and attempts to maintain the physician patient relationship and gets fired from their own practice that they sold out (pretty common already with Derm and Optho) or they don't and you get the actual medical version of the plastic surgery chop shops common in Miami. This ethical problem is why non-lawyers cannot own a legal practice and yet we failed to recognize the same destruction of the professional relationship when it comes to physicians.

  3. Aspen dental is a franchise based venture capital funded organization that already does this.

  4. This is where rationalists fall apart. Everything you say makes sense, but it doesn't take into account the sociocultural aspects that make a physician patient relationship different than the value extractive relationship that you propose.

Comment by Wbrom (Wbrom42@gmail.com) on Did Christopher Hitchens change his mind about waterboarding? · 2024-09-15T14:42:42.144Z · LW · GW

I think you are vastly overestimating the 2001-2010 internet's ability to preserve and catalog evidence.

Comment by Wbrom (Wbrom42@gmail.com) on Did Christopher Hitchens change his mind about waterboarding? · 2024-09-15T14:40:21.856Z · LW · GW

I would like to add a small element of purely anecdotal evidence to this debate as an avid follower of the "warblogs" and discussions at the time which is slightly different from the "he was pro torture before he was against it" take in your post. My general understanding is that Hitchens was always against "torture" (disagree with Nance's take on this) but there was both a legal and moral debate about water boarding qualifying as torture. For example see this NPR story from 2014: https://www.npr.org/2014/01/07/260155065/cia-lawyer-waterboarding-wasnt-torture-then-and-isnt-torture-now

Hitchens decided to answer the question for himself and came firmly down on the "it is torture and therefore wrong" side of the debate afterwards. He was initially wrong but continued to be intellectually consistent throughout.

Comment by Wbrom (Wbrom42@gmail.com) on Did Christopher Hitchens change his mind about waterboarding? · 2024-09-15T14:32:21.481Z · LW · GW
Comment by Wbrom (Wbrom42@gmail.com) on Are most people deeply confused about "love", or am I missing a human universal? · 2024-05-23T14:39:06.858Z · LW · GW

It's articles like these that make it clear that trying to extend rationalism to every aspect of the human condition is doomed to fail, and not only to fail, but to make anybody who makes the attempt seem like an alien to normal people.

There are people who have been Talking about the different types of love and what love actually means thousands of years. The Greeks talked about the difference between Eros and Agape. Today on poly forms, you can see people talking about all the different types of love they have for their partners throwing around words like "new relationship energy" and "limerance." Well known biblical quotes like "Greater love hath no man than this, that a man lay down his life for his friends," makes it clear that there are different types of love.

Most people are just comfortable with context clues instead of working down a flow diagram to make sure they are using the perfect word at the moment.

For example, if someone asks me how I'm feeling and I say "bad" the fact that I have the flu vs if I just got a divorce is enough to clue most people in to the fact that the words "feel" and "bad" are referring to physically and emotionally respectively. Most people and situations don't need more clarity than that for human relationships to progress.

Comment by Wbrom (Wbrom42@gmail.com) on Surgery Works Well Without The FDA · 2024-01-27T14:20:29.384Z · LW · GW

The FDA does not provide good guidance on what treatments should be applied in what situations. They approve drugs for a limited set of uses and that's it. Most drugs are applied "off label" which the FDA rules that drug companies specifically cannot comment on -- so not only does the FDA not provide guidance on the most common use for most medications, they actually prevent that guidance from being provided.

Comment by Wbrom (Wbrom42@gmail.com) on Surgery Works Well Without The FDA · 2024-01-27T14:16:59.882Z · LW · GW

You mean the Theranos that is specifically regulated by CLIAA and Medicare which did nothing to stop them until they actually destroyed people's lives?

Comment by Wbrom (Wbrom42@gmail.com) on Surgery Works Well Without The FDA · 2024-01-27T14:14:58.147Z · LW · GW

Or you can buy UL listed ones that work. The UL is a private organization. Which again goes to prove his point.

Comment by Wbrom (Wbrom42@gmail.com) on Surgery Works Well Without The FDA · 2024-01-27T14:13:19.752Z · LW · GW

Everything you said about the myriad of ways the field of surgery regulates itself actually works to support the point you are trying to argue against.

Comment by Wbrom (Wbrom42@gmail.com) on The likely first longevity drug is based on sketchy science. This is bad for science and bad for longevity. · 2023-12-12T12:37:30.412Z · LW · GW

Why are you nervous to predict the drug doesn't work? Your take seems reasonable and opinion isn't liable so?

Comment by Wbrom (Wbrom42@gmail.com) on Buy Nothing Day is a great idea with a terrible app— why has nobody built a killer app for crowdsourced 'effective communism' yet? · 2023-11-30T21:13:27.632Z · LW · GW

Because you can't make money off of it (by definition) so no-one wants to work hard enough on it to make it work. Sort of like communism itself.

Comment by Wbrom (Wbrom42@gmail.com) on Scott Alexander is wrong about slurs · 2023-11-21T14:26:38.094Z · LW · GW

There is a difference between normal language evolution and forced changes as a tactic in the post-modern power struggle game. These are usually signaled by the fact they are strongly advocated by a small minority of activists, often not even of the group affected. They are at best generally used to signal allegiance to a certain in-group and "other" less enlightened people. Examples are the term "Latinx" which most Hispanic people dislike. Attempts to rename the homeless a "unhoused" or "people experiencing homelessness" are also noted.

Comment by Wbrom (Wbrom42@gmail.com) on My Effortless Weightloss Story: A Quick Runthrough · 2023-10-02T14:09:06.966Z · LW · GW

Thanks for the reply

Comment by Wbrom (Wbrom42@gmail.com) on My Effortless Weightloss Story: A Quick Runthrough · 2023-10-02T12:33:33.559Z · LW · GW

Hi there. I'm confused about the units you are using through the post. You start using milliliters (mL) as a unit when referring to the KCl salt that you were putting on your food. Was it a liquid supplement? If not did you mean milligrams? How did you measure?

Do you have an estimate of the total milligrams or milliequivalents per day?

Thanks for the post!

Comment by Wbrom (Wbrom42@gmail.com) on Bariatric surgery seems like a no-brainer for most morbidly obese people · 2023-09-27T14:42:45.527Z · LW · GW

I am a physician trained in bariatric surgery but do not do it as part of my practice. That being said, on a population level and until the recent introduction of the GLP drugs bariatric surgery is the only thing that actually results in long-term weight loss for morbidly obese people. It does, however, have significant risk of early and late complications and vastly changes behavior, which some people find it hard to deal with. Early complications include leak with about a 2% risk, death with about 1/500 or so, and various and sundry other minor complications that have a risk of about 10%.

I would absolutely undergo sleeve or bypass if my BMI went over 35 with any comorbidities if I did not get adequate results from the new GLP medications, which, in my opinion, should definitely be first line for people without contraindications.

Comment by Wbrom (Wbrom42@gmail.com) on AI romantic partners will harm society if they go unregulated · 2023-08-01T10:10:45.138Z · LW · GW

About 80% of this could (and was) said about the development of the printing press. Smart people trying to ban new technology because it might be bad for the proles is a deeply held tradition.

Comment by Wbrom (Wbrom42@gmail.com) on [Book review] No nonsense meditation · 2022-05-04T13:10:45.590Z · LW · GW

This sounds like a more serious take on “Meditation for Fidgety Skeptics” which I really enjoyed.

Comment by Wbrom (Wbrom42@gmail.com) on Judge Overturns Transportation Mask Mandate · 2022-04-20T16:04:06.933Z · LW · GW

I generally agree with the above post however I disagree that ending the CDC addiction moratorium was political in any way. It takes forever to get a case on a federal docket. As soon as the rule got to court it was struck down.

Comment by Wbrom (Wbrom42@gmail.com) on Are there any preventive steps someone can take after being exposed to strep throat? · 2022-02-14T13:00:02.254Z · LW · GW

Once the hypothetical girlfriend has been on antibiotics for 24-48 hrs she is no longer contagious and to be extra careful the imaginary boyfriend could pop one of her antibiotics an hour before snogging.

Comment by Wbrom (Wbrom42@gmail.com) on Some ideas for interacting with reporters · 2022-02-14T01:38:35.187Z · LW · GW

It is implied in some of the things you said but to be explicit, always have your own video and audio recording of any interview.

Comment by Wbrom (Wbrom42@gmail.com) on Soup design: Everyone likes it, but few know how · 2022-02-07T21:00:41.100Z · LW · GW

It sounds like they found the room design pretty but not useful. Optimization problem.

Comment by Wbrom (Wbrom42@gmail.com) on How would you learn absolute pitch? · 2022-01-30T02:04:10.810Z · LW · GW

It’s been done. https://pubmed.ncbi.nlm.nih.gov/31550277/

Comment by Wbrom42@gmail.com on [deleted post] 2022-01-25T11:26:43.413Z

Have no information or opinion on the main issue. However in regards to the question about the community, As someone who got into the community late and alone I will tell you that yes, LW is exactly like that.

Comment by Wbrom (Wbrom42@gmail.com) on A fate worse than death? · 2021-12-13T14:34:17.178Z · LW · GW

Your premise that “permanent death is the only brain state that can't be reversed, given sufficient tech and time” is absolutely without basis. A technology that could reverse “a million years of terrible pain” is indistinguishable from magic and therefore assuming it could resurrect people (or at least their minds) is at least as plausible.