Lifestyle

Skyrocketing health care costs and longer lines at the doctor’s office are met with harried physicians more concerned with trying to meet their quota for the day than listening to health problems: This is the future of U.S. health care, according to UC health policy expert Thomas Bodenheimer. Arash Keshmirian/Guardian Medical school student Sasan Massachi (right), wants to pursue a career in oncology, while Kevin Burnham is undecided. Students are increasingly choosing specialized fields over primary care. A drastic decrease in the number of primary care physicians over the past decade prompted the attention of Bodenheimer, a UC San Francisco professor of family and community medicine whose background includes not only an M.D. but also a master’s degree in public health. In a perspective piece published last month in the Annals of Internal Medicine, Bodenheimer and two other doctors blamed the income gap between specialty and primary care physicians for the decline. While the incomes of primary care physicians are by no means meager, the discrepancy in comparison to specialists has become large enough to “”discourage medical school graduates from choosing primary care careers,”” Bodenheimer wrote in the article. The article said that the percentage of medical school graduates in the United States choosing primary care has dropped from 14 percent in 2000 to 8 percent in 2005, a figure that has been dwindling since the mid-1990s. Studies have indicated that patients under consistent primary care have lower health care costs, making the decline a serious situation, especially with the number of people affected by chronic diseases on the rise. The American College of Physicians has expressed a need to take action to prevent what they call an “”impending collapse”” of primary care. At UCSD alone, the number of students choosing primary care as a career has dropped to roughly 10 percent of the graduating class over the past 20 years, according to Rusty Kallenberg, head of the division of family medicine at UCSD. Kallenberg said he believes one of the main factors fueling students’ decisions to specialize is the looming debt, averaging $130,000 to $200,000, after leaving medical school. However, patients put themselves in potential danger when they see several specialists but no primary care physician, because the specialists often lack knowledge of the patient’s overall health, he said. “”[If it is] no one’s job to coordinate everything, [it is] not good news for patients,”” Kallenberg said. The Resource-Based Relative Value Scale, implemented by Medicare in 1992 with the intent of reducing the disparity costs between office visits and procedures, has become the mechanism fueling the income divide, according to Bodenheimer. Instead of paying for face time with the doctor, the difference in the relative value unit, or RVU, of a visit is based on the work that is done. A colonoscopy costs more than a normal office visit because the intensity of the work – mitigated by factors of skill, effort, judgment and stress – is seen as greater for p rocedures, as opposed to doctors’ cognitive efforts. Over the years, the volume of procedures performed by specialists has increased more rapidly than office visits, contributing to the higher salaries of specialists. In addition, several studies have shown that private insurers favor specialist procedures over primary care. A 2002 study revealed that, on average, private insurers pay 120 percent of Medicare’s fee for procedures over 104 percent for office visits, allowing specialists to negotiate higher rates than primary care physicians. Bodenheimer’s report also highlighted the somewhat biased process of updating RVU values. The American Medical Association and other specialist societies created the Relative Value Scale Update Committee, which is designed to recommend RVU updates every five years. Of the 29 members of the committee, 23 are from specialist societies, and only 15 percent of the voting members represent primary care. The paper alleges that specialist-heavy membership, along with specialist society influence in the committee, has led to the avoidance of increasing evaluation and management RVUs – the meat and potatoes of primary care physician income. Revelle College junior Matt Wiepking is one of many premed students on campus. Originally, Wiepking had his sights set on being a general practitioner or pediatrician, but has since been considering specialist fields like radiology. “”There is obviously a financial factor, but a lot of it is lifestyle, patients and decisions you get to make,”” Weipking said. He said he believes that more than the money, students may be more interested in the immediate, tangible benefits from specialty fields. In being able to see a change in the patient’s condition, Weipking said students may feel more useful. After watching doctors and spending many volunteer hours in hospitals, Weipking said he does not necessarily agree with current method of charging patients. “”I think there is a definite lean on doing the tests, but that stems from fear of malpractice,”” Weipking said. “”A lot of unnecessary procedures done [are] not a good way to practice medicine. [It’s] not helping patients.”” Bodenheimer suggested in his report that experts seek out alternate payment models that work to suit each area’s approach to treating patients. In the short term, he recommended that Medicare and private insurers identify ways to modify their reimbursement approaches while primary care tries to bolster its ranks. “”Do we need surgeons if you get hit by a bus?”” Kallenberg said. “”Of course, but we also need vibrant primary care to prevent disease from unhelpful behavior.”” ...

The level of narcissism and self-entitlement has reached an all-time high in Generation Y college students, according to a recent study conducted by five nationwide university researchers. The study was the largest of its type ever conducted, and was spearheaded by Jean Twenge, a San Diego State University psychology professor and the author of a leading book on narcissism in young people. “”Far from being civically oriented, young people born after 1982 are the most narcissistic generation in recent history,”” Twenge said in a press release. The study asked its subjects for yes or no responses to statements such as, “”If I ruled the world, it would be a better place”” and “”I think I am a special person.”” The responses were alarming, the authors said. Two-thirds of all subjects answered “”yes”” to over half the statements, which is 30 percent more than when the test was first introduced in 1982. “”Narcissism feels good and might be useful for meeting new people or auditioning on ‘American Idol,'”” said W. Keith Campbell, co-author of the study and a psychology professor at the University of Georgia. “”Unfortunately, narcissism can also have very negative consequences for society, including the breakdown of close relationships with others.”” Campbell’s arguments are supported explicitly in the study, which states that narcissists “”are more likely to have romantic relationships that are short-lived, at risk for infidelity, lack emotional warmth and to exhibit game-playing, dishonesty and over-controlling and violent behaviors.”” The question now is, can anything be done to stem the self-centered tendencies of today’s students? As far as Twenge is concerned, possible tactics include sterner parenting. “”We need to stop endlessly repeating, ‘You’re special’ and having children repeat that back,”” Twenge said. “”Plus, current technology fuels the increase in narcissism.”” Campbell, however, suggested that the study’s results may show that a simple solution is impossible. “”Permissiveness seems to be a component,”” he said. “”A potential antidote would be more authoritative parenting.”” UCSD students had mixed reactions about the findings of the study. “”I’ve noticed that students tend to refuse to accept responsibility for doing poorly in class, as if they think it’s not possible that they themselves are to blame for a bad grade,”” Revelle College sophomore Elizabeth McDevitt said. But Eleanor Roosevelt College sophomore Virginia Cheng disagreed. “”Students today seem to have more of a grasp today on worldly events and issues that don’t pertain to them personally,”” she said. “”We seem to care more about everyone else.”” ...

The Student Center expansion promises to offer future space for new resources and services. Currently, however, the infrastructural mess of machinery and metal offers little more than frustration to many of the center’s stores. For Food Co-op employees, is not merely an inconvenience, but also a purported blow to sales and revenue that has allegedly been overlooked by university administrators. Will Parson/Guardian John Muir College senior Adam Calo, an employee of the Food Co-op, stands amid construction areas outside the business. According to Co-op employees, construction has severely impacted revenues and caused intermittent obstructions in water supply. Employees from the Food Co-op, a student-run organization offering healthy meal alternatives to corporate food chains, have reported that the collective has experienced extensive problems, both financial and logistical, due to the surrounding construction. These difficulties include a significant reduction in space, blocked kitchen access, decreased foot traffic outside the store and, most notably, intermittent lack of basic utilities such as water. Consequently, Food Co-op employees said their business has seen a significant drop in already minimal profits. “”The construction is the toughest thing facing the co-op right now,”” Food Co-op accountant and Earl Warren College senior Matt Salerno said. “”Our net profits are 60 percent of what they were last year at this time.”” Will Parson/Guardian Customers wait in line to make purchases at the Food Co-op. Construction around Student Center has led to reduced foot traffic to the area’s businesses. The employees had expected construction to be finished by Feb. 22 – as promised by administrators – but no longer anticipate its completion in the near future. According to interim University Centers Director Paul Terzino, the construction was delayed due to unexpected plumbing conditions and underground electrical wiring. He estimated that construction will be finished sometime in late April. “”It’s not even close to being finished,”” Salerno said. “”Right now the date of completion is up in the air and it’s doing more harm than good.”” The absence of a kitchen has impacted the co-op’s ability to produce prepared foods. As a result, its temporary sale of exclusively vendor-provided food has made employees especially resentful of the construction. “”We don’t have the means of producing the amount of food that we used to, so the food doesn’t look as good and it’s not as appealing to people,”” Food Co-op employee and Sixth College junior Rikki Cunningham said. “”Of course, we have a loss of revenue because we normally generate more money from the food that we make than from [that] of our vendors.”” The construction has also resulted in a sporadic interruption of water supply to the Food Co-op, forcing it to utilize the water source from its satellite location in Price Center. “”We have to do dishes in our other location, so oftentimes we can’t offer dishes to our customers,”” Food Co-op employee and Thurgood Marshall College senior Ian Morrison said. “”Instead, we offer them disposable products that cost more money and produce more waste.”” Workers at the Food Co-op say the profit loss caused by affected water supply necessitates contractually mandated compensation from the university, but they have been unable to reach a compromise with administrators. “”[UCSD administrators] try to work with us a little bit, but they look at us as a student organization,”” Cunningham said. “”They don’t look at us like we know what we’re doing. We do – we’ve read the space agreement and we have a lawyer.”” Section 7 of the Retail Cooperative Space Agreement requires rent relief if “”interruption in utility services”” occurs due to renovation. Terzino said the university provided 30 days notice of these interruptions, as mandated by the RCSA. Furthermore, despite the inability to access food production areas, Terzino maintained that the Food Co-op’s sales floor and offices have remained operational during renovation. “”A rent reduction of 50 percent has been given to the Food Co-op while the production area is closed for renovation,”” Terzino said in an e-mail. Salerno disputed the rent reduction, and said that the offer, which was made approximately a month after construction began, has not yet been accepted by the Food Co-op. “”We talked to them about a variety of different offers concerning rent, and we, as a group, have not decided on the one that we will pursue,”” Salerno said. Regardless of whether these offers are accepted by the Food Co-op, Terzino said that Section 7 of the RCSA only pertains to rent relief when utility interruption forces a store to close. “”The intent of Section 7 of the space agreement concerning utility interruption is if utility interruption forces a co-op to close,”” Terzino said. “”The partial utility interruption at the Food Co-op did not force them to close.”” However, the text of Section 7 does not explicitly dictate that the university will provide rent relief only when a store is forced to close. It states that if utility interruption takes place over a period of four hours, the “”monthly rent … shall be reduced by one-thirtieth,”” and one additional thirtieth for each day the interruption persists. Despite difficulties caused by lack of essential utilities, crucial details – specifically, those concerning the number of days that the Food Co-op has operated without utilities – have not yet been presented to the administration, Terzino said. Although employees are upset by difficulties they associate with construction, their negotiations with administrators have not become truculent. “”At the end of the day, the administration has been helpful and responsible in working with us,”” Morrison said. “”We’re not trying to be antagonistic with the university, but our goals and their goals in the way we operate sometimes conflict. We like to solve these conflicts as peacefully as possible.”” While the construction is potentially responsible for a significant impact on Food Co-op earnings, the slumping sales have also been affected by the recent opening of the store’s offshoot Price Center location. Apart from raising the prices of sold goods to offset lost revenue, workers reported forfeiting personal gains in an attempt to alleviate the store’s mounting debt. “”We’re careful in writing down our hours – sometimes I’d rather volunteer the shift I’m supposed to be working than pay myself for the shift because we’re barely scraping by,”” Cunningham said. “”The co-op is our main priority at this point.”” Food Co-op employees described their organization as one of many that have been negatively affected by construction. “”Every student organization in the old Student Center is experiencing these conflicts,”” Cunningham said. “”The General Store Co-op is losing money because of loss of foot traffic. The Bike Shop got moved.”” However, workers from other Student Center businesses have not reported the same extent of losses due to renovation. “”There hasn’t been a big dip in terms of customers, although the outdoor seating area has less people because of the noise,”” Grove Caffe employee and John Muir College senior Jason Grishkoff said. “”We have the same customer base. Not many new people come along because not many people have heard about the Grove in the first place.”” While other stores may face impending losses, they have not described the same degree of fiscal decline as those suffered by the Food Co-op. Additionally, the student-run General Store Co-op is more hesitant in linking profit loss solely to construction difficulties. “”I don’t think we are [losing profit] as of yet,”” General Store Co-op employee and Muir junior Lindsey Tan said. “”We wouldn’t be sure whether we were losing revenue because of the construction, because we just hired new people or because minimum wage just increased.”” Construction problems aside, student-run organizations agree that their overarching problem stems from a general lack of campus awareness. The Food Co-op asserted that, because construction physically complicates entrance to their store, the lack of interest or knowledge regarding student-run organizations within the student body is intensified. “”One of the struggles is getting students involved – we exist to offer alternatives to students,”” Morrison said. “”[Collectives] foster interaction between people beyond buying and selling, beyond teacher and student – it’s an interaction gained when people are cooperating for a common cause.”” ...

I’ve never been a sports fanatic like my roommates. They can rattle off any sports stat, from baseball to tennis, citing almost any game in history while monitoring every minute detail of the players, coaches and commentators. Needless to say, when they got into the fantasy sports drafts, it was far out of my league. I, on the other hand, am a film nut – while they can spout home runs and touchdowns, I speak in purely filmic language: directors and writers, camera angles, artistic design, musical scores, etc. – it’s an addiction. So, naturally, it was a shock to hear from IMDB that a new draft site had opened up: www.fantasymoguls.com, where they ask the billion-dollar question: Can you choose successful films better than the studios can? I wouldn’t be “”drafting”” based on free throws or assists; I could draft for my own studio based on the credibility of talent behind each film and the essential ability to discover a great project. There are two ways of playing Fantasy Moguls: a basic version, where you draft films based on how much cash you expect them to earn or, my personal favorite, the advanced version, which factors in bankability, critical reviews and the amount of people in each theater. The latter proves a true challenge, forcing you to branch out beyond the blockbusters and look at the indies, which are often the big winners among advanced players (during the last draft it was the small foreign flick “”Volver”” which gave some drafters the silver bullet). And the unpredictability of the session adds to the aura of the game – films that appear to be big winners may turn out to be box office duds (that happened to me three times last draft) or vice versa. The Web site has expanded considerably since it launched last fall, now covering the winter movie season, and is about to head into the long spring/summer haul from March to September. I’ll be playing – realizing now that there’s no difference between knowing sports or cinema in-depth, or for that matter music, history or architecture. Knowledge is knowledge, only with everyone’s personal touch. ...

The UCSD women’s basketball players have already had a stellar season this year: They are the university’s first-ever California Collegiate Athletic Association champions in women’s basketball, they have a perfect road record, their head coach Janell Jones was recently named CCAA Coach of the Year and they have the two-time CCAA Most Valuable Player in 5 foot, 10 inch star senior guard Leora Juster. Will Parson/Guardian Sophomore forward Michelle Osier earned CCAA First Team honors, along with two other teammates, for her second straight year with an average of 11.1 points and 7.6 rebounds per game. Now, the Tritons are looking to continue their assault on the UCSD athletic record books by traveling deeper into the postseason, which will begin when No. 1 seed UCSD hosts No. 8 seed Western Washington University on March 9 at 8 p.m. in RIMAC Arena at the Division II West Regional Tournament. The two teams have not met since earlier this season. In that game on Dec. 20, the Tritons took advantage of a 34-point night from Juster to beat Western Washington University 83-64. “”It does help that we’ve seen them already this season because not only can we watch tape of them playing other teams, we can point out our weaknesses and strengths in our game against them,”” sophomore forward Michelle Osier said. Jones also believes that the Tritons have an advantage in this game, although for different reasons. “”The biggest advantage for us is that we will hopefully be playing in front of a big home crowd,”” she said. UCSD will host the regional tournament after going 23-4 in the regular season and winning the CCAA championship with the best record in the division. Considering their perfect 12-0 away record, playing at home is more of an honor than a necessity for the Tritons. “”Honestly, it doesn’t matter where we play because we can win wherever we go,”” Osier said. “”But it is an honor since [UCSD] has never won CCAA and has never been ranked first in the region.”” Western Washington University currently holds an 18-9 record but has only won four out of its 10 away games. Leading the Vikings in points and assists per game is senior guard Mollie Shelmack, with 15.9 points and 3.4 assists. The Tritons are less concerned about what the Vikings are going to bring to the game and more concerned with their own play. “”This is the time of the year that you go to your strengths,”” Jones said. This UCSD team has a lot of strengths and contributions from a variety of players. Although MVP Juster and First Team selections Osier and senior forward Hillary Hansen provide most of the points for the Tritons, other players have been key to the success of the team so far. Junior center Jillian Ricks leads the Tritons with 20 blocks and junior forward Meaghan Noud has been an invaluable sixth-woman, averaging 9.2 points per game off the bench. It also can’t hurt that the Tritons have this year’s CCAA coach of the year in Jones. “”She runs very intensive practices and that really prepares us for games,”” Osier said. “”At important points in the game, she knows what to do. She really knows how to coach.”” With a lot of the players from last year’s squad still on the team, experience will undoubtedly be useful this year as last year’s team was the No. 4 seed and suffered a first-round loss to Seattle Pacific University in the postseason. “”It makes a big difference that we are older this year,”” Osier said. “”The experience from last year’s playoffs will definitely help. Last year, we were scared and we were drained from the anticipation of playing a playoff game. Now, we know what to expect, and we can prepare.”” ...

Ever wish somebody would have slipped Mozart some acid? With their fourth official project, French duo Air attempt to reconcile modern electronica with symphony-hall sheet music, achieving a delicately novel antiquity by looping their already sparse, arpeggioed beats into an acoustic guitar-and-piano orchestra. Pocket Symphony is a departure from 2004’s acclaimed Talkie Walkie, spotlighting nude instrumentals over poppy synthesizer and sound-board pump. The album’s milder aesthetics are still classic Air – a melodic dream-trip with a computer-generated soundtrack – but at a slower, more methodical pace. The pair further simplify their lives by skimping on the vocals (a third of the songs are purely instrumental), a haunting godsend to tracks like “”Mayfair Song”” but an elevator-music ultimatum for others – “”Space Maker”” requires an attentively active listen to avoid completely fading into the background. The most engaging moments occur during the voice-sprinkled “”Mur du Japon”” and “”Napalm Love,”” jolting the listener awake after the meandering tinker of the majority of the album. But the overall sleep-inducing ambience is not necessarily a drawback – because sometimes a pleasant musical haze is the only answer to a rainy day. ...

The No. 16 UCSD women’s tennis team earned a huge win against Villanova University, a nonconference Division I school, by a score of 5-4, improving its overall season record to 5-3. Will Parson/Guardian Sophomore Ina Dan won her doubles match alongside senior captain Marsha Malinow, and in the No. 2 singles spot, Dan picked up an easy 6-1, 6-3 victory to lead UCSD to their 5-4 win over Villanova. The team managed to take a 2-1 lead after some determined play in the doubles matches. No. 3 doubles senior Allison Legakis and sophomore Yekaterina Milvidskaia managed to win their match with a close score of 9-7. However, No. 2 doubles junior Justine Ang Fonte and senior Christy Knudsen fell 4-8. With the match tied at one-all, No. 1 doubles seniors Marsha Malinow, the senior captain, and Ina Dan were able to put the Tritons on top as they eked out a 9-8 victory following a tiebreaker. The singles matches were equally tough and exciting. No. 2 Dan and No. 3 Fonte both had very easy matches, with Dan winning 6-1, 6-3, and Fonte completely dominating her opponent, 6-0, 6-0. Fonte was thrilled with her individual victory, as well as the team’s performance. “”I had a cream cheese,”” she said, referring to the win she had without giving up a set. “”We expected them to not be very strong and sort of paid for it in doubles. But the girls stepped it up a lot and pulled through and Tessa [Tran] closed it out for us.”” No. 5 singles sophomore Tran clinched the victory for the team, winning 6-4, 6-3. While the team did win, there were still disappointments, as the other singles players fell in straight sets. On the opposite side of the spectrum from Fonte was Malinow, who has been plagued by an abdominal strain and lost in the No. 1 spot, 3-6, 1-6. Malinow’s match disappointed her, but she was still excited about the team’s victory. “”My performance was less than what I expected, just because I could not serve at all,”” Malinow said. “”I was serving underhanded and the girl was ripping them. I was really impressed by everyone’s performance and I thought Ina and Justine were working their matches very well.”” The remaining singles losses were from No. 6 singles Legakis, who fell 5-7, 0-6, and No. 4 singles freshman Pooja Desai lost 1-6, 6-7. Head coach Liz LaPlante was very satisfied with the result. “”We had some tough doubles matches,”” she said. “”We played them two years ago, but they were much weaker. The girls they had this time were deep. It was a good match to get ready for the Sonoma State-UC Davis trip.”” The Tritons will be going up north to face conference foe Sonoma State, an opponent they already defeated 7-2 previously this season and a strong Division I team in UC Davis. For Fonte, the match against UC Davis is personal. “”I was actually offered a full ride by the coach at UC Davis but I decided to come to SD,”” she said. “”For me, it’s a test to prove that I am as good as the girls they have up there.”” Malinow seemed both anxious and excited for the trip. “”We have a deep team so there isn’t too much pressure on me,”” she said. “”It mostly comes from my mental weakness and I know that if it wasn’t for [the injury], I would be a lot more consistent right now. I’ve never played against UC Davis’ No. 1 so I really don’t know what to expect.”” ...

As “”dead”” as the Wu-Tang legacy is declared to be, the hip-hop collective’s growing swarms of underground worker-bee offspring don’t seem to be getting the message. Latest case in point: RZA’s prodigious new “”Wu-Element”” (producer) Bronze Nazareth, who – as if the family tree hasn’t sprouted enough branches – has picked up three hitchhiking twigs off the streets of Detroit to form a fresh-faced mini-clan of his own, self-assuredly titled the Wisemen. Their mission is an admirable one, if overambitious: revive the raw, beats-rhymes-life purity of hip-hop’s golden era at the dawn of the ’90s. Yeah, right. But Nazareth is one of the most promising hands behind the new age of always-stellar Wu beats, and his most recent – in a royal march of sawing strings, chirp-cut soul samples and jumping heartbeats – are no exception. However, if these wide-eyed hopefuls want to come anywhere near the minimalist genius of the golden-age greats they so admire, they’re going to need a far better tutor – Nazareth, for all his musical prowess, goes bland and sloppy behind the mic, clumsily recycling the spiritual/militant flow and lyrical fodder of his forefathers. A student can’t surpass his master; likewise, Nazareth – whose 2006 solo debut The Great Migration showed some promise – is dragged down by amateurs, a second-grader in a first-grade classroom. Even top-notch guest listers Killah Priest, Vast Aire and GZA (crammed into the beginning of “”Associated,”” tripping over a messenger-trumpeting sonic gallop) offer no more than sloppy seconds. In this noble fight, the Wisemen may actually be digging the Wu grave that much deeper. 2 1/2 Stars ...