Root Canals, the Economy and Health Care in General

Since October I’ve been making the rounds of appointments between a general dentist, oral surgeon, endodontist and periodontist. What started as a simple filling turned into six months of extractions, surgery, root canals, re-treated root canals and more surgery. I’ve discovered how nerve damage can affect ability to pronounce words, cause loss of taste and contribute to TMJ making it painful to chew food. But this post isn’t a tale of woe, nor a complaint against these professions.

I’ve had good care despite complications and, thankfully, I have dental insurance that has covered a major portion of the costs. But the experience has highlighted a health issue I’ve given little thought. How we pay for dental care needs reforming as badly as other segments of health care. But dentistry isn’t mentioned in the wider health care discussion perhaps because it’s not perceived as the cause of life-threatening conditions and, except in acute circumstances, it’s considered optional. But oral health is neither benign nor optional. It’s as important to quality of life as sound heart and lungs, and as directly connected through the circulatory system. Sometimes a toothache isn’t just a toothache.

Sitting in waiting rooms I’ve heard patients talk about health, work and money. They speak of working with pain or missing work. Their untreated problems are costly to businesses in lost productivity and effectiveness. And dental problems are equally costly to individuals. They contribute to other health problems, some of which have significant effects on individual health. They can lead to emotional reactions that affect attitudes on the job. And they are costly in lost wages.

In every waiting room I’ve heard patients negotiating how to pay for services, sometimes unsuccessfully. I’ve wondered about the woman with no dental insurance who needed endodontal services but couldn’t work out a payment plan and the student looking for a referral who would take a small insurance payment. What does one do when the problem doesn’t go away but the cost is prohibitive? Find a dental school clinic? Keep searching for another provider who will deal? Stock up on ibuprophen and self-treat the symptoms?

Probably all of the above, especially if you’re working and can’t spend the time doing this research and can’t get the money together to pay the upfront portion of a large bill. In every office I’ve visited, the first matter dealt with is ability to pay. Then the consulting and diagnosis begin. Receptionists are trained to make clear what the costs will be. It’s done with finesse in some places and heavy-handed clumsiness in others, but in all cases this is the first item of business. (pun intended)

After hearing many variations of the problem, I wonder how many patients dental professionals are carrying and writing off. While I don’t wonder why the receptionists are trained to screen for financial ability, nor why the dentists don’t want to discuss finances after the patient is in the chair, a couple of times I felt as if I were buying a used car.

“If we do option A it will cost $500. Option B will cost $1000. Any questions?”

I say, “No.”

But I’m thinking, “Whatever it takes to end this pain.”

“Sign here for option A, and here for option B.”

Monetizing medical procedures changes the relationship between  patient and provider. It frames health and healing as a commercial relationship, which it is of course, but only in part. It is also a relationship of trust and compassion. One hopes for something more than a financial transaction, a modicum of personal touch and humanity, perhaps. I hope the person putting sharp objects in my mouth while I’m drugged is not only technically skilled but also compassionate and sensitive to my fears and concerns. Framing our exchange as a transaction from the outset puts this into question. It changes expectations, trust and, perhaps, results. I suspect it changes attitudes toward healing and followup.

Am I just old-fashioned and out of touch? Should we even attempt to change? And what would we change if we could? Well, that’s for another day. And I haven’t even begun with the time-consuming, wasteful, frustrating, incoherent maze we call insurance–dental insurance, health insurance, prescription drug coverage. But I’ll stop here. Just thinking about it reminds me I’ve got to take a pain pill.

Can Macs Get Malware?

Macs are relatively free of spyware, malware and malicious trojans, so they say. "They" are those who know better than I how computers become infected. And truth to tell, until now I’ve had no hint of infection and I’ve used a Mac for several years.

That changed recently when this blog got an unwelcome visitor. Fortunately, I was aware of the intruder almost as quickly as it appeared and removed it in a matter of minutes. But it was pure luck.

The visitor appears to be malware that attached a corporate logo and link to the opening page of Perspectives along with the Share This plugin logo. The logos redirected users to an online Japanese electronic store.

I disabled a suspect blog plugin and ran software to remove malware. I followed this with commands to remove infected files I found on the Internet from a reliable Mac magazine . I’m a rank amateur at using terminal commands but the instructions were clear and graphically illustrated. The symptoms matched and instructions to remove it worked, to my relief. I checked for unusual files in WordPress, based on other descriptions provided on the web.

Even after this I was unsure of my efforts and went to the Mac store and a local Mac dealer and asked about malware removal and protection. While staff at both places were courteous and helpful, neither was familiar with malware on a Mac because, they said, it’s so unusual.

The folks at Mac Authority took the time to look at my files, however, and agreed they look as they’re supposed to.

A couple of Mac blogs comment that as Macs increase market share they’re becoming bigger targets for viruses and malware. I can’t confirm that, but I can confirm that it’s a strange feeling to discover someone’s gotten into your computer and is using it for their purposes. It’s the same as someone violating your privacy. And, in fact, that’s what malware, spyware and viruses do. Hackers break into your space, and some are more damaging than others.

Windows users are familiar with viruses and other malicious intruders and know they must be on guard. As a Mac user, I’ve been less cautious but that changed today. I’m less trusting and better protected.

Social Ethics, Global Trade and Christian Faith

A few years ago I said in a meeting of colleagues I thought my denomination needs a global trade specialist. My remarks were met with a chuckle by one person and fell into the bottomless silence of rejection without words.

Now we’re in the midst of a global economic crisis that demands more of theologians than the balm of words. It demands structural change to address accountability, responsibility, equity and justice through specific actions.

Churches are good at offering words of comfort and hope. Words of hope and comfort are necessary and important. We need to be reminded that meaning and purpose in life are not defined by the bottom line of balance sheets. In Christian teaching, the core of faith is hope.

However, sometimes we need to be reminded that quality of life is also about our relationships to each other individually and collectively in communities of people, some of whom we know and some we don’t. Another core teaching of the faith is that we exist in community.

We need social policies and laws that at least attempt to ensure equity and justice in the economic system for all people. That’s why I thought we needed a global trade expert who could operate deftly in both social ethics and global economic policy. Mohammad Yunus is already offering insights that provide a different lens through which to view economic policy with his social business models, for example.

For the past several years religious faith in the public conversation has been narrowly defined by conservative politics and a culture war agenda. Morality was framed as individual behavior. Corporate accountability was ignored. While these debates raged, the world got its pockets picked by those who gamed the system. This is a theological issue and it’s about more than individual behavior, or even good personal intentions. It’s about our responsibility to ourselves, to each other and to God.

William Sloane Coffin said "Given human goodness, voluntary contributions are possible, but given human sinfulness, legislation is indispensable. Charity, yes always, but never as a substitute for justice. What we keep forgetting in this country is that people have rights, basic rights; the right to food, the right to decent housing, the right to medical care, the right to education." (Credo , William Sloane Coffin, Westminster John Knox Press, pp. 55-56)

Thomas Freidman writes that the world has reached a point of historic change. He refers to Paul Gilding’s phrase, the "great disruption." We’ve hit a wall. The whole growth model we created over the last 50 years, Freidman writes, is simply unsustainable economically and ecologically.

That behavior has led to the collapse we’re all struggling through just now, but it will return. And when it does, we as a society must ensure justice and collective responsibility are more than promises. They must be expressed in social policies that protect human rights and look after our communal responsibilities on a global scale.

It’s now abundantly clear that the world is so interrelated that economic ripples in one region slosh into other parts and cause erosion, or worse. Much as some try to deny it and fall back into national parochialism, we are global citizens. The system in which we live is global. Sometimes we forget how interdependent we are. But everything from the fruit we buy to the clothing we wear is now a globalized product. Our churches and educational systems have not caught up to preparing us for global awareness and a few loud voices are actually opposed to it.

We need new models . And the models should be informed by our best ethical thinking in addition to new sustainable economic policies. As Coffin said, Christian faith teaches that we are connected to each other through a variety of bonds that include human rights and a fundamental belief in human dignity. Where these values have been overshadowed by the contentiousness of the past few years, we need to put it to rest and offer a more holistic definition of faith.

In the perceptions of many in the U.S. and globally, Christianity is viewed as intolerant, doctrinaire and anti-science. Among other things, faith leads to probing questions, inclusive thinking and a framework for ethical behavior individually and collectively. It’s a comfort in times of distress but it’s also a challenge to act, to question and to stand for universal values that affirm the goodness of Creation and the human community.

Further, as I understand it, Christian faith is ultimately about service and sacrifice, both values that are counter to the  culture of individualism and acquisition. As the world looks for new models of behavior individually and collectively perhaps adding these values to the discussion could benefit the global community. They need not be proposed in a sectarian way. They are shared values that permeate many of the world’s great religions and ethical systems. The tragedy of the past decade is that we forgot them, or they got out-shouted by fear and undermined by self-serving behavior.

If we are indeed at a hinge point in history, and if the cultural values by which we’ve lived these past decades must change, then the time has come for a new social ethic , or a review of the social ethic that got set aside and ignored as we fought about these other issues.

And that’s why I thought my denomination needs a specialist in both social ethics and global trade, and it still does.

From Santelli to Kramer to CNBC

(Update: It just keeps on going and going and going and going.)

As millions of others, I’ve been watching the spat between the Daily Show and CNBC as it evolves. David Bauder of the Associated Press writes of the more serious journalistic questions the public interrogation is raising about CNBC . The trail from Santelli to Kramer is now leading to questions about the relationship of CNBC’s business journalists to the businesses and business persons they cover and it’s raising ethical questions about rumors and their effects on stock prices.

Bauder quotes Dean Starkman of the Columbia Journalism Review saying the CNBC commentators need adult supervision. He says they need to assess how closely they are to their subjects and get critical distance.

The issue of proximity in business news coverage isn’t particularly new and it isn’t limited to CNBC. In another period of my life I challenged–very mildly and unsuccessfully–PBS for its business news coverage. I proposed a  television documentary on an economic development project which would have been funded in part by religious organizations. PBS wouldn’t consider it because of these funding sources. They viewed it a conflict of interest.

I asked them how it was possible, then, for Wall Street Week, to receive sustaining production funds from the same businesses whose stocks and operations were discussed on a regular basis by the program’s host and guests. I received no answer and our conversation ended.

Beyond proximity, the story is viewed from another angle in a blog post on Fortune/CNN. Comments by Kramer about Apple stock in a video reprises attention about media comments, rumor and stock pricing. Kramer outlines how a strategically placed rumor could affect Apple’s stock prices. This raises a different ethical dimension to the story.

Santelli’s rant has focused attention on the relationship between business journalists and the subjects of their coverage. Stewart has brought the standards, ethics and practices of CNBC’s business coverage into public scrutiny.

If, for no other reason, we can thank Santelli for this, but he probably didn’t intend to put the credibility and reliability of CNBC’s business news coverage in the spotlight.


Kramer appears on the Daily Show and it’s covered by several media outlets.

The Motley Fool makes A Modest Proposal for Jim Cramer.

The Daily Show has moved from Santelli to sharp critique of CBNC’s Jim Kramer, CNBC and NBC. Bloggers have picked up the storyline.

It’s becoming a study in the dynamics of crisis communications management in the new media environment involving cable, broadcast, blogs and online video.


Drew Kerr on ragan.com, makes it clear why there’s nothing worse than saying "no comment."  Kerr gives the background to Jon Stewart’s sharp satire on Santelli and CNBC after Santelli "bailed out" after agreeing to appear on the Daily Show.

Santelli not only brought attention to himself, he brought scrutiny to the network, and it’s not favorable. In fact, it’s withering. An old principle of journalism states the reporter should not become part of the story. Neither should the reporter’s organization.

With the refusal to appear on the Daily Show, Santelli broke a principle of public relations, Kerr says. He says it would have been better for Santelli to appear, laugh at himself, take the ribbing he would surely get from Stewart and let the air out of the balloon. He didn’t, and he gave the story new legs. He brought attention to his colleagues at CNBC and they were held up to unfavorable public satire. The story lived for yet another day.

All this from "no comment."

HP Mini Review

I’ve been working with the HP Mini 1000 Netbook for about a month. I chose it for its keyboard. HP says the Mini’s keyboard is 92% the size of a full size keyboard. It’s laid out edge-to-edge, similar to 12" Mac laptops. This allow for larger keys than other netbooks, and it’s a decided advantage for comfort and function. I used it during a board meeting and took notes during a visit to Southwest Airlines general offices and found it a good choice. I got nearly three hours of battery life before re-charging.

The HP Mini has been priced slightly higher than other netbooks but Costco recently sold it online at a competitive price and street prices seem to be edging downward.

It weighs in at 2.3 lbs and easily slipped into a carry-on bag. Thankfully, it won’t cause back strain. I travel frequently and weight makes a difference.

In most other features , the mini is competitive with other netbooks but it has a few limitations. It has a single switchable jack for mic or earphone use and two USB ports. Dell has three USB ports and jacks for both audio and mic. And HP also expects you to buy a proprietary SD card for an external drive. A standard media card would probably have been sufficient. The Mini comes with a webcam. It runs on the same Intel Atom processor others use. This processor is adequate but you can over-task it and you’ll have wait for it to catch up, and eventually it does.

Mouse keys are located on the left and right of the touchpad and I found it easy to adjust to this arrangement. The left side of the touchpad moves the cursor while the right side scrolls the screen. I’m used to Mac touchpads that allow me to use one finger to move the cursor and two to scroll. The transition here is easy enough, yet it’s not quite the same. Sensitivity, however, is a moving target. I’m still experimenting with touchpad sensitivity and cursor speed.

The netbook came with Windows XP but after a couple of weeks I downloaded HP’s Mi Linux operating system. If you buy it configured on the netbook, this edition is approximately thirty dollars less than the XP version. HP recommends the XP version but in my opinion Linux is more intuitive and functional, especially if you’re used to the Mac OS. The HP Linux adaptation, however, disables the command line function of the Ubuntu Linux operating system which I find frustrating.

However, after using it for a week, I’ll keep the Ubuntu system even with HP’s limits. It’s closer to the Mac OS, but far from equivalent to it. I like the desktop which includes easy access to email, favorite web pages, videos, music and a file browser. The open source software performs remarkably well. I’ve synced my bookmarks on Firefox , and Thunderbird email works as well as any off-the-shelf program, in fact, better than some that cost a pretty penny. Open Office is more than adequate for word processing. I haven’t tried the spreadsheet or presentation software.

I plugged in a new Minos Flipcam to see how it would work with the HP and the media player downloaded and played the Flipcam video without a hitch. However, the HP doesn’t want to download the Flipcam’s editing software which is written for Windows and Mac. I also discovered it won’t play TokBox video online. When I tried it set off a loud screech that brought staff running into my office. That’s a humbling experience in a technology company.

Netbooks won’t replace full-featured laptops. They’re made to read email and access the Internet. They’re mostly plastic, inexpensive and, therefore, replaceable if stolen, lost or dropped. I like the HP, but after using it for a few days while traveling, I returned to a full-size MacBook Pro with a smoothly operating glass touchpad and it felt like a cool drink on a hot day. I realized how constricting the small screen is, and how it requires to you attend to it more intensely. A netbook is a useful, functional utility. A MacBook is a wholly different experience.

Media Convergence or Individual Empowerment?

A billboard with the phrase iamsecond .com peaked curiousity in Dallas and drove the curious to a website where they learned it was a religious campaign. It was intriguing and edgy. Blogs were employed to create a viral response. Get enough people referring to the campaign through social media and drive them to the website and you’ve created the buzz necessary to  build awareness without putting enormous money into the campaign.

The campaign converges multiple media; print , billboards, blogs , video, earned media and a book. It illustrates how people use information differently and follow different media paths to get it. Today there are more pathways and more information than ever.

And that’s what has marketers, editors, publishers and other media types frustrated, mystified and excited. Multiple media empower people in ways unimagined. These pathways can lead to separation so extreme it can seem like the atomization of the individual. And they converge in ways that are more holistic, useful and community-building than ever. Thus, the dilemma and promise.

But the media landscape is built, it seems, on shifting sand and information users are a moving target. As quickly as we adopt a new form of media something replaces it and early adapters move to it, leaving the old “new” media behind. Jeff McNealy, CEO at Sun Microsystems says,Technology has the shelf life of a banana .”

Where but a technology museum would one find an artifact only thirty years old? he asks.

And this technology is re-pogramming us. Like the young adults we heard in our meeting, people develop sophisticated capacity to filter out those messages they don’t want to deal with and equally sophisticated ability to utilize media in a way that serves their purposes. The old gate keeping systems of one-way information flow are broken and we’ve yet to fully comprehend how the new media will deliver reliable, trustworthy information when anyone can be a producer and generate content. (I know some critics don’t think mainstream media have done this job well, but the question of veracity and truthfulness is never the less a standing issue on the wide open Internet. And whether the self-correcting capacity of the Internet can run as quickly as an untruth remains in question, as I see it. Mark Twain’s comment still holds, “A lie can travel half way around the world while the truth is putting on its shoes.” Today a lie can travel the whole world in a millisecond before truth can reach for its shoes.) But this is a diversion from the subject at hand–convergence.

Convergence has been applied to multiple technologies residing on one device, and to multiple media whose content relate synergistically. Whichever perspective you take, the result is the empowerment of individuals. They not only choose which technology to use, they use the technology to reach content they desire. And therein lies opportunity and challenge.

To Tweet or Not to Tweet, That is the Question

The discussion in the board meeting about the usefulness of Twitter was like a ping pong ball–it’s useful, it’s a time waster. Back and forth it went. But it was a moving feast of discussion, not merely a predictable debate with no resolution.

It’s clear most of us don’t want to know when someone just stepped out of the shower. But we are interested in ideas, links and helpful suggestions about myriad subjects. In fact, some are using Twitter for this purpose and are creating "knowledge communities." Others haven’t found it worthwhile and have let their Twitter accounts go idle.

In an article a few weeks ago NY Times technology writer David Pogue wrote about an experiment in which he posted a question on Twitter (How do you cure hiccups?) as he spoke to a trade group. He received his first response in 15 seconds and they continued for several minutes. The primitive experiment was an illustration of an instantly available knowledge community.

In our meeting we used Twitter to capture short, key points we thought worth flagging for later discussion and expanded consideration. Subjects can be identified with a hashtag # and title. For example, #title can be accessed at search.twitter.com and all the posts related to the #title will display. Already, however, some Twitter users are complaining that overuse is making the search tool less useful.

The blog Wardman Wire discusses a the use of Twitter as a virtual meeting tool.

We also used Facebook to share ideas and capture points for later processing and discussion. Everyone had a netbook or laptop and could participate. A website for our Commission has been created for online communication about the issues, strategies and key communication concerns identified at the meeting.

It’s too early to know if this style will prevail and how valuable it will be in the long run. Most likely, it will serve a purpose under specific circumstances and be less useful in others. But the introduction of social media to the conversation about how to reach out to new people was fruitful and will be informed by this experience regardless.

More tomorrow.

New Media. Who Uses What? Why? And How?

As the young panelists addressing our board meeting discussed how they use new media it became instantly apparent that generational differences in media usage are like chasms in the Arizona desert. Some in our group had never heard of Twitter. Others use it frequently. Some are on Facebook, others not.

On one hand, the panelists, including our own young adult board members, said they are moving away from Facebook because their elders had discovered it. They related how they use text messaging for personal contact and hinted that it is a way to avoid some of the discomfort of communicating face-to-face. And they emphasized how the technology is both as natural as breathing and also a background function enabling them to fulfill a real need for meaningful, authentic relationships. Technology shouldn’t get in the way of relationships and should be used to enhance them, they said.

One young woman indicated her primary community involved face-to-face contact and she uses text messaging and other tools to enhance personal interaction.

On the other hand, in a small group discussion later, a very perceptive young adult member of our board told the group she uses Facebook for more meaningful relationships with friends around the world, and these relationships contrast with her day-to-day casual relationships with people at work, in classes and elsewhere.

Her meaningful community–the people she goes to when she has important questions–are those with whom she’s shared important life experiences, and they live in Africa, Europe and across the U.S. They are her primary community.

Another member of the board from another generation has a similar community. Having been imprisoned by an authoritarian regime in the past, he has renewed his relationship with two men with whom he was held captive. They live in different countries and meet up on Facebook. No one can understand the meaning of their experience and its influence of their lives quite so authentically as the three, he said.

Social networking tools are replacing some qualities of face-to-face community while also enhancing face-to-face community. We are experiencing new forms of community and seeing the decline of old forms of community, perhaps even seeking, as one SMU professor said, the loss of skill to relate to each other face-to-face.

These tools make possible community in real time and on-demand, as intimate or as distant as you want it to be. They must be used carefully, with sophistication and concern for privacy. And young people need to consider how online images and comments might affect them in the future.

These tools can be abused and be terribly harmful, or utilized in a way that makes life more understandable and even compassionate.

More tomorrow.

Is Advertising Dead?

(Update: Traditional branding is broken according to an article in Marketing Vox .)

The good news is the folks I wrote about yesterday are concerned about and calling for review of the brand promise of the denomination. They’re paying attention. This is a good thing. In fact, it’s a wonderful thing!

For a mainline denomination to have conversation about its brand and how to describe itself in the media is a conversation worth having–wide and deep. It’s exciting and almost breath-taking in light of the history of the mainline which has been to disengage and abdicate responsibility for media presence. So, thank you treasurers of the church. Your feedback is welcome, heard and gratefully received.

For strategic reasons, we will continue with the strategy that is bringing us success, but we are adjusting it to fit the interests, media practices, information utilization and expressed needs of the target audiences with whom we’re trying to communicate.

Network television ratings and audience share have continued a downward slope since the 1980’s and have begun to approach a point where diminishing mass puts the business model of network broadcasting in peril. Radio faced this challenge when television became the dominant medium and transitioned to serving "niche" audiences. Radio isn’t out of the woods by any means as young people are not relying upon it in the same way their elders did. But it has adapted, for now.

One of the points made by the Pew State of the News Media 2008 report is the uncertainty that has crept into advertising company offices. The report says, "Talking to ad executives, one gets the sense that few know how to cope even with the changes to the media landscape that have already happened, let alone the ones that are still to come."

If the business models that have sustained network television are dying, what does that say about advertising? Will a new model emerge and what will it look like? Product placement inside programming is one of the adaptations. How will it be accepted and how will it affect content?

Given the highly evolved capacity of the audience to filter out messages, how does one gain "mind share" today? These questions are part of the unsettling dynamics of the changing media landscape we inhabit.

More on this tomorrow.

The Brand’s Working, Drop it!

I got a note from a colleague that instructed me to change a key component of the advertising of the denomination for which I work. The note was unusual for many reasons, not the least of which was the naivete it revealed about communications strategies.

A group of treasurers had decided, the note said, that the "theme" of the campaign had outlived its usefulness. That this was an opinion based on personal perspectives escaped the treasurers who otherwise are people who demand facts and figures before making decisions.

In fact, the research shows the brand promise–which they refer to as a theme–has not only worked to establish an identity that is sticking in the perception of people who don’t know the church or are hostile to it, it is far from being obsolete. It’s only begun to be appropriated and understood.

As with any message in the volatile media landscape in which we exist, it must be adjusted, redefined and assessed continually. A brand is a living relationship. It’s dynamic.

Moreover, in the territory of the mind there is no deed that grants permanent recognition of an organization or a brand. It takes constant repetition and reinforcement to maintain awareness in a world in which the average person is confronted with more than 20,000 messages a day. When this brand was created, the awareness of the church did not register in unaided recall among the target population. Eight years later unaided recall is between 30 and 40%.

I can only imagine what would happen if I were the CEO of a major corporation that had seen a 40% increase in its favorable rating and actually took the advice of the accounting department when they said without basis in research, without knowledge of the marketing strategy, or future plans, "OK, that’s done, now let’s move on. Change it."

I’ve written ad nauseam in this blog about the inexperience of mainline denomination leaders in media. So I won’t go there again but to say that we are on a steep learning curve and it’s urgent that we catch up to the present as best we can while also trying to stay abreast of the current wave of technology as we look to the future. And that’s the challenge these oldline religious organizations face. It’s a challenge they may, or may not, be up to. Only time and experience will tell.

I’ll have more to say about this tomorrow.