One Cause of Increasing Burnout of Physicians Is “the Politicization of Science”

(p. A25) Ten years of data from a nationwide survey of physicians confirm another trend that’s worsened through the pandemic: Burnout rates among doctors in the United States, which were already high a decade ago, have risen to alarming levels.

Results released this month and published in Mayo Clinic Proceedings, a peer-reviewed journal, show that 63 percent of physicians surveyed reported at least one symptom of burnout at the end of 2021 and the beginning of 2022, an increase from 44 percent in 2017 and 46 percent in 2011. Only 30 percent felt satisfied with their work-life balance, compared with 43 percent five years earlier.

“This is the biggest increase of emotional exhaustion that I’ve ever seen, anywhere in the literature,” said Bryan Sexton, the director of Duke University’s Center for Healthcare Safety and Quality, who was not involved in the survey efforts.

. . .

The increase in burnout is most likely a mix of new problems and exacerbated old ones, Dr. Shanafelt said. For instance, the high number of messages doctors received about patients’ electronic health records was closely linked to increased burnout before the pandemic. After the pandemic, the number of messages from patients coming into physicians’ In Baskets, a health care closed messaging system, increased by 157 percent.

And physicians pointed to the politicization of science, labor shortages and the vilification of health care workers as significant issues.

For the full story, see:

Oliver Whang. “New Survey Suggests An Alarming Increase In Physician Burnout.” The New York Times (Friday, September 30, 2022): A25.

(Note: ellipsis added.]

(Note: the online version of the story has the date Sept. 29, 2022, and has the title “Physician Burnout Has Reached Distressing Levels, New Research Finds.”)

Super PAC Heavily Funded by Associates of Bankrupt and Corrupt FTX, Donated $212,000 to John Fetterman Senate Campaign

(p. A1) In the three years since Mr. Bankman-Fried launched FTX, the company, its executives and its philanthropic arm spent or pledged hundreds of millions of dollars in political and charitable (p. A17) contributions, consulting fees, investments in media outlets and even real estate.

A network of political action committees, nonprofits and consulting firms funded by FTX or its executives worked to court politicians, regulators and others in the policy orbit, with the goal of making Mr. Bankman-Fried the authoritative voice of crypto, while also shaping regulation for the industry and other causes, according to interviews, email exchanges and an encrypted group chat viewed by The New York Times.

. . .

Mr. Bankman-Fried and Ryan Salame, another FTX executive, burst onto the big-money political scene during the 2022 election campaign.

. . .

In early March [2022], representatives for one super PAC, Web3 Forward, were pleased when the campaign of John Fetterman, the Pennsylvania Senate candidate, returned a completed questionnaire expressing support for the cryptocurrency industry, according to people familiar with the situation.

“Need nothing further from Team Fetterman. Thrilled he is pro crypto,” a consultant for Web3 Forward emailed an ally of Mr. Fetterman.

About two months after the email, Web3 Forward began airing an ad casting Mr. Fetterman as a working class champion who was not “gonna get schmoozed by lobbyists.” The super PAC spent nearly $4.7 million boosting Democratic candidates in the midterm elections, mostly in their primary campaigns, including more than $212,000 supporting Mr. Fetterman, who won his race and is set to begin his term Jan. 3 [2023].

. . .

In a statement, Adam Goldberg, a spokesman for Web3 Forward, said that neither Mr. Bankman-Fried, Mr. Salame “nor anyone else at FTX or representing its interests had any role in deciding the candidates we supported.”

But campaign filings show that Web3 Forward received almost all of the roughly $5.9 million it raised in 2021 from GMI PAC, a super PAC for which Mr. Salame was a founding board member. GMI, in turn, received about 32 percent of its nearly $11.6 million from Mr. Salame, Mr. Bankman-Fried and an FTX affiliate.

For the full story, see:

Kenneth P. Vogel, Emily Flitter and David Yaffe-Bellany. “‘It Was Relentless’: Inside a Crypto Exchange’s Bid for Influence.” The New York Times (Wednesday, November 23, 2022): A1 & A17.

(Note: ellipses, and bracketed years, added.)

(Note: the online version of the story has the date Nov. 22, 2022, and has the title “Inside Sam Bankman-Fried’s Quest to Win Friends and Influence People.”)

Elon Musk Asks Twitter Employees for “Long Hours at High Intensity”

(p. B5) SAN FRANCISCO — Elon Musk gave Twitter employees a deadline of 5 p.m. Eastern time on Thursday [Nov. 17, 2022] to decide if they wanted to work for him, and he asked those who did not share his vision to leave their jobs, in his latest shock treatment of the social media company.

Mr. Musk made the announcement in an early-morning email to employees on Wednesday [Nov. 16, 2022]; The New York Times obtained the message, which had the subject line “A Fork in the Road.” In the note, Mr. Musk, 51, reiterated that Twitter faced a difficult road ahead and offered employees three months of severance if they did not want to continue working there “to build a breakthrough Twitter 2.0.”

. . .

In his note to Twitter employees on Wednesday, Mr. Musk said they would need to work hard — very hard. “In an increasingly competitive world, we will need to be extremely hard core,” he wrote. “This will mean working long hours at high intensity. Only exceptional performance will constitute a passing grade.”

For the full story, see:

Kate Conger. “Musk’s Ultimatum: Buy In or Get Out.” The New York Times (Thursday, November 17, 2022): B5.

(Note: ellipsis, and bracketed dates, added.)

(Note: the online version of the story has the date Nov. 16, 2022, and has the title “Elon Musk Gives Twitter Employees a Deadline to Stay or Leave.”)

To Get Fed Funding, Rural Hospitals Must Agree to Transfer In-Patients to Bigger Hospitals that Do Not Want the Transfers

(p. A1) CASCADE, Idaho — It was 3 a.m. at the 10-bed hospital near the River of No Return, and by every measure, Ella Wenrich should have been dead.

Gastrointestinal bleeding had sent her hemoglobin level — typically above 12 — down to 3.3, and she needed an enormous blood transfusion at a larger medical center. But amid a surge in Covid cases, every major facility within 400 miles refused to take her. The smallest hospital in Idaho was, once again, on its own.

. . .

For 46 million Americans, rural hospitals are a lifeline, yet an increasing number of them are closing. The federal government is trying to resuscitate them with a new program that offers a huge infusion of cash to ease their financial strain. But it comes with a bewildering condition: They must end all inpatient care.

The program, which invites more than 1,700 small institutions to become federally designated “rural emergency hospitals,” would inject monthly payments amounting to more than $3 million a year into each of their budgets, a game-changing total for many that would not only keep them open (p. A16) but allow them to expand services and staff. In return, they must commit to discharging or transferring their patients to bigger hospitals within 24 hours.

The government’s reasoning is simple: Many rural hospitals can no longer afford to offer inpatient care. A rural closure is often preceded by a decline in volume, according to a congressional report, and empty beds can drain the hospital’s ability to provide outpatient services that the community needs.

But the new opportunity is presenting many institutions with an excruciating choice.

“On one hand, you have a massive incentive, a ‘Wow!’ kind of deal that feels impossible to turn down,” said Harold Miller, the president of the nonprofit Center for Healthcare Quality and Payment Reform. “But it’s based on this longstanding myth that they’ve been forced to deliver inpatient services — not that their communities need those services to survive.”

Some rural health care providers and health policy analysts say the officials behind the rule are out of touch with the difficulties of transferring rural patients. Bigger hospitals — bogged down with Covid surges, pediatric R.S.V. patients and their own financial woes — are increasingly unwilling to accept transferred patients, particularly from small field hospitals unaffiliated with their own systems.

There are also blizzards, downed cattle fences and mountain pass roads that close for months at a time.

. . .

Cascade Medical Center, where Ms. Wenrich was treated, seems like exactly the type of hospital that federal officials had in mind.

This former lumber mill community is home to less than a thousand people, but the hospital serves patients from across 2,800 square miles; patients travel up to eight hours round trip from homes without addresses.

For the full story, see:

Emily Baumgaertner and Michael Hanson. “Hospital Funding Has Catch: Cut Inpatient Care.” The New York Times (Saturday, December 10, 2022): A1 & A18-A19.

(Note: ellipses added.)

(Note: the online version of the story was updated Dec. 13, 2022, and has the title “A Rural Hospital’s Excruciating Choice: $3.2 Million a Year or Inpatient Care?”)

Deregulating Entrepreneurship Enables Upward Mobility

(p. A15) I saw the power of entrepreneurship firsthand after co-founding the Home Depot. My experiences led me to believe that preserving and expanding entrepreneurship is the key to advancing racial and economic equality.

. . .

With almost no money, I had the idea to open a hardware store, a lumberyard and a garden store all in one. What began as a single store in Georgia grew to more than 2,000 locations nationwide and made me a billionaire in the process. Only in America could a member of an ethnic minority from a poor immigrant family write that kind of success story.

. . .

You can see the entrepreneurs driving around town in their trucks full of tools and material. Many of them are minorities. They don’t consider themselves victims of racial wealth or income gaps; they are actively overcoming economic disparities through work.

That isn’t happening only in building and landscaping. In almost every part of the economy, you’ll find entrepreneurial minorities breaking through difficult circumstances to achieve and live the American Dream. Accelerating this process is the key to bridging the country’s economic divides.

Unfortunately, government is moving in the wrong direction, erecting hurdles to entrepreneurship. My company wouldn’t have succeeded if it had started in today’s climate of regulations and taxes that disproportionately burden small businesses. The Home Depot almost went bankrupt several times in its first decade, and today’s policy environment would have tipped us into insolvency—as it does to countless entrepreneurs each year.

The biggest victims of bad government policy aren’t the elite; they will always be able to get into good schools and get their foot in the door of corporate America. The people hurt most by big government are those who lack advantages in becoming economically independent, often minorities.

For the full commentary, see:

Bernie Marcus. “Entrepreneurship Will Lift Minorities Up.” The Wall Street Journal (Tuesday, Jan. 10, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date January 9, 2023, and has the title “A History of Humanity in Cubits, Fathoms and Feet.”)

Marcus’s commentary is adapted from his foreword to this book:

Ortiz, Alfredo. The Real Race Revolutionaries: How Minority Entrepreneurship Can Overcome America’s Racial and Economic Divides. Conroe, TX: Defiance Press & Publishing, LLC, 2023.

“It’s Not Clear What We Are and Aren’t Allowed to Say”

(p. B1) When Gov. Gavin Newsom signed into law a bill that would punish California doctors for spreading false information about Covid-19 vaccines and treatments, he pledged that it would apply only in the most “egregious instances” of misleading patients.

It may never have the chance.

Even before the law, the nation’s first of its kind, takes effect on Jan. 1 [2023], it faces two legal challenges seeking to declare it an unconstitutional infringement of free speech. The plaintiffs include doctors who have spoken out against government and expert recommendations during the pandemic, as well as legal organizations from both sides of the political spectrum.

“Our system opts toward a presumption that speech is protected,” said Hannah Kieschnick, a lawyer for the Northern California branch of the American Civil Liberties Union, which submitted a friend-of-the-court brief in favor of one of the challenges, filed last month in U.S. District Court for the Central District of California.

That lawsuit and another, filed this month in the Eastern District of California, have become an extension of the broader cultural battle over the Covid-19 pandemic, which continues to divide Americans along stark partisan lines.

. . .

(p. B5) The plaintiffs in California have sought injunctions to block the law even before it goes into effect, arguing that it was intended to silence dissenting views.

One of them, Dr. Tracy Hoeg, a physician and epidemiologist who works in Grass Valley, near Sacramento, has written peer-reviewed studies since the pandemic began that questioned some aspects of government policies adopted to halt the spread of Covid-19.

Those studies, on the efficacy of masks for schoolchildren and the side effects of vaccines on young men, exposed her to vehement criticism on social media, she said, partly because they fell outside the scientific consensus of the moment.

She noted that the medical understanding of the coronavirus continues to evolve, and that doctors should be open to following new evidence about treatment and prevention.

“It’s going to cause this very broad self-censorship and self-silencing from physicians with their patients because it’s not clear what we are and aren’t allowed to say,” said Dr. Hoeg, one of five doctors who filed a challenge in the Eastern District. “We have no way of knowing if some new information or some new studies that come out are accepted by the California Medical Board as consensus yet.”

. . .

Dr. Jeff Barke, a physician who has treated Covid patients at his office in Newport Beach in Southern California, said the law was an attempt by the state to impose a rigid orthodoxy on the profession that would rule out experimental or untested treatments.

Those include treatments with ivermectin and hydroxychloroquine that he said he had found to be effective at treating the coronavirus, despite studies suggesting otherwise. “Who determines what false information is?” he said.

. . .

“What comes next?” he said. “How I talk to patients about cancer? How I talk to patients about obesity or diabetes or asthma or any other illnesses? When they have a standard of care that they think is appropriate and they don’t want me going against their narrative, then they’ll say Barke’s spreading misinformation.”

For the full story, see:

Steven Lee Myers. “Law to Stem Medical Misinformation Is Facing a Free Speech Challenge.” The New York Times (Thursday, December 1, 2022): B1 & B5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Nov. 30, 2022, and has the title “Is Spreading Medical Misinformation a Doctor’s Free Speech Right?”)

Electrical Vehicle (EV) Chargers Are “Often on the Fritz”

(p. A1) One of the biggest roadblocks to the mass adoption of electric vehicles is the troubled business model for the commercial chargers that power them.

The government is pouring billions of dollars into developing a national highway charging network. But businesses aren’t sure how they will make money, and the nascent industry looks messy.

Utility companies and gas stations are at war with each other over who will own and operate EV chargers. Rural states say some charging stations could operate at a loss for a decade or more. (p. A10) New companies that provide charging gear and services are contending with the equipment’s spotty reliability.

. . .

Equipment is often on the fritz. Communications can break down between the car and the charger, the charger and the company operating the charging network, and with payment systems. On occasion, a wasp crawls into the gear and builds a nest. Vandals can strike, sticking gum in the credit card readers and bashing the machines.

. . .   A 2022 study led by the University of California, Berkeley tested all 657 public EV fast chargers in the greater San Francisco Bay Area and found more than a quarter didn’t work.

For the full story, see:

Jennifer Hiller. “Electric Cars Have A Charging Problem.” The Wall Street Journal (Wednesday, Nov. 30, 2022): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the story has the date November 29, 2022, and has the title “Why America Doesn’t Have Enough EV Charging Stations.”)

Some Gain-of-Function Bat Coronavirus Research in Wuhan Was Done in Level 2 Biosafety Lab (Instead of Higher Level 3 or 4)

(p. A1) Some scientists and officials in the Biden administration are pushing for more oversight, globally, of risky bioresearch. One focus is laboratory work that enhances a pathogen or endows it with new properties—sometimes called “gain-of-function” research—which is often done to assess its potential to infect humans.

. . .

(p. A12) Scientists and government officials have debated the risks of gain-of-function research since at least 2011, when virologists genetically modified the deadly H5N1 avian-flu virus so it could spread among ferrets.

. . .

Dr. Collins and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the risks could be mitigated, and the information might accelerate efforts to develop vaccines or stop outbreaks.

. . .

Then in 2014, the U.S. government declared a pause to gain-of-function research on certain dangerous viruses and set out to develop a new set of rules following incidents including an unintentional exposure of lab workers to anthrax bacteria and a discovery of some decades-old overlooked vials of smallpox virus.

Some research was allowed to continue: work seeking to identify coronaviruses that might jump to humans. Ralph Baric at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill and colleagues published a study of a bat virus closely related to SARS, or Severe Acute Respiratory Syndrome, a disease that emerged in 2002 and killed nearly 800 people.

. . .

They inserted a portion of the bat virus into a SARS virus adapted for lab tests in mice—creating a novel pathogen—and sought to see whether it would infect human cells. It did, and in mice it caused disease, though less deadly than SARS.

Then, he and his colleagues published research showing that another virus closely related to SARS infected both mice and human airway cells in the lab. They warned it was “poised for human emergence.”

Dr. Baric has said he thinks SARS-CoV-2 most likely evolved naturally to infect humans, yet he joined the scientists who in May [2021] called for serious investigation of the lab-accident hypothesis as well.

Researchers in Wuhan used techniques similar to his to test whether eight SARS-like bat coronaviruses had the potential to infect human cells, according to a paper they published in 2017. It was part of an effort to find out how SARS-like bat viruses might make changes that would render them a danger to humans.

Biosafety levels in laboratory research range from 1—used in high-school or college labs for work that doesn’t pose a disease risk to humans—to 4, reserved for the most dangerous pathogens.

At least some of the bat-coronaviruses work at Wuhan was done in a level-2 lab, which some U.S. scientists say is too low a safety level for that kind of work.

For the full story, see:

Betsy McKay and Amy Dockser Marcus. “Virus Research Explodes, Igniting Worry.” The Wall Street Journal (Saturday, Sept. 25, 2021): A1 & A12.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date September 24, 2021, and has the title “Virus Research Has Exploded Since Covid-19 Hit. Is It Safe?”)

Regulation of Truckers’ Driving Hours Caused Higher Speeds and More Fatalities

(p. A13) Falling asleep at the wheel is deadly. “It is obvious that a man cannot work efficiently or be a safe driver if he does not have an opportunity for approximately 8 hours sleep in 24,” the Interstate Commerce Commission declared in 1937. Ever since, federal rules have limited the work hours of interstate truckers. Also ever since, truckers, their employers and their customers have circumvented the rules when they stand in the way of making money.

Congress tackled the problem in 2012 by requiring long-distance truckers to track their hours with an “electronic logging device” connected to the engine. The mandatory rest breaks and the limits on drivers’ daily and weekly hours didn’t change, but the Transportation Department estimated that monitoring compliance with an ELD would avoid 1,844 crashes and save 26 lives annually.  . . .

. . .

In “Data Driven: Truckers, Technology, and the New Workplace Surveillance,” Karen Levy makes a provocative case against this approach.   . . .  Her concise and lively book will interest anyone concerned with the complicated business of regulation.

. . .

. . ., Ms. Levy raises important questions about regulation in general by examining the unintended effects of a well-meant initiative designed to address a serious safety problem. She reports on a 2021 study linking ELDs to greater compliance with regulations but no reduction in truck crashes. Fatalities in crashes involving large trucks actually increased, as drivers sped up to cover as many miles as they could during their permitted driving time.

For the full review, see:

Marc Levinson. “BOOKSHELF; Miles of Mandates.” The Wall Street Journal (Wednesday, Jan. 4, 2023): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date January 3, 2023, and has the title “BOOKSHELF; ‘Data Driven’ Review: Miles of Mandates.”)

The book under review is:

Levy, Karen. Data Driven: Truckers, Technology, and the New Workplace Surveillance. Princeton, NJ: Princeton University Press, 2022.

FTX Fraudster Bankman-Fried Made $40 Million in Midterm Political Donations Which Mostly “Went to Democrats and Liberal-Leaning Groups”

(p. A1) FTX founder Sam Bankman-Fried oversaw one of the biggest financial frauds in American history, a top federal prosecutor said in charging that the former chief executive stole billions of dollars from the crypto exchange’s customers while misleading investors and lenders.

. . .

(p. A6) Mr. Bankman-Fried is also accused of defrauding the Federal Election Commission starting in 2020 by conspiring with others to make illegal contributions to candidates and political committees in the names of other people.

He and his associates contributed more than $70 million to election campaigns in recent years, The Wall Street Journal previously reported. He personally made $40 million in donations ahead of the 2022 midterm elections, most of which went to Democrats and liberal-leaning groups.

For the full story, see:

Corinne Ramey, James Fanelli, Dave Michaels, Alexander Saeedy and Vicky Ge Huang. “FTX Founder Is Charged With Fraud.” The Wall Street Journal (Saturday, Dec. 14, 2022): A1 & A6.

(Note: ellipsis added.)

(Note: the online version of the story was updated Dec. 13, 2022, and has the title “FTX’s Sam Bankman-Fried Charged With Criminal Fraud, Conspiracy.”)

As of January 2022, Koch Industries Had Invested $1.7 Billion into Renewable-Energy Infrastructure

(p. B10) Norwegian startup Freyr Battery and energy conglomerate Koch Industries Inc. are accelerating their plan to build a multibillion-dollar battery plant that will be among the largest to tap incentives in President Biden’s climate, tax and spending plan, Freyr said.

. . .

Koch has emerged as one of the biggest investors in batteries, a turnabout from its emphasis on fossil fuels. It has said it wants to benefit from the falling cost of renewable-energy technologies and help drive it down further. As of January [2022], it had invested a total of $1.7 billion into electric batteries, energy storage and solar-power infrastructure, according to its website.

The plan is unusual among battery projects in being dedicated primarily to the energy-storage market rather than electric vehicles.

For the full story, see:

Stephen Wilmot. “Koch Teams Up on Battery Plant.” The Wall Street Journal (Saturday, November 12, 2022): B10.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the story has the date November 11, 2022, and has the title “Koch Teams With Startup to Build Giant Battery Factory.”)