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The art of being different – a girl scout’s story

Girl scout cookie season is upon us, and recently our office was swarming with youngsters taking cookie orders. I wasn’t sure which girl I should order from (one can’t really order from each of them and expect to maintain any semblance of a normal BMI) and as I was considering how to choose, one energetic little girl simply walked right up to me and asked if I’d like some cookies.

She was slim and blonde, with bright eyes and an honest face. I knew the “sales pitch” didn’t come naturally to her, and I tried to make it easier by joking a bit. She was shy, but on a mission. I asked her which type of cookie she liked best, and if her daddy ate too many of them. She was innocently pleased with the interaction and disappeared down a hallway near some cubicles.

Many weeks later a large delivery of girl scout cookies arrived. There was a mass distribution strategy in place with moms and girls cutting open cardboard boxes of cookies and delivering them to buyers. I asked if my cookies were on the list. They told me that they didn’t sell me the cookies, so I’d need to wait for the specific little girl who sold them to me to stop by.

About a week later, when I had assumed that my little girl scout had forgotten about my order (and the rest of our staff had well and truly gorged themselves on thin mints), her dad came into my office with a pretty bag tied with a ribbon and a hand written card from his daughter. He told me she asked him to deliver it personally, because she wanted her service to be different than the other girls. Her dad joked that he was trying to train her about “differentiators” but I was quite touched by the effort she had made to make me feel like a special customer.

Later that afternoon I sat down to write a thank-you card to the girl. I wanted her to know that her efforts made a difference, and that I noticed her hard work in making my cookie purchase a personalized experience (not just part of a bulk delivery service). I put some stickers on the card, I used colorful paper, and a big red envelope.

A few days later I asked her dad if she liked the card. This is what he wrote to me:

“She loved it. She saw it at breakfast and came screaming upstairs to show it to everybody. Thanks!”

That really made my day. I hope in some way that I’ve encouraged this little girl to continue to reach for excellence, to stand out in the crowd, and to know that her work is appreciated. It is this sort of attitude toward life that will help her grow up to be… a revolutionary.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Does “aging gracefully” require plastic surgery?

In this latest report from the BBC, we see that our friends across the pond are just as obsessed with appearance as we are in America. Apparently, women in their 70’s and 80’s are getting cosmetic breast surgery and face lifts.

One surgeon is quoted as saying:

“We have a growing population of pensioners – and for those who want to maintain a good appearance, ageing gracefully, the surgical options are there.”

Since when did gracefulness have anything to do with surgery?

I wonder if we’re missing the more important things in life (friendship, love, kindness, charity) by focusing on our exteriors? Beauty is a matter of the heart, I think.

Sophia Lauren once said, “Nothing makes a woman more beautiful than the belief that she is beautiful…” but then again, it looks as if she’s chosen to have extensive cosmetic work done as well.

What do you make of the growing trend in plastic surgery among seniors?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Food Labels: Brits Vote to “Keep It Simple”

In a recent poll, 80% of consumers (along with the British Medical Association) preferred a simple “stop light” food label to a long list of percentage figures of recommended daily amounts. The stop light icon simply categorizes food as containing low (green), medium (yellow), or high (red) levels of the following ingredients:

  • Fat
  • Saturated Fats
  • Sugar
  • Salt

The guideline daily amounts (GDA – the rough equivalent of America’s RDA system) supporters argue that the stop light is an oversimplification, and does not effectively convey all the important nutritional value of food.

What do you think? Would you like to see this sort of labeling in the US?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

What does a twinkie have in common with your car?

Well, twinkies are made of petroleum (among 38 other ingredients), and gasoline is also a type of petroleum product! This gives “food as fuel” a new meaning.

Dr. Charles, a young family physician, reviews the ingredients of twinkies in his recent blog post amusingly called “Reduce Twinkie Consumption and Dependence on Foreign Oil.”

This reminded me of the shock I felt when watching a documentary about America’s oldest citizens recently. I clearly remember them interviewing a man who was about 105 years old, who lived alone and used a golf cart to get around outdoors. The interviewer couldn’t resist asking the man why he thought he had lived so long in such good health.

The man said, “Well, I eat pretty good, get enough sleep, and I don’t worry about much.”

The interviewer then asked a probing question, “What do you eat?”

And I leaned in towards the TV screen, curious as could be.

And the elderly gentleman said, “Well, I eat a bowl of cornflakes for breakfast and then I usually eat a twinkie later on…”

Either the segment didn’t plan enough seconds for further investigation, or that was the sum total of his nutritional advice.

I was dumbfounded. For some people, it seems, good genes and good luck take them a long way.

But I’m still not going to eat petroleum products.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

The dark side of measuring healthcare quality?

Improving quality in healthcare is an important fundamental goal. New “pay for performance” measures initiated by the Center for Medicare and Medicaid services is a well meaning attempt to provide financial incentives to physicians who demonstrate improved patient outcomes. Unfortunately, this incentive program could backfire.

A recent article in Medical Economics (via Kevin MD) raised the question of “cherry picking and lemon dropping” your way to higher pay. In this frightening scenario, physicians would be tempted to select healthier, more compliant patients for regular treatment in their practices. In this manner, they can demonstrate better outcomes, since the sicker, poorer, or less compliant patients no longer factor into their performance measures. And with the upcoming physician shortage, it really is a seller’s market.

It is critically important for the government programs to allow physicians to accurately risk stratify their patients so that they are not financially penalized for taking care of sicker patients bound to have below average outcomes. The same goes for surgeons, who should not be discouraged from undertaking potentially lifesaving surgeries for patients who are critically ill.

Dr. Kellerman, the president of the American Academy of Family Physicians, reminds us that quality of care is vastly improved by having a central medical home (i.e. one physician who can coordinate care for patients, so they’re not left with a group of disconnected specialists ordering duplicate tests and prescriptions). I personally think that a centralized EMR/PHR controlled by the patient (and located at an Internet based “medical home” complete with disease management tools and the ability to email a physician as needed) would go a long way to improving quality.

What do you think?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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