The Oriana Singers
WEEK IN REVIEW
William Metcalfe, Conductor
ETHICAL TREATMENT
The Vermont Air Guard 134th Fighter Squadron has had some pretty noisy
Bravo, Harry Bliss, for your insightful, apropos cartoon [“Bliss,” November 27]. Foie gras is a product of convenience and ignorance: It’s convenient to ignore the means of obtaining it because there is no justifiable reason to sell or eat it but for self-serving profit or gratification. Wouldn’t it be remarkable if we were all conscientious, responsible business owners and consumers making decisions based on a broader outlook of the world rather than what will simply fatten our wallets and guts? Lisa Vear
St. Paul’s Cathedral, Burlington
Tickets: FlynnTix.org or at the door: $25 general/ $10 students
Grand OpeninG
december 16
Spinning classes now open for registration
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Go online today or stop in and see us just off the corner of College and St. Paul!
ENJOY THE RIDE 126 College Street, Burlington 802-363-0564 • cyclepathvt.com
ONE-OF-AKIND GIFTS GALORE!
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FOIE GROSS
Friday, December 13, 2013 at 7:30 pm
12/6/13 12:39 PM
No one is born hating another person because of the color of his skin, or his background, or his religion. People must learn to hate,FRand IDAY if theyNITcan E! learn to hate, they can be taught to love, for love comes more naturally to the human heart than its opposite. Nelson Mandela
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12/2/13 1:44 PM
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FEEDBACK 7
QUIETER THAN THEY WERE
fun!
with soloists Sarah Cullins and Mary Bonhag, Sopranos Wendy Hoffman, Mezzo-Soprano Adam Hall, Tenor Gary Moreau, Bass and the Oriana/NYCS Orchestra
SEVEN DAYS
SOUTH DUXBURY
Get ready for crazy
12.11.13-12.18.13
Robert S. Emmons, M.D.
Peter Magoon
RANDOLPH CENTER
G.F. Handel
SEVENDAYSVT.COM
Ken Picard finds that patients are very satisfied with the quality of care they receive in concierge practice [“What’s Up, Doc?” November 13]. He also finds a policy statement by the American Medical Association that this type of practice creates “ethical concerns that warrant careful attention.” This particular statement by the AMA is so vague as to provide no meaningful guidance for physician conduct. The AMA Code of Medical Ethics contains many sections. Read in its entirety, it affirms repeatedly that individual physicians are duty-bound to serve their individual patients, not populations. The framework of Green Mountain Care creates ethical problems of far greater concern than concierge practice. The state’s plan for payment reform envisions an elaborate system of financial rewards and penalties that will be used to shape the everyday clinical decisions of physicians toward the costsaving goals of the state, which can often conflict with physicians’ ethical responsibilities to promote optimal clinical care for individual patients in accordance with their personal values. In addition, physicians who participate in Green Mountain Care will not have the final authority to direct the use of electronic clinical records they create, an authority that is central to fulfilling the ethical responsibility to protect patient confidentiality. I applaud Mr. Picard for raising the issue of medical ethics. It may seem tedious and technical to actually read medical codes of ethics in a comprehensive way, but if it is glossed over, quality of care for individual patients will be degraded. Green Mountain Care only amplifies the loss of confidentiality and care-limiting financial incentives that already pervade all systems of third-party reimbursement. Concierge practice is just one form of direct-pay practice, the whole point of which is to eliminate third-party influences that are destructive to the patientphysician relationship. Every payment model, current and proposed, should be subjected to close ethical scrutiny. Concierge and other forms of direct-pay practice provide an antidote for the serious ethical problems created by third-party reimbursement.
aircraft over the years [Last 7, “Prepare for Takeoff,” December 4]. Prior to the F-16 they had the twin-engine F-4 Phantom, and even the EB-57B Canberra Bomber, also a twin-engine plane. When I was at UVM from 1969 to 1973, they flew the F-102A Delta Dagger. I remember them blasting over the top of Mount Mansfield at low altitude, scaring the heck out of us skiers. Years later, a friend of mine in Atlanta recalled being one of those pilots and enjoying the practice immensely. These jets were clearly audible on takeoff from my perch at Coolidge Hall (the “highest place in Burlington”) but their noise was not nearly as annoying as that made by my fellow students. By far the noisiest aircraft I have ever heard was a 707 passenger jet that seemed to hang in the air over our dorm as it climbed out. Engine technology improvements have made for generally quieter and more fuel-efficient planes over the years, and traffic patterns are more respectful of those on the ground. You’d probably have to go back a long way to find a better time than now.
12/10/13 5:44 PM