Taylor J. Christensen, M.D.

Physician, business strategist, revolutionary without a revolution. Govt, healthcare, sound money. I like exhaustive, mutually exclusive categorizations.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

I made a community dedicated to crafting a constitution for Mars.

It's mostly an opportunity for big-picture thinkers to collaborate so we can figure out how to (1) design an optimal government and (2) keep it that way.

https://t.co/EUCx6Fok0J

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@sayjayhynes Apparently so!

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

Today was day two of my first time ever working as a physician in the Canadian healthcare system. I am Canadian and grew up in Canada but did all my training in the U.S. (plus a month in Thailand) and then worked in the U.S. healthcare system up to now. All of this is anecdotal from only two days working in a single Canadian hospital (in British Columbia), so take it with a grain of salt.

1. There's a different feel in this Canadian hospital compared to all of the big and small hospitals I've worked at in the U.S. I'm not quite sure how to describe it. It's like we're here working and there are things to get done but there's no stress about our employer thinking we're not working hard enough, so we just focus on getting the work done without worrying about big brother finding a way to eke out more labour from us if we happen to have a spare moment. Those spare moments aren't taken guiltily, they're enjoyed and appreciated as part of a good work environment. It feels more like the atmosphere at a hospital in Thailand than it does like a hospital in the U.S.

2. A mix of electronic and paper charting is quite a shock to me, but the division is clear what goes in the EMR and what doesn't. Writing orders by hand is actually pretty quick for me (often easier than trying a bunch of different search strings to find a specific order I'm looking for that's named something different than my last hospital), although then it creates a lot of work after I write those orders for people to scan them in and send them to places (like the pharmacy) to make them happen.

3. The physical facilities in the U.S. are much nicer and more organized. Even small old rural hospitals in the U.S. are more organized and much better maintained. This is purely an aesthetics commentt.

4. Discharging patients from the hospital is such an easy process. I write the order and do the medicine reconciliation (which, admittedly, is sometimes super annoying on paper), and then pretty much the nurse just walks the patient out right after that. If the IV is still in, they'll just pull it right there in the hallway on the way out. Way less paperwork and red tape. It's shocking.

5. Charting is so much easier. I don't have to write anything just for the sake of some stupid rule that requires me to include it to justify my billing code. There is not note bloat. I just communicate my clinical information without regard for how many physical exam systems or details about the character and location and severity and timing of someone's pain.

6. Until now, I had no idea how much my patient encounters were shaped by documentation requirements. I felt like the encoutners had to be all rigid in the U.S. because if I go out of order I would forget to ask about family history or do the review of systems or the right number of physical exam maneuvers, and then my billing code would be downgraded and the hospital would get me in trouble for not generating enough revenue. But now when I walk into a patient's room, I just find myself focusing on figuring out what's wrong with them and working through how to deal with it without documentation and billing requirements clogging my brain. It's a bigger relief than I expected.

7. Discharge criteria are much more relaxed. If someone wants to stay in the hospital, I think they can just stay. Unless it's doing them harm, then they will be discharged. But if they need a bit more time just for comfort or because they're not sure they'll be strong enough quite yet to function at home, then they stay longer. They'll just be converted to an alternate level of care, doctors will only see them once a week, and nurses will only do vitals once or twice a day and administer meds. The cost of those things plus the food is probably not a lot, so it's no huge deal.

There are many more differences, but those are the ones that stuck out today. And maybe my impression of some of those will change with more experience here.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

Some preliminary thoughts about wars over territory. The main causes are

1. Scarce/valuable resources
2. Historical and ethnic claims
3. Strategic importance (usually militarily)
4. Expansionism

As countries begin to colonize the moon and then mars, I hope they can get borders settled firmly before number two becomes relevant.

And the lower the likelihood of a war over territory, the less likely number three provokes any conflict.

And with plenty of other land available (for now) on these celestial bodies, expansionism can run wild without causing any conflict.

But number one will be the kicker. Unless humanity can approach resource sharing more collaboratively than we have on earth. Which is possible for a while but doubtful to be a permanent solution. Because we're still humans with human genetic programming.

So probably what we need most is great collaboration initially and then eventually solid governments via strong foundational constitutions.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@XFreeze Surface traffic plus below-the-surface traffic plus . . .

Naw, nevermind.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@LeConneatois I love this. And I feel the same. To succeed, one just has to overcome the human tendency to feel less valuable (and develop less self-confidence) when they compare unfavorably to others in that ocean.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@EndWokeness First property goes. Then liberty. Then life.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

In anticipation of the first Starship V3 launch, I made my daughter's 15th birthday card Starship themed.

Minus the booster. I only have so much construction paper and tape.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@DanManley5 @PerBylund Not exactly. As long as the patient pays more when they choose a more expensive provider (i.e., they need to pay at least part of the price differential between their different options), incentives are pretty well aligned.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@deanstein12 @PerBylund I agree with it. And as for the people who don't agree with it, they don't understand how free markets work and how government has interfered with that.

BTW, this doesn't mean we can't have universal access as well.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

Time for another reminder that profit is *usually* not evil.

If profit is gained through exploitation or crony capitalism, it can rightly be seen as evil.

But if it's gained through providing a good or service that is valuable to consumers, it can be rightly seen as virtuous. It's the reward of offering a higher-value solution to a job that people wanted done.

But what about what the business owner does with that profit? Can that turn a virtuous profit evil?

There are only three things the business owner can do with that wealth: save it, spend it (which includes giving), or invest it.

Save it: Usually only done with a very small percentage of the wealth earned. Mostly for an emergency fund, like to cover 6 months of expenses. This is great. It prevents people from defaulting on loans or making imprudent and short-sighted business choices prompted by running out of personal funds.

Spend it: If a business owner spends "too much" of their virtuously earned profit on themselves (like by choosing to live a lavish lifestyle), it can come to be seen as unfair or even "immoral." I dislike the judgment applied to how others "should" spend their money. An interesting fact about this spending is that the wealth they are spending is now getting redistributed to others in society. Isn't that what those calling the lavish lifestyle immoral want?

Invest it: The more profit the business owner accumulates, the larger the percentage of their wealth that ends up going to investments. And since investments are the driver for innovation and, thus, for all further wealth improvements for the entire society and world, I think this use of their wealth is a great service to the country. And the owners of successful businesses are probably uniquely qualified to choose which other business ideas should be funded.

If the people calling for socialism, wealth taxes, etc. would take but a few moments to think through the assumptions motivating the policies for which they advocate, maybe they would change their minds.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

Teaching my kids about scientific thinking today:

1. Have a question
2. Think of possible answers
3. Gather evidence to determine which is the most likely answer to be correct

I think most people don't know how to apply this simple process to their political opinions.

Here's a question I recommend:

"Which economic system would lead to the greatest quality of life for our society?"

And don't forget to gather evidence before determining which one you think will be best.

Hint: There's plenty of historical evidence about each system.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

I've recently realized that self-driving cars will substantially accelerate innovation.

Here's how:

The cost of transportation is a primary factor in determining the potential size of a market for a company that sells physical goods.

This is because when transportation costs are low, the value delivered by your product can even be competitive with the local options in far-flung places in spite of having to add extra transportation costs to the price.

Larger markets allows economies of scale and centralizes resources for R&D to improve the value of the products being produced. Basically it maximizes the benefits of specialization through trade.

So larger markets = more value-improving innovation.

Self-driving cars will expand to self-driving trucks and other self-driving forms of transportation, which will substantially lower the cost of the transportation of goods in the form of lower labour costs and fewer accidents and damaged goods. Thus, expanded markets and more value-improving innovation.

And this is on top of all the personal-life benefits to quality of life in enhanced safety and time saved.

Thanks @Tesla for pushing this forward and generating all of these positive externalities!

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@ironwoodbook Thanks! I wish my econ classes had used it.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

I'm teaching my kids economics for one of their homeschool classes.

Today I created a game where they started with only one good and had to trade for other specific goods. I set the price of each good and only told that price to the one who started with that good. Then I gave them a rule that they can only make equivalent trades (and no stealing or donating), and I said "Go."

They all started with enough wealth units to be able to buy everything they needed.

I deliberately placed their starting stash of items in separate rooms.

One was the jeweler, who had a bunch of earrings worth 1 wealth unit and necklaces worth 3 wealth units. The rest of the items were worth 5 or more wealth units and were mostly not simple price multiples of each other.

They were frustrated at first because of a (deliberately designed) lack of coincidence of wants and a lack of money. They were also running around the house because there was no central marketplace.

They took a full 30 minutes to complete the game.

It was so interesting to watch market innovations start to arise organically throughout that time, including forming a centralized marketplace and starting to use the earrings and necklaces as money, all of which expedited trade. They didn't make a whole market price list, which I thought they might do, because they started memorizing the prices of everything through experience in the market. I guess I needed a greater variety of goods!

The second time through, they used the innovations from the first time through and it only took 10 minutes to complete the game.

I just hope our discussion afterward about markets and ways to make a market effective solidified the lessons so they can see clearly how these market mechanisms happen in the real world!

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@Handre Is there no group of people working together to change this? Because a group can accomplish more than a bunch of individuals. Even the libertarian party doesn't seem to be achieving anything. I feel like we lack a rallying point.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

I think he believes that after a person has accumulated a certain amount of wealth, the excess just sits there doing nothing.

But what really happens is the vast majority if it gets invested.

And investments into business is what drives wealth-improving innovations forward. To bring greater wealth for all.

Take that away, and it's tantamount to an anti-investment (a short-term gain for a long-term greater loss).

So that's what a wealth tax is. It's an anti-investment into our society's future wealth.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

If you think of all physical things that have any value as simply different forms of wealth, and if you remember that money is simply another form of wealth (but a special one because it's useful to trade for other forms of wealth), then money becomes much less confusing.

Try it next time you're struggling to figure out whether a statement about money is true.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

I know there's a pretty good correlation between the S&P500 and the strength of the economy, but that decouples when there's a bubble.

So I would say the value in the S&P500 looking good in spite of many of the top 10 (mostly AI-heavy companies) not being near their peaks is a good sign specifically because it suggests we're not in an AI bubble.

Ever since you wrote about freight data being a good sign of a strong economy, I've been wondering about what the truly reliable indicators are. And I suspect you're right--trade is the basis for all wealth increases, so strong trade suggests wealth is growing.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@LeConneatois 💯

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

And organizations also don't have built-in morals to stop them from driving the humans in temporary control of them to do anything to sate that appetite.

Unless maybe there's a founding document that specifies hard limits of the organization's growth and existence.

For government, that's what a constition does.

Ours has proven indequate to that task.

[Taylor J. Christensen, M.D. @DoctorTaylorJay]

@elonmusk There's nothing more power hungry than an organization. They have an intrinsic appetite for growth and immortality. That includes governments.