Unraveling of pre-Christmas sales

Stores Push Black Friday Into October says the NY Times (today,Thursday, Oct 28):


"The first “Black Friday Now” deals at Sears will be available beginning Friday and Saturday. Amazon’s electronics department will offer sales on items like Blu-ray players and high-definition TVs on Friday, and Toys “R” Us is putting all the items in its 80-page Christmas toy book on sale on Sunday.


"Black Friday creep has been around for a while, but analysts say this year breaks new ground: the range of stores offering early discounts is wider, the discounts are steeper and the sale periods longer — in some instances, a full month before the real thing. Sears, for example, offered early promotions last year but expanded the hours and days this year, while Amazon is beginning earlier than ever.

“Consumers have been trained to buy merchandise only ‘on sale,’ ” Sherif Mityas, a partner in the retail practice at the consulting firm A. T. Kearney, said in an e-mail. “Given a limited budget, if retailers don’t capture that first or second purchase, they may find themselves with a lot of inventory the week before Christmas and the need for massive discounting to save the holiday.”

"Some shoppers asked for a longer sale period, both for convenience and out of nervousness over crowds, said Barbara Schrantz, executive vice president of marketing and sales promotion at Bon-Ton Stores. After a Wal-Mart employee was trampled and killed on Black Friday in 2008, stores increased their crowd-control measures, but they do not want safety concerns to keep shoppers away from stores.

"In some instances, deal hunters say, stores are just hijacking the Black Friday label. Mike Riddle, who started the site Black-Friday.net in 2006 to track deals, said shoppers should not believe that “special” prices for the Friday were necessarily lower than the usual price.

“Retailers are taking advantage of the term,” he said, citing the first Sears “Black Friday Now” circular as “nothing more than their weekly ad rebranded.” Tom Aiello, a spokesman for Sears Holdings, said the prices were not standard discounts; so far, customer response has been positive about this weekend’s deals, he said.

"Traditionally, stores used low prices on the Friday after Thanksgiving to attract shoppers, who, they hoped, would put full-price items in their carts alongside the bargains.

Kidney paired donation conference: financing kidney exchange

A conference in Philadelphia today will take a look at a so far unresolved aspect of kidney exchange: how to finance it. Since transplantation is far cheaper than dialysis, this shouldn't in principle be a big problem, but there are still lots of kinks to iron out in determining who pays for what. I spoke to a similarly constituted group in Minneapolis in 2007...
Kidney Paired Donation Conference, Philadelphia, Pennsylvania, WEDNESDAY, OCTOBER 27, 2010

8:00 a.m. Welcome and Opening Remarks, Chris Pricco, Chief Operating Officer, Complex Medical
Conditions, OptumHealth Care Solutions

8:05 a.m. Introduction and Conference Overview, Dennis Irwin, MD, National Medical Director, Transplant Solutions, Complex Medical Conditions, OptumHealth Care Solutions

8:15 a.m. Kidney Transplantation: Alternative Donors, Lloyd E. Ratner, MD, New York-Presb - Columbia
Campus

8:35 a.m. The Unmet Need for Kidney Transplantation as Viewed by the National Kidney Foundation,
Bryan Becker, MD, University of Illinois-Chicago

8:55 a.m. The OptumHealth/UnitedHealthcare Experience with End Stage Renal Disease, Kidney
Transplantation and the Unmet Need, F. Gregory Grillo MD, National Medical Director, Kidney
Resource Services, OptumHealth Care Solutions

9:15 a.m. The United Network for Organ Sharing (UNOS) Pilot, Kenneth Andreoni, The Ohio State
University Hospitals

Representation and Overview from UNOS Coordinating Centers

9:45 a.m. Ruthanne L Hanto RN MPH, New England Program for Kidney Exchange

10:00 a.m. Dorry Segev, MD, PhD, Johns Hopkins Hospital

10:15 a.m. Michael Rees, MD, PhD, Alliance for Paired Donation

10:30 a.m. Jeffrey L. Veale MD, Ronald Reagan UCLA Medical Center

Successful Single Center Experience with Paired Kidney Donation

10:45 a.m. John Friedewald, MD, Northwestern University Hospital

11:00 a.m. Adam Bingaman, MD, PhD, Texas Transplant Institute

11:30 a.m. National Kidney Registry, Garet Hil, National Kidney Registry (Invited)

11:45 a.m. Kidney Paired Donation from the Donor’s Perspective, John Milner, MD, Loyola University
Medical Center

12:00 p.m. The OPO perspective, Speaker TBD

12:15 p.m. Summary of the recent Living Kidney Donor Follow-Up: State of the Art and Future Directions
conference, Alan Leichtman, MD, University of Michigan

12:30 p.m. National Marrow Donor Program (NMDP): 23 Years of Experience in Establishing and
 Managing a Successful Program for Matching Willing Donors to Recipients, Jeffrey W. Chell,
MD, Chief Executive Officer, National Marrow Donor Program

1:30 p.m. Facilitated Discussion, Clifford Goodman, PhD, Vice President, The Lewin Group

4:00 p.m. Closing Remarks

Note: OptumHealth reserves the right to make any necessary changes to this program. Efforts will be made to keep presentations as scheduled. However, unforeseen circumstances may result in the substitution of faculty or content. Last Updated: 10/05/10

Flash sales--buying in a hurry

Time Is Money
...
"But commerce will always require the creation of scarcity, bottlenecks and stampedes. The most immediate way to do this is to make time seem tight — the going-going-gone approach to sales. For years, digital-world salespeople have been putting in overtime to resurrect the illusion that consumers must put up their money now or life will pass them by.


"Not long ago they figured it out: the online private-shopping club. It’s brilliant and insidious. No current retail trick so successfully conjures the bygone retail climate of hotness and nowness — with its proven capacity to create value — as luxuriously capitalized clothing vendors like Gilt Groupe, HauteLook and Rue La La. For shoppers who register, these services host “flash sales” — sudden sales of limited inventory that offer a seemingly exclusive group of consumers deep discounts on known labels in a few-frills atmosphere.
...

"Gilt Groupe, HauteLook and Rue La La are the holy trinity of flash-sale event dealers, at least when it comes to clothes. Know them by their five-star labels, their ticking clocks, their sheen of exclusivity and their limited searchability.


"EBay won’t be left out of the private-club revolution. The latest way to beat those preposterous M.S.R.P.’s — manufacturer’s suggested retail prices — is eBay Fashion Vault, a shopping club like Gilt Groupe but with some of the madcapness of eBay. "

Susan Athey on online experiments

My colleague Susan Athey (in whose class I'll be guest lecturing today) speaks to NPR:

"Susan Athey: Did you know that every time you do a search on Google or Bing, you are improving the quality of the search engine? The more people click on a search advertisement from a clothing company or on a link on an online news story, the more prominently it is displayed for the next consumer. And the firms constantly experiment to get things right. They watch what consumers do and adapt their products in response to the results of their experiments.


"But designing the right experiment is difficult. To see just one example, consider spam. An e-mail provider wants to eliminate spam from your inbox. It is nuisance for all of us. That company might test out a new way to filter spam. The filter may do a great job in short-term experiments, where the spammers don't have a chance to respond. But once the new filter is introduced in practice, spammers may find a way around the filter. So, that means that some legitimate e-mail is filtered out and the end result may be that you haven't solved the spam problem at all. You could very well end up worse than where you started, even though the experimental numbers looked great.

"So, if you want to figure out whether a new product will work out the way you hope, you need to be able to anticipate how people will react to your innovation. That is, you don't just have to be a good statistician. It's not just about the numbers that come out of simple experiments; it is about predicting how people will react to the changes you make. You need to understand behavior and how to build models that reflect the choices we all make.

"Unfortunately, our universities and business schools haven't figured out how to train students to do this kind of modeling and prediction. That is, we aren't preparing students to manage the new data-driven businesses. And let's face it: This is where our economy is headed, as consumers are spending more and more of their time online. Creating new jobs in this economy is a must, but making sure that the workforce is ready for the jobs where our growth is happening is more important. The good news is that the young people who do develop the talent and skills to capitalize on this opportunity will be in high demand, which puts them in a great position in today's tough economy."

Single-hospital kidney exchanges in Texas and Illinois

A recent letter to the editor in the New England Journal of Medicine reports on the kidney exchange ("kidney paired donation") program at Methodist Specialty and Transplant Hospital in San Antonio, TX.

Bingaman AW, Wright FH, Murphey CL., "Kidney paired donation in live-donor kidney transplantation," N Engl J Med. 2010 Sep 9;363(11):1091-2.

"Our center established a KPD program enrolling all consenting recipient candidates who had incompatible donors as well as compatible pairs with donors over the age of 45 years. Since we initiated the program in March 2008, we have performed 83 KPD procedures, including 22 two-way and 13 three-way exchanges.
...
"If the productivity of our KPD program were to be replicated on a national level, it would potentially result in approximately 2000 additional
live-donor transplantations annually and reduce the number of patients on the waiting list. The increased use of this procedure would also probably avert many difficult desensitization therapies. No recent advance in transplantation has achieved such an apparent increase in access to live-donor transplantation, especially in sensitized patients.
"We believe that all transplantation centers should consider the development of an effective KPD program in order to give patients with incompatible donors a full range of options to achieve successful transplantation."

And here's a news report of another exchange at Northwestern Memorial Hospital.
All eight patients OK after four-way kidney transplant (Chicago Sun Times, Sept. 23, 2010)

"Arlene Hoffman was Jane Delimba's postal carrier for only about three months. But when Hoffman bumped into Delimba at a Wal-Mart seven years later and learned she needed a kidney transplant, Hoffman didn't hesitate to offer one of her own.

"The two weren't a compatible match.

"Still, Hoffman's generosity helped make it possible for four people, including Delimba, to receive kidney transplants last week in what's known as a "four-way paired exchange."

"In simultaneous operations that took place last Thursday at Northwestern Memorial Hospital, four living donors each gave up a kidney, and four people whose kidneys were failing each got one. All eight patients, ranging in age from 28 to 74, are doing well."

And from another story about that exchange: "Northwestern Memorial transplant surgeons performed their first paired exchange in 2006. To date, the hospital has completed 38 paired exchange transplants. "

How does repugnance change over time?

Kwame Anthony Appiah's latest book proposes it has something to do with honor:  The Honor Code: How Moral Revolutions Happen.

Here's a book review from Slate:
The Unappreciated Power of Honor: How it has driven moral progress in the past, and still can.

Update: and here's a NY Times Sunday Magazine article: The Art of Social Change By KWAME ANTHONY APPIAH, focusing on the relative success of the movement to abolish foot binding in China, compared to the movement against female genital cutting in Africa.

"A second essential reason for the campaign’s success was that it created institutions; it didn’t content itself with rhetoric. In particular, it created organizations whose members publicly pledged two things: not to bind their daughters’ feet and not to allow their sons to marry women whose feet were bound. The genius of this strategy was that it created both unbound women and men who would marry them. To reform tradition, you had to change the shared commitments of a community. If Chinese families bound their daughters’ feet because that was the normal thing to do, you had to change what was normal. "

Centralized enrolment in New Orleans public schools

The impetus seems to be special education, according to a story in the Times-Picayune, but the New Orleans public schools are going to combine all their public schools into one enrollment system:

"The New Orleans public schools will move to a centralized enrollment system in an effort to better serve special education students, State Superintendent of Education Paul Pastorek announced today.
"Since Hurricane Katrina, nearly three-quarters of city schools have become independently-run charters. Parents can fill out a common application for all the schools in the Recovery School District, but enrollment decisions happen on the school level.


"District and state officials acknowledge that children with special needs sometimes fall through the cracks, with no central clearinghouse to ensure they are matched with a school that is equipped to educate them."

HT: Neil Dorosin

NSF ScienceLives interviews me on market design

The NSF writes about market design by interviewing me...
Economist Finds Best Matches for Students and Schools
By Ellen Ferrante, National Science Foundation

Some of the questions are about market design, and you'll have to click on the link above if you want to read my answers to those.  But some of the questions were designed to personalize science, and here are those, and my answers...

"What is the best piece of advice you ever received?
"There’s no limit to what a person can accomplish if he isn’t worried about who gets the credit. "

"What was your first scientific experiment as a child?
"I went to public school in NYC, and as I recall we had science fairs each year starting in grade school. The first projects I recall weren’t experiments; they were demonstrations, little bits of engineering. I remember that I built a carbon arc furnace out of boards, a flower pot, curtain rods and pieces of carbon from the core of a flashlight battery.

"What is your favorite thing about being a researcher?
"You can schedule your own mind. There are plenty of jobs in which a person has an opportunity to solve interesting problems, but a researcher, particularly an academic researcher, gets to choose which problems to work on.

"Who has had the most influence on your thinking as a researcher?
"I think my older brother Ted first persuaded me that science was exciting, and I learned a lot from my Ph.D. advisor at Stanford, Bob Wilson. Over the long term, the group of people from whom I’ve learned the most are my students and post-docs and co-investigators; I’ve been very fortunate in who I’ve been able to work with. "

"If you could only rescue one thing from your burning office or lab, what would it be?
"As often as not there’s a student or postdoc in my office. I’d rescue him or her. "

And here's the picture they ran, over the caption "Al Roth and Marilda Sotomayor photographed with their 1990 book “Two-Sided Matching,” at the conference Roth and Sotomayor: Twenty Years After, held at Duke University in May, 2010. Credit: Marilda Sotomayor"

The history of the market for injectable insulin

First came the great, long awaited discovery. The NY Times has a great account by Dr. Abigail Zuger: Rediscovering the First Miracle Drug.

It's well worth reading the whole thing, but here's one snippet that caught my eye:

"“In some sense, the breakthrough is the easy part,” he said. “Then the real work begins.”

"For both insulin and the AIDS drugs the big challenge was “getting it from here to there,” Dr. Sepkowitz said. The expense and logistics of large-scale insulin manufacture were initially daunting. But soon trainloads of frozen cattle and pig pancreas from the giant Chicago slaughterhouses began to arrive at Lilly’s plant. By 1932 the drug’s price had fallen by 90 percent. "

Diabetes remains a killer disease, but now it's a chronic disease that haunts adults, instead of quickly killing children. 

"But the miracle went only so far: insulin was not a cure. In 1921, New York City’s death rate from diabetes was estimated to be the highest in the country, and today the health department lists diabetes among the city’s top five killers. Now though, it is adults who die, not children. What insulin did was turn a brief, deadly illness into a long, chronic struggle, and both the exhibit and the book, “Breakthrough,” by Thea Cooper and Arthur Ainsberg, on which it is based highlight the complicated questions that inevitably follow medical miracles: Who will get the drug first? Who will pay for it? Who will make enough for everyone?"

Diabetes is of course one of the big causes of kidney failure, and a real cure would go a long way to easing the long lines of people waiting for kidney transplants while undergoing dialysis. (Here's a good recent article on the various dialysis options from the WSJ.)

Rakesh Vohra on repugnant contracts for onions

Over at the Leisure of the Theory Class,  Rakesh  Vohra takes up the question of the day, which is Onions, and in particular, Public Law 85-839, which states

"No contract for the sale of onions for future delivery shall be made on or subject to the rules of any board of trade in the United States."

He invites us to consider why that might be a repugnant transaction. (And in the comments, a reader raises the related question of futures contracts on Hollywood movies, and speculation in general...)

Comment on the proposed NRMP scramble following the resident match

The NRMP website asked for comments on the NRMP's new plan for organizing the post-match scramble, and some of my young colleagues and I were moved to send one in:

Comment on the NRMP’s “Supplemental Offer and Acceptance Program” Proposed to Replace the Post-Match Scramble by Peter A. Coles, Clayton R. Featherstone, John William Hatfield, Fuhito Kojima, Scott Duke Kominers, Muriel Niederle, Parag A. Pathak, and Alvin E. Roth.

Executive Summary: "Historical precedent and economic principles suggest that the Supplemental Offer and Acceptance Program (SOAP) proposed for the NRMP Scramble will lead to unsatisfactory outcomes by forcing participants to make unnecessarily difficult decisions and giving them strong incentives to break the rules laid out in the SOAP proposal. We suggest, as an alternative Scramble mechanism, that the NRMP run a “Second Match” for the Scramble participants using rules similar to those of the Main Match."


Here's my previous post: Cleaning up the scramble for medical residents with SOAP

Is the law clerk hiring regime on its last legs?

That's the question asked by an Oct 18 article in the National Law Journal. Clerkship scramble: The system for placing them with federal judges is breaking down by Karen Sloan. The article notes both that many judges are hiring law students as clerks earlier than the current guidelines allow, and also, interestingly, that an increasing number of judges are essentially hiring later, by hiring law grads rather than current law students.

"Are the Wild West days of federal clerk hiring back? That's what some law school administrators and judges fear. They worry that the voluntary system whereby federal judges wait until September of the 3L year to hire clerks is teetering. Judges are choosing clerks earlier in the year and are being inundated with applications as the legal job market narrows. And a trend toward hiring the already graduated means fewer positions are available for fresh law graduates.


"There has been a definite strain on the system over the past couple of years," said Sheila Driscoll, director of judicial clerkships at George Washington University Law School and the chairwoman of the National Association for Law Placement's (NALP) judicial clerkship section. "People are really worried that it's not going to last."

"Before 2003, judges hired clerks as early as they pleased. That's when two appellate judges persuaded most of their peers to agree to a voluntary plan that pushed federal clerk hiring back from the 2L year to September of the 3L year.


"The reform has outlasted many previous attempts to make the process orderly and fair, but the prevailing sense among placement officers and even judges is that more judges are jumping the gun. The Administrative Office of the U.S. Courts doesn't track which judges hire before September, but plenty of anecdotal evidence suggests that judges are picking clerks during the summer and earlier, leaving applicants to wonder about the fairness and transparency of the process. "
...
"Certain circuits openly acknowledge that most of their judges don't follow the plan — most notably the 4th, 5th, 10th and 11th circuits. The judges on the 4th Circuit voted several years ago to bypass the hiring plan altogether, said Chief Judge William Traxler Jr. "There was a long discussion and a division of opinion, but the majority did not want to go along with it," he said.


"One clerkship adviser at a top law school said that many judges are openly advertising their desire to receive applications as soon as 2L grades are available — a change from years past, when judges would solicit early applications less brazenly. The adviser did not want to be identified by name because the situation is delicate for law school administrators trying to give their students the best chance to land clerkships while still adhering to the official time line. Students, meanwhile, have to do more legwork to find out which judges are hiring and when.
...
"The hiring plan received a boost in 2005 with the introduction of the Online System for Clerkship Application and Review (OSCAR), which allows applicants and law schools to submit materials online and lets judges sort applications by specific criteria, such as school or grade-point average. The system will not release student applications to judges until the September kickoff date, which helps encourage compliance. Judge participation has climbed steadily since OSCAR's introduction, but there is no guarantee that judges who advertise positions on OSCAR will wait until September to make decisions.


"You can have a judge who only uses OSCAR for purposes of posting clerkship opportunities, but doesn't adhere to the schedule," said Judge Nicholas Garaufis, who sits on the U.S. District Court for the Eastern District of New York and chairs the judiciary's OSCAR working group. "That judge can reach out to applicants who send papers in the mail at any point."

"The frenzy places judges not in preferred cities on the East or West coasts in a tough spot — it's harder for students to make it to their chambers during the whirlwind interview period.

"Quite frankly, we just saw that other areas of the country were not following the plan," said Chief Judge Mary Beck Briscoe of the 10th Circuit. "By the time students would come out to the Midwest for interviews, the candidates with the highest credentials had already been hired."

"Briscoe recalled one candidate two years ago who was hired by another judge while literally in transit to an interview with her in Lawrence, Kan.

"The declining legal job market and the ease of applying with multiple judges through OSCAR have resulted in a dramatic increase in the number of applications. In 2009, OSCAR funneled 401,576 applications to judges — a 324% increase from the 94,693 applications received in 2005.

"With so many applications coming in, some law school career counselors and students worry that connections are playing an even bigger role in the process, as judges look for ways to cut through hundreds or even thousands of applicants. One judge in the Eastern District of Pennsylvania received 1,900 applications, said Melissa Lennon, assistant dean for career planning at Temple University James E. Beasley School of Law. "What is going to cut through 1,900 applications? Nothing but a phone call," she said.
...
"Another factor is that the rules don't cover applications from people who have already graduated — judges may hire them at any point. That's a real incentive to hire alumni instead of law students, according to judges and law school administrators. "I think some judges don't like the hiring frenzy that takes place on the first day they can interview 3Ls under the rules," said New York University School of Law Dean Richard Revesz. "A way to avoid that and still comply with the rules is to hire alumni."


"Plenty of judges are going that route. Although federal court administrators don't track the percentage of alumni and law student clerk hires, OSCAR data show that clerkship applications from alumni eclipsed those from law students in 2009 — a first.

"Harvard University clerkship adviser Kirsten Solberg said approximately one-third of Harvard's federal and state clerks are alumni. The shift has been rapid at Temple, where alumni make up about 40% of the school's clerks, compared to about 25% the previous year, Lennon said. "

My previous posts on the judicial clerk market are here. My papers on that market are here.

The market for marijuana in CA--buying is almost legal, selling and growing not

Another transaction takes another step from repugnant to not: Schwarzenegger approves bill downgrading marijuana possession of ounce or less to an infraction

"Gov. Arnold Schwarzenegger, who opposes legalization of marijuana for recreational use, has approved legislation downgrading possession of an ounce or less from a misdemeanor to an infraction.

"Supporters say the change will keep marijuana-related cases from becoming court-clogging jury trials, even though the penalty will remain a fine of up to $100, with no jail time. Violations will not go on a person's record as a crime.

"I am signing this measure because possession of less than an ounce of marijuana is an infraction in everything but name," Schwarzenegger wrote in a message released after he signed the bill. "In this time of drastic budget cuts, prosecutors, defense attorneys, law enforcement and the courts cannot afford to expend limited resources prosecuting a crime that carries the same punishment as a traffic ticket."
...
"The governor's action immediately became a point of contention in the campaigns for and against Proposition 19 on the statewide November ballot, which would legalize marijuana for recreational use. Schwarzenegger opposes the measure."

At the same time, marijuana cultivation remains illegal in CA, e.g: Mendocino officials pursue third day of marijuana eradications
"Mendocino County Sheriff's officials, assisted by state and federal agencies, made several more arrests in the third day of eradicating illegal marijuana grows and sales in Round Valley on Thursday.

On Tuesday 17 people were arrested, and another 20 were arrested on Wednesday, officials reported."

Phone sex as a repugnant transaction

I was struck by the opening paragraphs of this story:

"In some ways, working as a phone-sex dominatrix is lot simpler than being on a college faculty. Your relationship with others is clearly defined, no one formally complains about anything you say to them, and you stand little risk of getting caught up in messy struggles over power.

"It gets complicated, however, if you try to do both jobs...."

That is from a Chronicle of Higher Education story about troubles in the English department at the University of New Mexico: In Professor-Dominatrix Scandal, U. of New Mexico Feels the Pain

Now you can buy copies of successful college applications

The Chronicle of Higher Education reports on a new business venture aimed at applicants to selective colleges. For Sale: Successful Ivy League Applications—Only $19.99  By Eric Hoover

"The path to the nation’s most selective colleges is crowded with entrepreneurs—independent consultants, test-preparation companies, and publishers of a zillion guides. They peddle information and insight, along with strategies for unlocking coveted gates. Recently, Howard Yaruss decided to join them.

"Mr. Yaruss is the founder of the Application Project Inc., which sells copies of successful applications to Ivy League colleges. Want to browse applications submitted by 21 members of Brown University’s 2009-10 freshman class? You can buy access to them for $19.99 on the company’s Web site, WeGotIn.net. For the same price, you can see applications filed by 14 members of the 2009-10 freshman class at Columbia University. Or you can buy both sets for $34.99.

"It’s all in the name of transparency, says Mr. Yaruss, who touts his new service a way to show students what successful applications look like—and what admissions officers look for when they evaluate them. Seeing how accepted applicants presented themselves, he says, can help high-school students, especially those who lack affluence, college savvy, and knowledgeable counselors.

“It’s the one remaining part of the process that’s shrouded in mystery,” Mr. Yaruss says. “Students spend thousands of dollars preparing for the SAT. We’re offering this for the cost of a trade paperback.”
...
"Alice Kleeman, a college counselor at Menlo-Atherton High School, in California, calls the service “revolting.” She suspects that the site might cause students to think they have no chance if they happen to lack the academic records, personal experiences, and writing abilities of students who were accepted.

"Ms. Kleeman also thinks there’s a high likelihood of abuse. “Even if students have the integrity not to simply lift responses from these apps, the site could also have the potential of causing students to believe they should submit something just like these apps, rather than their own authentic app,” Ms. Kleeman says. “I would hate to see my students spending money for something like this.”

Waiting lists

In the Chronicle of Higher Education, Toni Adleberg, a recent NYU graduate compares her experiences on the waiting list for graduate admissions, and the wait for a new liver: They'll Just Have to Wait.

Commerce and self interest in medicine

A Guided Tour of Modern Medicine’s Underbelly is a NY Times  book review by Dr. Abigail Zuger of  the book WHITE COAT, BLACK HAT: Adventures on the Dark Side of Medicine. By Dr. Carl Elliott.

"A physician who specializes in philosophy and ethics, Dr. Elliott hails from that quiet zone of medicine where much of the job involves thinking about, talking about and doling out medications. Hence his primary focus is on the ever-evolving relationship between the high art of medicine and the big business of drugs.

...
"Doctors get pens and trinkets, football tickets, junkets to beach resorts. Less visible are the large sums handed over in “I’m going to make you a star” projects to groom them as trusted faces and voices in the service of some drug. Education and advertisement merge in these elaborate ventures, as the paid professor travels the country, lecturing about disease and, incidentally, the treatment thereof.


"These “key opinion leaders” are bad enough, but who would ever imagine that the curricula vitae of many academic physicians (those on a medical school faculty) are packed with journal articles actually written by ghostwriters sponsored by pharmaceutical companies?

"“Nobody expects American politicians to write their own speeches anymore,” Dr. Elliott reminds us, “and nobody expects celebrities to write their own memoirs.” Apparently doctors have now joined the ranks of the charismatic talking heads, mouthing the words of others.

"And just as “professor” generally describes someone who writes his or her own sentences, “ethicist” generally describes someone who dwells (or at least works) on an unusually high moral plane. But Dr. Elliott also takes a brief and very informative excursion into the world of the medical ethicists. Once they were highly principled, underpaid gadflies, trying to sort out medical decision making. Now they are part of a booming industry, and, speaking of industry, their ties to the pharmaceutical industry are many and complex. Many companies now hire their own ethicists. But who guards those guards?
...
"What a world, what a world, as the melting witch said in “The Wizard of Oz.” But there is one small consolation: at least Dr. Elliott didn’t have to call his book “White Coat, Black Heart.” Now that would have been depressing. The bottom line is that much of what he describes is simply the big business of medicine as we have allowed it to take shape. His bad actors are mostly just that: actors caught up in a script not of their own devising. They all come home in the evening, take off their black hats and hang up their white coats, just regular working stiffs out to make a buck. "

Regulation of the hours that medical residents can work

The Chronicle of Higher Education reports Accreditor Tightens Limits on Medical Residents' 80-Hour Workweeks

"Doctors in training at teaching hospitals would continue to be limited to an 80-hour workweek, but some new limits would be imposed to cut down on errors by sleep-deprived residents under new standards approved on Tuesday by the Accreditation Council for Graduate Medical Education.


"The standards, which are scheduled to take effect in July 2011, will apply to the 111,000 medical residents who are training in accredited teaching institutions,

"Residents can work more than 80 hours some weeks, as long as the average over a four-week period doesn't exceed 80. First-year residents would be limited to working no more than 16 hours a day—down from 24 hours—and they would be supervised more closely. Residency-training programs would also have a tougher time getting exceptions to the work-hour limits.

"The changes are based on recommendations made in 2008 by the Institute of Medicine, which warned of widespread medical errors caused by sleepy residents, as well as a 16-month review of scientific writings on sleep issues, patient safety, and resident training.

"Some teaching hospitals have argued that limiting residents' work hours would hurt them financially without necessarily improving patient safety.

"The revised standards, which also deal with concerns about mistakes that occur when residents hand off patient-care responsibilities during shift changes, were developed by a 16-member task force made up of specialists from medical education, patient safety, and clinical care."

Market design at Aarhus University in Denmark

The Center for Research in the Foundations of Electronic Markets is having an inaugural conference, Oct. 13-15.

The full program is here.
The first three sessions touch on a number of themes that readers of this blog will recognize:

Wednesday, October 13, 12.30 to 17.30

Session Chair Ivan Damgård
12.30-13.15 – Hervé Moulin, Rice University: Impartial decision among peers
13.15-14.00 – Peter Bogetoft, Copenhagen Business School: Missing Markets
14.00-14.45 – Jens Leth Hougaard, Copenhagen University: Rationing with rights

Session Chair Peter Bro Miltersen
15.15-16.00 – Felix Fischer, Harvard University: Mechanisms for Large-Scale Kidney Exchanges
16.00-16.45 – Lance Fortnow, Northwestern University: Bounding Rationality by Computational Complexity
16.45-17.30 – Kevin Leyton-Brown, University of British Columbia: Computational Mechanism Analysis

Thursday, October 14, 9.30 to 18:00
Session Chair Peter Bogetoft
09.30-10.15 – David Parkes, Harvard University: Mechanism Design and Accounting to Enable Efficient Peer Production and Spectrum Sharing (joint work with Ian Kash (Harvard), Michel Meulpolder (TU Delft), Rohan Murty (Harvard), Jie Tang (UC Berkeley) and Sven Seuken (Harvard))
10.15-11.00 – Ivan Damgård, Aarhus University: How to compute securely – even if you trust no one but yourself

It looks like Aarhaus is a happening place this week.

HT: Noam Nisan at AGT.

The problem with Princeton

France Wrestles With Its 2 Tiers of Higher Education
The article, from the New York Times, discusses the French higher education system of Universities and Grandes Ecoles, and ends with this paragraph:

"It was Cédric Villani, a 37-year-old professor at Lyon who won the 2010 Fields Medal, who gave the most spirited reply to France’s critics. Calling himself “a pure product of the French system,” Mr. Villani, a Normalien who has often taught in the United States, said that while American academic salaries were higher “and it’s easier to make big projects,” France also has particular strengths: “Our tradition, our quality of life, our social cohesion. My big problem in Princeton was finding a place to buy a decent cheese.”