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- Aug 5, 2007
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FEEL FREE TO CUT AND PASTE AND FORWARD TO YOUR RESPECTIVE MEMBER OF CONGRESS/SENATE/POTUS:
Dear Mr. President/Senator/Congressman/Congresswoman:
Happy New Year! I hope this letter finds you and your family well.
Im writing to you, as a physician and one of your constituents (in your State), to express my concerns about the recent incident involving Umar Farouk Abdul Mutallab, and the attempted bombing of Northwest Airlines flight 253. According to the main details reported in the media, it appears that this was an isolated event that was imminently preventable had the proper systems already in place acted in concert and as supposed.
As a practicing physician who was born in the U.S., educated in the U.S., and having chosen to continue to live my life and engage in the practice of medicine in the U.S., I can personally disclose and vouch with the highest level of certainty to whomever may be interested that I represent exactly zero terrorist risk to anyone when I board an airplane either here in the U.S. or, for that matter, anywhere else in the world. And, that is the reason Im writing to you now.
Please allow me to use a medical analogy for a moment, which is especially timely as we attempt to contain costs with the recent passage of the modified Healthcare Reform Bill in the House and Senate.
Imagine, if you will, a patient who presents to the emergency department of a local hospital. He is in his mid-fifties, has truncal obesity, is a heavy smoker, and is diabetic. He is complaining of mild chest pain. The on-duty Emergency Department physician reviews his history briefly, orders some tests, and determines that there is a likelihood that he is having a cardiac event. But, that same physicians cannot be, at that immediate point in time, 100% certain. So, the patient is sent him home.
He dies.
This is tantamount to what happened in the Abdul Mutallab case. But, fortunately, in the Mutallab case, no one died. All of the screening tests utilized gave a reasonably high level of certainty that he should never have boarded that flight. So, why then was he allowed to board? That is the real question that needs to be answered in this affair. This appears to be a case of misapplication of effective technology and human failure, not one of current systems.
In the medical world, we use whats called pre-test probability and apply the principles of Bayes theorem to determine essentially when further testing is warranted. In the example medical case I provided and based on those principles, it would have been absolutely wrong for any physician to send this theoretical patient home. At the very least, he should have been kept for additional observation and testing.
Conversely, in the case of, say, an otherwise healthy 25-year-old female who presents to the emergency room with a complaint of chest pain, the likelihood of it being truly cardiac in origin is extremely low. In her case, it would not be prudent or good medical practice to order a battery of more sophisticated tests to simply rule out the possibility that it might be. It would be a waste of resources and only add additional cost with a next-to-zero probability of yielding a positive result. Furthermore, if we screened everyone who presented with a complaint of chest pain with a full, invasive cardiac work-up, it would add immeasurable additional unnecessary cost to an already-burdened system.
Thats tantamount to what the government is now proposing.
Instead of looking at the pre-test probability of certain cohorts of people who represent the greatest potential risk, the governments latest proposal is to additionally screen, with more invasive procedures, everyone who presents to the airport. Can anyone, at this time, even remotely predict how much additional cost and burden to the airline system this will add? These current proposals being potentially suggested as additional tactics for use by the TSA might be the last nail in the coffin of an already ailing airline industry. And, personally, I am a busy, practicing physician who doesnt believe I should have to present to the airport six hours each time before I board a domestic flight with the proposition that I might be virtually strip-searched (or worse) when, fact is, I represent absolutely no risk to anyone.
Right now, our Nations leaders seem to suffer from a perpetual case of zero risk bias. And, my contention is that, as we add further and more ridiculous screening tests to the pre-flight checklist, we will not and cannot more definitively improve security. The terrorists are far cleverer than we often give them credit at figuring out ways to thwart whatever systems we put in place. Its time to change tactics altogether.
So, instead of slowly and insidiously allowing our government to march forward with an ongoing encroachment on the civil liberties of those of us who represent zero risk, it is time to stop. It is time to stop wasting more money. It is time to stop wasting resources. It is time to stop adding additional time and burden to any already harried and overtaxed TSA system. It is time to focus our efforts on those who represent the greatest risk.
That leads us to at least two possible conclusions and future directions to go.
First, that our current security system is therefore already adequate. It just needs to be tweaked and directed at those who pose the greatest threat given their pre-test probability, and spend less time clogging up security checkpoint lines excessively screening, in the name of fairness, those of us who pose no real risk.
Or, conversely, our government actually needs to slow down for a second, take a breath, think about what they are doing, and work on coming up with more creative and cost-effective screening systems that dont encroach on the rights of decent Americans, as well as treat non-threats as de facto criminals in waiting. It would be wonderful for a change to actually see our government implement a plan that is not a knee-jerk, crisis-management type circus show each time an Abdul Mutallab-type climbs on-board an airplane that he, had the system that is already in place actually worked properly, never should have been on in the first place.
Thank you for your consideration of my position. I hope my points are echoed by your other constituents, as they most certainly are among my peers.
Sincerely,
-copro
Dear Mr. President/Senator/Congressman/Congresswoman:
Happy New Year! I hope this letter finds you and your family well.
Im writing to you, as a physician and one of your constituents (in your State), to express my concerns about the recent incident involving Umar Farouk Abdul Mutallab, and the attempted bombing of Northwest Airlines flight 253. According to the main details reported in the media, it appears that this was an isolated event that was imminently preventable had the proper systems already in place acted in concert and as supposed.
As a practicing physician who was born in the U.S., educated in the U.S., and having chosen to continue to live my life and engage in the practice of medicine in the U.S., I can personally disclose and vouch with the highest level of certainty to whomever may be interested that I represent exactly zero terrorist risk to anyone when I board an airplane either here in the U.S. or, for that matter, anywhere else in the world. And, that is the reason Im writing to you now.
Please allow me to use a medical analogy for a moment, which is especially timely as we attempt to contain costs with the recent passage of the modified Healthcare Reform Bill in the House and Senate.
Imagine, if you will, a patient who presents to the emergency department of a local hospital. He is in his mid-fifties, has truncal obesity, is a heavy smoker, and is diabetic. He is complaining of mild chest pain. The on-duty Emergency Department physician reviews his history briefly, orders some tests, and determines that there is a likelihood that he is having a cardiac event. But, that same physicians cannot be, at that immediate point in time, 100% certain. So, the patient is sent him home.
He dies.
This is tantamount to what happened in the Abdul Mutallab case. But, fortunately, in the Mutallab case, no one died. All of the screening tests utilized gave a reasonably high level of certainty that he should never have boarded that flight. So, why then was he allowed to board? That is the real question that needs to be answered in this affair. This appears to be a case of misapplication of effective technology and human failure, not one of current systems.
In the medical world, we use whats called pre-test probability and apply the principles of Bayes theorem to determine essentially when further testing is warranted. In the example medical case I provided and based on those principles, it would have been absolutely wrong for any physician to send this theoretical patient home. At the very least, he should have been kept for additional observation and testing.
Conversely, in the case of, say, an otherwise healthy 25-year-old female who presents to the emergency room with a complaint of chest pain, the likelihood of it being truly cardiac in origin is extremely low. In her case, it would not be prudent or good medical practice to order a battery of more sophisticated tests to simply rule out the possibility that it might be. It would be a waste of resources and only add additional cost with a next-to-zero probability of yielding a positive result. Furthermore, if we screened everyone who presented with a complaint of chest pain with a full, invasive cardiac work-up, it would add immeasurable additional unnecessary cost to an already-burdened system.
Thats tantamount to what the government is now proposing.
Instead of looking at the pre-test probability of certain cohorts of people who represent the greatest potential risk, the governments latest proposal is to additionally screen, with more invasive procedures, everyone who presents to the airport. Can anyone, at this time, even remotely predict how much additional cost and burden to the airline system this will add? These current proposals being potentially suggested as additional tactics for use by the TSA might be the last nail in the coffin of an already ailing airline industry. And, personally, I am a busy, practicing physician who doesnt believe I should have to present to the airport six hours each time before I board a domestic flight with the proposition that I might be virtually strip-searched (or worse) when, fact is, I represent absolutely no risk to anyone.
Right now, our Nations leaders seem to suffer from a perpetual case of zero risk bias. And, my contention is that, as we add further and more ridiculous screening tests to the pre-flight checklist, we will not and cannot more definitively improve security. The terrorists are far cleverer than we often give them credit at figuring out ways to thwart whatever systems we put in place. Its time to change tactics altogether.
So, instead of slowly and insidiously allowing our government to march forward with an ongoing encroachment on the civil liberties of those of us who represent zero risk, it is time to stop. It is time to stop wasting more money. It is time to stop wasting resources. It is time to stop adding additional time and burden to any already harried and overtaxed TSA system. It is time to focus our efforts on those who represent the greatest risk.
That leads us to at least two possible conclusions and future directions to go.
First, that our current security system is therefore already adequate. It just needs to be tweaked and directed at those who pose the greatest threat given their pre-test probability, and spend less time clogging up security checkpoint lines excessively screening, in the name of fairness, those of us who pose no real risk.
Or, conversely, our government actually needs to slow down for a second, take a breath, think about what they are doing, and work on coming up with more creative and cost-effective screening systems that dont encroach on the rights of decent Americans, as well as treat non-threats as de facto criminals in waiting. It would be wonderful for a change to actually see our government implement a plan that is not a knee-jerk, crisis-management type circus show each time an Abdul Mutallab-type climbs on-board an airplane that he, had the system that is already in place actually worked properly, never should have been on in the first place.
Thank you for your consideration of my position. I hope my points are echoed by your other constituents, as they most certainly are among my peers.
Sincerely,
-copro
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