(Q).
Job offer many years ago. I had two, one for staff accountant and the other was as accounting manager for a holistic health clinic. The clinic job paid about 40% more and came with a "manager" title. I believed in myself and all that, but who offers someone just out of school with only 2 years of internship and no specialty in field manager level? That kept bugging me. Something just wasn't right. Acting on instinct, I took the other job. Good thing! A few months later, I read that the owner of the clinic (an MD) and his two partners (his wife and the CFO) had all been indicted for numerous counts of fraud. They were cheating the state, they were cheating the church they were affiliated with, they were cheating Medicare and private insurance companies. The IRS was after them it was supposed to be not-for-profit but it turns out they were living large. Not only that, but they hadn't been sending in w/h tax for non-church member paid employees. Then there was the allegation that they were abusing mentally handicapped workers who were related to church members. The church itself tried to distance themselves, but three elders were also on the clinic's Board of Directors. It was nasty and the entire management team ended up with at least some jail time. There was no way anyone who had any access to the records (medical or financial) could have claimed innocence. My job would have included filing false budget and financial statements with the Board, IRS and other agencies. I would have also probably known that they were withholding but not remitting tax from employee checks. Fact is, the poor kid who took the job got 2 years, so I found out. Those in on the medical fraud got even worse and the three principals all got 2-digit sentences. He probably feels that because of his decision: Pick the correct answer from the following options: A. not enough information B. He is lucky C. He made the wrong decision D. He is indifferent
(A).
B

(Q).
In his lifetime, Ray had done a number of things for which he was not proud, things he'd like to see just as well stuffed down a dark hole. Everybody had things of which they were ashamed. Everybody has committed their share of sins that they wish they could take back. But this wasn't one of them, and he resented the implication that it was -- the implication that someone would dare to judge him for something they did not fully understand. It was a good thing, a right thing, like the time he had given emergency CPR to the woman already ten minutes dead and gone, the woman whose mouth tasted of chocolate death and scrambled eggs, just to spare her horrified children the sense of helplessness while waiting for the ambulance to arrive. That had been a noble thing like this one was. Should have been. Perhaps it was always less difficult to have things fail here, with the living, than it was with the dead. The dead had no opinions, no agendas. They weren't sensitive. The dead did what you fucking told them to do and didn't complain. Right? The living simply did not understand that there were rules. They didn't want to understand something so banal. Someone who didn't take the time to understand the rules had no right to pass judgment on him. Not that it ever stopped them. "I hear that you are unhappy," he said into the phone, then had to pull the receiver away from his ear so the woman on the other end could scream at him some more. Conflict de-escalation technique number one was invariably affirmation. Make it clear that you are aware of the individual's feelings and frustrations, that you are at least listening to their side, whether or not you personally may eventually have the authority to validate or alleviate those feelings. People liked to be listened to. The illusion of having a voice was almost as good as actually having one. Isn't that why people still bothered to go to the polls on election day and vote? And it worked on most people. This woman was not one of them. Why is Ray on the phone? Pick the correct answer from the following options: A. He has a job in human resources B. He wants to help this woman be a better person C. He has a job in customer service D. not enough information
(A).
D

(Q).
And once again, high blood pressure is making headlines in the news: the American Heart Association and the American College of Cardiology (AHA/ACC) have just released new guidelines about hypertension. Since this development is likely to cause confusion and concern for many, I'm writing this post to help you understand the debate and what this might mean for you and your family. By the way, if you've read any of my other blood pressure articles on this site, let me reassure you: I am not changing my clinical practice or what I recommend to others, based on the new AHA/ACC guidelines. The core principles of better blood pressure management for older adults remain the same: * Take care in how you and your doctors measure blood pressure (more on that here), * Start by aiming to get blood pressure less than 150/90 mm Hg, as recommended by these expert guidelines issued in 2017 and in 2014, * And then learn more about what are the likely benefits versus risks of aiming for more intensive BP control. Perhaps the most important thing to understand is this: treatment of high blood pressure in older adults offers "diminishing returns" as we treat BP to get lower and lower. Scientific evidence indicates that the greatest health benefit, when it comes to reducing the risk of strokes and heart attacks, is in getting systolic blood pressure from high (i.e. 160-180) down to moderate (140-150). From there, the famous SPRINT study, published in 2015, did show a further reduction in cardiovascular risk, when participants were treated to a lower systolic BP, such as a target of 120. However, this was in a carefully selected group of participants, it required taking three blood pressure medications on average, and the reduction in risk was small. As I note in my article explaining SPRINT Senior, in participants aged 75 or older, pushing to that lower goal was associated with an estimated 1-in-27 chance of avoiding a cardiovascular event. (The benefit was even smaller in adults aged 50-75.) After educating others on the new guidelines, how does the author feel about the new guidelines implemented by AHA/ACC? Pick the correct answer from the following options: A. not enough information B. She completely agrees with the new guidelines C. She supports them and their research D. She doesn't agree with them, but wants to educate others
(A).
D