(07-07-2015 03:23 PM)Mark Douglas Wrote: Doc FYI "cowboys" are darned hard working dependable yet independent people.
You may have watched too many Hollywood movies while you were here..
Cowboy is a common English and European expression for unqualified handworkers who do a shoddy job. Not sure how it started, although probably the association was the wearing of blue jeans by many of the less scrupulous builders running around the UK and Europe in the 1970's. Blue jeans was still not a common fashion for workers in those days (overalls or smarter work wear was far more common) and the association to blue jeans and American cowboys was probably inevitable at the time, especially given the fashion of cowboy boots that was also growing at the time. I learned my English in the UK and so I probably tend to use UK expressions. American English is, as I learned when first doing a residency there, a completely different beast. As Mr. Shaw (and often attributed to Mr. Wilde as well) once said, America and the United Kingdom are two countries divided by a common language.
On my first day in Residency in the US I described a patient's legs as "cute" meaning the shape of them in relation to each other, only to discover to my chagrin that it meant something else in the US, and since the patient was male, and I had what Americans took to be a posh British accent (I learned to speak RP) at the time it seemed to imply to some of my colleagues that I had certain proclivities that I do not have. Equally causing misunderstandings was my offer to come and knock-up one of my colleagues in the morning. The ladies took it rather hard, the men with a certain look of surprise. It took several weeks before someone set me straight on that. It took longer than that for me to get a date after all that.....
(07-07-2015 03:23 PM)Mark Douglas Wrote: I assume you are tired and your feet hurt but far as our political problems perhaps that ought to be an Off-Topic Forum subject? For example even though you are a physician I assume you won't be voting for the Freisinnig-Demokratische Partei as they are big on personal liberties?
(Wife works for)
Your Missus works for UBS? Three of my private accounts are with them, and my wife's uncle was a vice president of UBS for several decades. I have never had anything to complain about with them. CS, on the other hand.... (and I and my wife have several accounts at CS, too. You should never keep all your money in one place, you know)
No, I don't vote FDP, I vote EVP, even though I am not Christian - they are the only party that vaguely resembles my values at all. Parties that support bars being open 24 hours a day and people drinking themselves into alcohol poisoning are not parties that I will vote for. FDP is in favour of a 24 hour party society, just as they were stupidly in favour of free use of drugs in public that led to the debacle of Needle Park in Zurich. Their basic view is that if you want to go to hell in a hand-basket, go right ahead, and if you inconvenience other people in the process, so what? You should still have the right to do it. Not my idea of a good party to belong to.
Incidentally, I never vote along party lines for any of our four times yearly plebiscites (we remain the closest thing to a true democracy in the world, and frankly, sometimes I think it is a colossal waste of money, but I suppose it works because we still have a small enough population - it could not work in the US - too many people and too big a country) - as far as I am concerned, once they are in Parliament they have a job to do - when a proposal or law is handed back to the Swiss folk to decide, Parliament's opinion does not count, and I must again take up the decision for myself and cannot be influenced by what my or any party thinks. Their job to represent me has at that point been abrogated, so I don't let them represent me by their influence in that particular vote. But that part does belong in another section of this forum.
What I was saying wasn't intended to be political (although it crept in I am sure), but an explanation of the hard reality of any advance in medicine (and as such, on topic) - until legislation catches up, people will take advantage, and in a determinedly free market economy as you have, profiteers will be the first to have a foot in the door and legislators will be hampered by their political agendas, the influence of lobbyists and the tendency of the electorate to vote against their own interests (we have that problem here too, four times a year). Once sleep clinics become commonplace enough to be "mainstream" inevitably more regulation will come into place, but in the US that will be a long road, as the experience of plastic surgery has shown. It took decades before anything was done in any state to wean out the unqualified surgeon from the qualified, and you still have some "cowboys" practising and hurting patients. I expect the same for sleep clinics, so it does pay to really check up on the credentials of the practitioners in the sleep area before you go to them.
Remember, anyone in the US who has a general license can hang out a shingle and call himself a sleep doc and there is nothing one can do about it, so long as he doesn't put any certification letters after his name beyond M.D., but to be board certified is another matter. You can't call yourself board certified without having that certification, and the certifying body comes down pretty hard on those who do. Jail time is not unknown in such cases. (see how I brought it round to the topic again?)