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The Point - May 8, 2014

In this edition of The Point:

Article #1

Excerpted from "Thin skins and legislative prayer,"Washington Post commentary by George F. Will, May 7, 2014 — After the marshal on Monday spoke the traditional “God save the United States and this honorable court,” the Supreme Court ruled that the Upstate New York town of Greece does not violate the First Amendment’s prohibition of “establishment of religion” by opening its board of supervisors’ meetings with a prayer. This ruling would not have scandalized James Madison and other members of the First Congress, which drafted and sent to the states for ratification the First Amendment and the rest of the Bill of Rights. The Congress did this after hiring a chaplain.

Three decades have passed since the court last ruled on the matter of prayers during government meetings. In 1983, the court held:

“From colonial times through the founding of the Republic and ever since, the practice of legislative prayer has coexisted with the principles of disestablishment and religious freedom.” Since then, however, many Americans have become more irritable and litigious and less neighborly. Also, there are many more nonbelievers.

The majority held that ceremonial prayer — an encouragement to gravity and sobriety — is not harmful to the plaintiffs, who felt somehow coerced when present at public prayers, and who said such prayers are necessarily divisive. The court should have told them: If you feel coerced, you are flimsy people, and it is a choice — an unattractive one — to feel divided from your neighbors by their affection for brief and mild occasional expressions of religiosity.

Taking offense has become America’s national pastime; being theatrically offended supposedly signifies the exquisitely refined moral delicacy of people who feel entitled to pass through life without encountering ideas or practices that annoy them. As the number of nonbelievers grows — about 20 percent of Americans are religiously unaffiliated, as are one-third of adults under the age of 30 — so does the itch to litigate believers into submission to secular sensibilities.

The United States would be a more congenial place if it had more amiable atheists who say, as one such did, that “it does me no injury for my neighbor to say there are 20 gods, or no god. It neither picks my pocket nor breaks my leg.” Some will say Thomas Jefferson was a deist, not an atheist.

Still, Jefferson made statesmanlike accommodations of the public’s strong preference for religious observances. As president, he attended Christian services conducted in the House of Representatives. They also were conducted in the Supreme Court chamber and the Treasury building. Jefferson attended a service in the House two days after praising (in an 1802 letter) “a wall of separation between church and state.”

Jefferson was no slouch when it came to asserting rights. But Greece’s prickly plaintiffs, having taken their town to court, might now ponder his example of relaxed, friendly respect for practices cherished by others and harmless to him.

Commentary #1

CMA VP for Govt. Relations Jonathan Imbody: “I hesitate to add to the eloquent and insightful commentary by George Will, other than to suggest that Christian healthcare professionals as well as town councils should cheer this decision. Healthcare professionals are not exempt from the rising tide of litigation by people disaffected by faith, whether their complaint focuses on homosexual issues, abortion ‘rights’ or any other of a host of issues that conflict with your conscience and the tenets of your Christian faith.

“Every case the Supreme Court decides in favor of religious freedom builds a bulwark of precedents and highlights what the First Amendment clearly guarantees::

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

“Since the framers of the Constitution never separated conscience and religion, this first right enumerated in the Bill of Rights means that you as a Christian healthcare professional or student have a right to decline or participate in practices and prescriptions according to the dictates of your conscience and moral standards, free from government coercion. The rub, of course, comes when discrimination comes not from the government but from your healthcare specialty college, or the admissions committees of the schools you're trying to get into, or the ethics committee at the hospital where you practice (see reporting discrimination, below).

We need to strengthen and expand conscience protections in law while simultaneously convincing colleagues and countrymen of the benefits to all that come from respecting conscience and religious freedoms: promoting tolerance, diversity and non-discrimination.

Article #2

Excerpted from “How Being a Doctor Became the Most Miserable Profession,” The Daily Beast commentary by Daniela Drake, MD, MBA, April 14, 2014 — By the end of this year, it’s estimated that 300 physicians will commit suicide. While depression amongst physicians is not new—a few years back, it was named the second-most suicidal occupation—the level of sheer unhappiness amongst physicians is on the rise. Simply put, being a doctor has become a miserable and humiliating undertaking.

Not surprisingly, many doctors want out. In fact, physicians are so bummed out that 9 out of 10 doctors would discourage anyone from entering the profession. It’s hard for anyone outside the profession to understand just how rotten the job has become—and what bad news that is for America’s health care system.

Unfortunately, things are only getting worse for most doctors, especially those who still accept health insurance. To make ends meet, physicians have had to increase the number of patients they see. The end result is that the average face-to-face clinic visit lasts about 12 minutes. Neither patients nor doctors are happy about that. What worries many doctors, however, is that the Affordable Care Act has codified this broken system into law. While forcing everyone to buy health insurance, ACA might have mandated a uniform or streamlined claims procedure that would have gone a long way to improving access to care.

Yet physicians have to go along, constantly trying to improve their “productivity” and patient satisfaction scores—or risk losing their jobs. And now that Medicare payments will be tied to patient satisfaction—this problem will get worse. Doctors need to have the ability to say no. If not, when patients go to see the doctor, they won’t actually have a physician—they’ll have a hostage.

Almost comically, the response of medical leadership—their solution— is to call for more physician testing. In fact, the American Board of Internal Medicine (ABIM)—in its own act of hostage-taking—has decided that in addition to being tested every ten years, doctors must comply with new, costly, "two year milestones." In an era when nurse practitioners and physician assistants have shown that they can provide excellent primary care, it’s nonsensical to raise the barriers for physicians to participate. It is tone deaf. It is punitive. It is wrong. No wonder doctors are suicidal. No wonder young doctors want nothing to do with primary care. But for America’s health to be safeguarded, the wellbeing of America’s caretakers is going to have to start mattering to someone.

Commentary #2

CMDA Psychiatry Section Chair John Yarbrough, MD, MBA:“Working as a physician today is different than it was when my father began his practice in internal medicine nearly 40 years ago. Insurances, laws, decreased time with patients, board certifications and electronic medical records are amongst many potential contributors to making life miserable. The demands placed upon us can be overwhelming.

“Recent experiences on a trip to Am_an, Jord_n were unsettling and left me in need of spiritual and emotional refueling. One event in particular while treating Syri_n refugees was when, outside our building, a young 11-year-old girl emerged onto the street with her upper body lit on fire. She had poured kerosene on herself and lit herself on fire after receiving news that her abusive father was coming to pick her up and she would no longer live with her grandmother. This desperate child saw no other way of escaping her situation and is still in a Jord_nian hospital’s ICU with third-degree burns.

“As Christian physicians, the restoring love and grace offered by Jesus Christ dying on the cross for our sins is our path to salvation and an eternity in fellowship with God. While all of us have a wish list of things we would like to see change in our field, our higher calling is our antidote to misery. We are to focus on storing up treasures in heaven and not focus on earthly things."

Country names censored for security reasons

Article #3

Excerpted from “Even casually smoking marijuana can change your brain, study says,” The Washington Post. April 16, 2014 — The days when people thought only heavy Cheech-and-Chong pot smokers suffered cognitive consequences may be over. A study in The Journal of Neuroscience says even casual marijuana smokers showed significant abnormalities in two vital brain regions important in motivation and emotion. “Some of these people only used marijuana to get high once or twice a week,” said co-author Hans Breiter, quoted in Northwestern University’s Science Newsline. “People think a little recreational use shouldn’t cause a problem, if someone is doing OK with work or school,” he said. “Our data directly says this is not the case.”

The study analyzed 20 pot smokers and 20 non-pot smokers between 18 and 25. Scientists asked them to estimate how much marijuana they smoked and how often they lit up over a three-month test period. Even those who smoked once a week showed brain abnormalities, while larger changes were seen in those who smoked more.

In the study, scientists compared the size, shape and density of the nucleus accumbens and the amygdala, which control emotion. Those who had smoked had abnormally large nucleus accumbens, an area of the brain that controls pleasure, reward, and reinforcement learning. In the brains of marijuana users, natural rewards are less satisfying.

Commentary #3

CMDA’s National Director of Campus & Community Ministries Dr. J. Scott Ries, MD: “Innocent until proven guilty...or dubious until proven safe?

“There is little dispute about the medical hazards of heavy marijuana use. What remain in question are the demonstrable potential effects of so-called ‘casual’ marijuana consumption.

“This study highlights apparent physical changes observed in the amygdala and nucleus accumbens of casual users compared to non-users. Granted, causality is not proven, but does it need to be for us to be concerned?

“Setting aside ‘legality,’ where does our duty begin with regard to caution of an unknown hazard? Should we, as those charged with advising the health of our patients, not demand evidence that such hazards are not present before acquiescing to the capricious eagre of our mercurial society?

“The most telling and scientifically accurate message should be that there is no known level of ‘safe’ recreational use of marijuana. Let us not retreat from wisely counseling our patients with Paul’s advice that while everything may be legal, everything is not good.

“We are free to do all things, but there are things which it is not wise to do. We are free to do all things, but not all things are for the common good” (1 Corinthians 10:23, BBE).

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