You don't say much about your first point. I don't know any people with ordinary insurance who see doctors when they don't need to--it's not just ERs that keep you waiting and then charge too much. (Maybe my circle of acquaintances particularly hates waiting.) I could well see how hypochondriacs might do this, but enough to make a big difference? I don't know.

Or did you mean the people who visit doctors when they don't need to because they don't know that they don't need to? Because they think there is a stark division between sick and well that requires expert care the moment the line is crossed. I had the flu recently and was surprised by how many people asked if I had gone to the doctor. But it's not just insured people who do that. People getting free medical care at a public clinic don't always have jobs to miss, and will visit doctors quite often.

About your second point, I read an article in the Atlantic not too long ago about how there are actually too many doctors for our own good...but I can't...quite...remember the argument. Sorry.

I think all of you retail clinic naysayers have great points, by the way. It's just that I have far too much familiarity with what free clinics and ERs look like, and they are worse. I am a late adopter, so perhaps by the time I get around to trying one of these clinics, they'll have improved a little.

The antibiotic issue (or any other unnecessary medication) is important, but I think public education (that is, education of the public rather than public schools) is already making a difference there. There is a persistent desire for people to FEEL something happening, even if that feeling is a pill going down the hatch, in order to believe a treatment is working. I'm reading a book about medical treatment from the 60s and damn, did they used to overmedicate. I'm not sure my entire generation wasn't born high, with the drugs they regularly gave women during the course of normal deliveries. So I see the antibiotic thing as a passing problem, if providers stick to their guns and educate patients.

There is nothing I won't do in the service of procrastination.

I found the Atlantic article, which is called "Overdose" by Shannon Brownlee (probably online but I don't think available to non-subscribers). It offers two main arguments to the idea that we need more doctors. They are both deeply cynical, so I sort of believe them.

1) Doctors congregate in communities where patients are able to pay. (So the rural poor are still screwed.) Further, it's the doctor, rather than the patient, who drives medical costs. If a doctor says someone needs such and such medication, test, or treatment, the average patient is likely to go along. So a doctor can live in a kick-ass, affluent city and still keep plenty busy, giving more and more medical (ahem) care to patients who can pay for it.

2) Statistically, communities and hospitals with a high concentration of doctors offer similar health outcomes as those with fewer doctors (and at lower costs to the system).

Gavin Newsom, I was living in San Francisco when the city started issuing marriage licenses. I saw it as a brave and awesome act of civil disobedience, and it made me proud to live in SF. It always seemed clear that you were doing it out of an authentic conviction that it was right; but I also saw you as a canny politician looking far into the future, when gay marriages will be legal everywhere and it will seem utterly silly that there was ever such a fuss about it. I still believe that will happen one day, but I guess we have farther to go than I thought. No matter--I will remember it, always.

The idea that Gavin Newsom should be blamed for the wave of anti-gay hysteria during the last election is just complete bullshit. He did something that the entire country should be doing. The fact that it scared a bunch of bigots is their own lookout. He did something that was RIGHT. I hope it does eventually rebound one day to his political advantage, but whatever the case, when gay people finally and inevitably enjoy the rights they deserve as CITIZENS, it will have started with the few in power who were willing to stand up.

LW, don't you think there's a pinch or two of propaganda behind how frickin guilty you feel about doing something to your own frickin body? Who cares if other people like 'em bigger or smaller--they're yours! You said you had a great career, so presumably you can afford it. People may assume that you must have big-time Issues deep down, and that bigger breasts won't solve your "real" problems, but judging from your letter, I doubt it. I go to the gym in part because it makes me look good, and people think that's great. This doesn't seem too different to me, in principle. My advice? Listen to the song "Tits and Ass" a couple of times to get your mojo back.