Ricky's Riffs:

Random Thoughts on Travel, Education, Health, and the World in General


Sit/Stand Desks: A Review And Critique

June 4th, 2019

Both my patients and non-patients ask me about sit/stand desks.  They are all the rage. Many of the workplaces I visit are open-plan and stocked with various versions of these up/down desks, which enable computer workers and others who rely on monitors to change positions throughout the day.

The popularity of the sit/stand desk has given rise to a burgeoning market. There are lots of choices at a variety of price points. There are several things that determine the best choice for an individual or a company: They include space, look, ease of use and budget. I’d like to describe the pros and cons of some of the top models in the marketplace.Read the rest of this entry »


Book Review: “Decisive Intuition” by Rick Snyder

May 21st, 2019

Condition is a health news and information website.  So why am I reviewing a book about business coaching?  Rick Snyder’s Decisive Intuition: Use Your Gut Instincts to Make Smart Business Decisions would seem to belong squarely in the business section of the bookstore. But this book is about much more than business.Read the rest of this entry »


In Guatemala with the Integrative Health Project

April 2nd, 2019

I just returned from a week in Guatemala, where I worked with the Integrative Health Project.  The project was started by a few acupuncturists about eight years ago.  They wanted to work with the underserved, indigenous population living around Lake Atitlan, a beautiful, fertile and impoverished region in the Guatemalan highlands.Read the rest of this entry »


Book Review: “The United States Of Opioids” by Harry Nelson, JD

January 17th, 2019

There is a growing canon of work on the opioid epidemic. The best of these books include “Dreamland” by Sam Quinones, “Dopesick” by Beth Macy, and “Chasing the Scream” by Johann Hari. Each tells the story from a different angle.  Together, they describe the confluence of heroin, Oxycontin, and fentanyl, the complicity of Big Pharma, and the failed “war on drugs.”

There is a new book to add to the list: “The United States of Opioids,” by Harry Nelson, JD.  As a practicing health care attorney, Harry brings a legal eye—as well as a deep heart of compassion—to this very complex subject.Read the rest of this entry »


Pain, the Opioid Crisis, and Alternative Care

November 19th, 2018

Drug overdoses killed approximately 72,000 people in in the United States in 2017. This was an increase of 10% from 2016. The two reasons cited are (1) Americans continue to use opioids in increasing numbers, and (2) there are more powerful, deadlier, synthetic opioids available in the underground marketplace—mainly fentanyl, which is 100 times stronger than morphine.  While the latter is the primary cause of fatalities, there is a connection between the two explanations.

It is established that of those who die of opioid overdoses, 80% started their use/abuse of these drugs with a prescription for pharmaceutical painkillers: for football injuries, work injuries, post-surgical pain, dental issues. Too many medical doctors prescribe these drugs routinely.Read the rest of this entry »


Interview: “A Rationale For a Single Payer Health Care System.”

November 9th, 2018

Ricky is interviewed by Michael Finney, consumer affairs reporter for Channel 7 Bay Area and KGO Radio, about his article “A Rationale For a Single Payer Health Care System.”


On the Opioid and Gun Violence Epidemics: Rationales in Common

September 19th, 2018

We are currently in the midst of the most lethal drug epidemic in our country’s history. One of the shocking things about this crisis is that it has been going on for the past 20 years without showing any signs of letting up.  In 2016, overdoses involving opioids killed more than 42,000 people.  Of those deaths, 40% were from prescription opioids.   (Statistics are still being finalized for 2017.)

Several recent books describe the evolution of this epidemic, each from a slightly different perspective.*  I’ll focus on just one of them here.Read the rest of this entry »


A Rationale For A Single Payer Health Care System

August 27th, 2018

Real change is coming to our health insurance system.  This is inevitable for the simple reason that the system, as it stands, is not sustainable.  Premiums and deductibles keep rising, way beyond the rate of inflation. Drug prices also rise, as do hospital and medical device costs.

In 2010 President Obama pushed through his landmark legislation, the Affordable Care Act (ACA), which enabled millions of previously uninsured people to get health insurance for the first time. But the model was still rooted in the same private insurance system, and dominated by the usual players: Aetna, United Health Care, Cigna and the “Blues”. So there was little reason to expect the inflationary trends to slow down.Read the rest of this entry »


Book Review: “Witches, Nurses and Midwives” by Barbara Ehrenreich and Deirdre English

May 17th, 2018

Witches, Nurses, Midwives (WNM) is one of the seminal works of second-wave feminism.  It was written in 1973 by two professors at State University of New York at Westbury, a new public college. At SUNY Westbury the curriculum included alternative subjects, such as Women’s Studies, and served a student body of older, ethnically diverse and working class students. Professor Barbara Ehrenreich went on to become one of our most important cultural critics; Professor Deirdre English, a prominent journalist, author, and an editor for Mother Jones.

This book was originally published as a pamphlet.  Passed from person to person, it became an underground classic, addressing power, misogyny, and class struggle in the evolution of American medicine and health care.Read the rest of this entry »


Book Review: “Irresistible: The Rise Of Addictive Technology And The Business Of Keeping Us Hooked” by Eric Alter

March 26th, 2018

With the recent revelations about the Russian trolling of the 2016 presidential election, during which both Facebook and Twitter were manipulated by a foreign power, we are witnessing the beginning of a national reckoning with social media.  A global network that was initially seen as a great gift to humankind is now being reconsidered.

Hailed as a great unifier, and a way to connect people—social media was the force behind the Arab Spring and other revolutionary movements—the broader implications of this network have come crashing down on us.  There has even been a good deal of hand wringing among some ex-Facebook executives, who have had second thoughts about what they have created.

Irresistible, the new book by Eric Alter, that describes the effects of social media on our children and the science behind those effects, sheds light on some of the reasons for this soul searching.Read the rest of this entry »