I’m sure you will all be surprised to learn this, but apparently the doctor who is turning away patients if they support Obama has no idea what is in the bill and no clue what he is talking about, but he is firmly against it:
Cassell: Hospice cuts in 2012…Does the government want people to die slowly?
Colmes: Do you really think the government wants people dead?
Cassell: Well I think that they’re cutting all supportive care, like nursing homes, ambulance services…
Colmes: What to you mean they’re cutting nursing homes?
Cassell: They’re cutting nursing home reimbursements
Colmes: Isn’t what they’re cutting under the Medicare plan what was really double dipping; they were getting credits and they were getting to deduct them at the same time.
Cassell: Well you know, I can’t tell you exactly what the deal is.
Colmes: If you can’t tell us exactly what the deal is, why are you opposing it and fighting against it?
Cassell: I’m not the guy who wrote the plan.
Colmes: But if you don’t know what the deal is why are you speaking out against something you don’t know what the deal is?
Cassell: What I get online, just like any other American. What I’m supposed to understand about the bill should be available to me.
Colmes: It is; it’s been online for a long time; it’s also been all over the media…
We all know where this is going next, don’t we? The guy intentionally made a big scene, he got the attention he wanted, now has been given an open mic to expose himself as a clown, so you do know what is coming next, don’t you?
This guy will be the next great conservative martyr by the end of next week. National Review or the glibertarians will have gushing pieces about him, one of the “Big” websites will have a breathless all-caps piece stating “MEDIA TRYING TO DESTROY BRAVE INDIVIDUAL WHO SPOKE OUT AGAINST OBAMACARE.” He’ll be on Hannity discussing how his life was ruined for just trying to speak truth to power and now people no longer come to him for treatment and on and on.
Move over Princess Jesus Boobies and Joe the Plumber, there’s a new kid in town.
beltane
I’m glad this asshat is limiting his practice to Republican patients. It can only be a good thing when an incompetent doctor mucks around with glibertarian pe-nises.
Cathie from Canada
I wonder what he would think if the local hospitals refused to give him admitting privileges because of his politics?
Quackosaur
I seem to recall him saying that he wouldn’t explicitly turn away patients in favor of the reform package, but he would tell O-bots what he felt if they volunteered their own views. So really, he’s actually helping these people by saving them from being berated by a misinformed lunatic.
Brian J
I’m curious about what this guy thinks of Paul Ryan’s plan, which would pretty much eliminate Medicare as we know it over the course of a few decades, slowly but surely. I wonder what he thinks of repeated Republican attempts to make cuts in the program.
There’s a legitimate debate about how much money can be found in potential savings based on changes in the fee-for-service structure, and it’s unclear how much will actually change. But as far as I can tell, the Democratic changes to the program are about eliminating waste, but not about phasing out the program or just shutting it down right away.
This guy, to the extent he has a worthwhile opinion, is either a ludicrous partisan or a big government conservative. There doesn’t appear to be any other option.
El Cid
If you want to make this guy’s life really fun, start a movement to get the TeaTards to volunteer to go to this guy for treatment.
Alan
Bottom line they don’t want their medicare payments cut further than they are. Evidently there’s no way to get rich when govt doesn’t pay. Free markets baby!
Cerberus
I’m actually grateful that he did this. Now everyone sane in his general area knows that he’ll bring this same desire for truth and intellectual curiosity to their problems and thus have an idea of who to avoid if they need a specialist.
But yeah, he’s now a martyr, ruining his life, blah blah blah. Oh that trans woman who was stripped naked and butchered in a hotel bedroom? Yeah, she’s no one, better not to even investigate something like that.
Not when proud brave right-wingers are engaging in self epic-fails and the nasty mean left-wingers are making private snarky comments about what a bad doctor he is.
unabogie
The most distressing thing about this health care debate is that I can’t recall a single argument I’ve seen about the subject that wasn’t based on total bullshit.
We’re arguing with people who have no grip on reality and insist on believing in fantasy.
My Teabagger neighbor insisted that this bill was going to give free health care to all “illegals” and “fund abortions”, while at the same time introducing rationing and making us all go to government doctors.
How do you argue with people who refuse to even learn the basic facts?
Imagine if this guy said “well, I don’t know the deal with this prostate cancer thing, I just know what’s online. The researchers should have made it more clear to me”.
On second thought, that’s probably how he DOES run his practice.
Cerberus
I’m actually grateful that he did this. Now everyone sane in his general area knows that he’ll bring this same desire for truth and intellectual curiosity to their problems and thus have an idea of who to avoid if they need a specialist.
But yeah, he’s now a martyr, liberals ruining his life, blah blah blah. Oh that trans woman who was stripped and butchered in a hotel bedroom? Yeah, she’s no one, better not to even investigate something like that.
Not when proud brave right-wingers are engaging in self epic-fails and the nasty mean left-wingers are making private snarky comments about what a bad doctor he is.
SiubhanDuinne
It scares the shit out of me that there’s a med school somewhere in this country that gave this clown an M.D. I’m not sure anyone this stupid should have been allowed to graduate from high school.
raff
Man, isn’t it always the way? Some wingtard gets his info “online” & makes no effort at independant fact-checking, just accepts the lie as truth & carries on. I expect this kind of thing from Tea Baggers, but not a presumably educated professional.
If I was a patient of Cassell’s, I’d be looking for another doctor as soon as I read his sign, but not before blasting him on his shakey ethical & moral understanding.
Cerberus
Coises, moderation, and I’m not entirely sure what word triggered it.
Sly
Jack the Doctor.
You know its coming.
Lisa K.
Outed as a twerp by Alan Colmes, even. He must be a complete idiot.
Even if I were a teabagger I think I would seek my urology services elsewhere.
eemom
how does he examine other guys’ wee wees with his head up his ass?
Ty Lookwell
Exactly. Later, we find out his name is actually Kevin, and he’s an out-of-work real estate broker. On disability for back problems.
geg6
This guy is, on top of being an ill-informed asshole blowhard, is apparently not much of a physician. Can’t remember where I read it, but someone posted about his patient ratings the other day and this guy was bottom of the scale in every category. And this was the same day as this story came out, so there can be no complaint that they were skewed by his newfound media celebrity.
fucen tarmal
i think think we have an answer to a question posited by george carlin decades ago.
paraphrasing: somewhere in the world is the world’s worst physician, i mean by process of elimination, someone has to be the world’s worst doctor, and someone has an appointment to see him tomorrow.
what he says is interesting in that it is a version of the first round of complaints about obama, way back in what now seem more innocent times. that conservatives had no idea who he was or what he stood for. no one came out and told them, specifically them exactly what obama was going to do, on whatever complex of issues was important specifically to them…
the information being available widely on the internet wasn’t good enough, because they were entitled to their own custom tailored explanation, in terms and in priorites that made them happy…
because paying attention, or researching it yourself might be complicated, perhaps confusing, and full of stuff they don’t actually care about…but still the fault is with the person who doesn’t speak to them personally…
like oreally and beck do, throught the tv…
Comrade Jake
I read somewhere that doctors make the worst pilots, ostensibly because they think they already know everything and can’t admit it when they don’t.
cleek
stuck on his own little island of insanity, constantly angry because people won’t do exactly what he says, and the only woman he likes is hooked-up with a redneck conman….
WereBear
Facts just get in the way of the grievances, people.
stevie314159
Just imagine the outcry if lesbian bondage strip joints started turning away Republicans.
Glidwrith
I have a more general question. I’ve seen a lot of advocacy for the fee-for-service plan; the idea being that only if you get results should there be payment. I undserstand this is based on the concept that some doctors just order a bunch of tests and rake in their money on those fees. However, I’ve always been puzzled by a possible counterargument: what if the physician doesn’t know what’s wrong but has to run through a series of tests to eliminate various possibilities? Should he then get paid for only the diagnostic test that pays off? I’ve heard of a number of neurological diseases, for example, that share several symptoms and their diagnosis isn’t simple (not that I can think of anything right now – it’s Easter and I’m shutting down my brain).
Politically Lost
I managed to tear the cartlige in my knee the other day. I was referred to an orthopedic surgeon on Wednesday. In his exam room I noticed a poster from focus on the family talking about abstinence as the way to prevent pregnancy and the spread of STDs.
I laughed about that a bit and forgot about until Friday. After showing me the results of the MRI and I was scheduling surgery for next week with his nurse he said loudly from the hall, “you’re lucky I was able to expidite your surgery, who knows what will happen once Obamacare gets going.”
I now have word he’s a fine surgeon but is universally hated in the community, both from a business standpoint and as a doctor. I’m tempted to go elsewhere but I can’t continue another week with my knee locked.
I hate to give him the business, but I can’t live like this much longer.
SRW1
He’ll be on Hannity discussing how his life was ruined for just trying to speak truth to power and now people no longer come to him for treatment and on and on.
Maybe he’s tired of sticking his fingers up other people’s ass all day long and has decided it’s time for a career change? I hear conservative martyr pays quite well.
licensed to kill time
@Cerberus
The word that refers to a person who specializes will trip the mod filter because of its horror of the boner pill word contained within.
And really, still no reply arrow? Cut ‘n pasting links is tedious….hell, I’d take that dancing reply arrow over no arrow at all. Sulk.
SiubhanDuinne
@Cerberus. You used tyhat bad! Bad word *speshalist* . It’s just like *soshulist* because it has that *shalus* word embedded.
SiubhanDuinne
Oops couldn’t see what I was typing!
Citizen_X
@SiubhanDuinne:
Don’t worry! Said country would actually be Grenada.
(I read that on the internets somewhere. I’d find the link, but hey, Doc, live by unsubstantiated internet facts, die by unsubstantiated internet facts!)
WereBear
@Politically Lost: Ouch. But being as asshole is nothing new for surgeons, so if you are comfortable with his skill level, you should be fine.
Of course, Republicans think you should shop around for the cheapest surgeon. If you are feeling frisky during the aftercare, you could mention that.
lawguy
You know I think I’ve got to agree with you this time. Or I guess he might just disappear down the memory hole and by next week he just never existed as far as the right and the MSM are concerned.
Pasquinade
which is in Grenada
http://www.vitals.com/doctors/Dr_Jack_Cassell.html
ebbAndflow
Spot on and needed repeating.
morzer
I believe he’s a urologist, not a proctologist, so he might not be able to perform the requisite operation.
Janet Strange
Obviously, this joker knows nothing about the CLASS act that’s part of hcr.
(I know, I should have just stopped at “Obviously, this joker knows nothing . . .” but I wanted to get the link out there about CLASS, cuz I think it’s a very cool part of the bill and I’m not sure how many people know about it. Another liberal media fail.)
Bubblegum Tate
Don’t forget about the inevitable wingnut welfare book, John. Probably called something like The Proctologist’s Promise: How To Get Obama America’s Head Out of Its Ass. You know, snappy and stupid.
kay
I think you have fee for service backward and are conflating fee for service with “outcome based” care, which is another issue.
On fee for service: most physicians operate on a fee for service model now. What was explored during the health care debate by Obama and others was the other model: salaried physicians.
The theory is that there is a profit incentive on fee for service, particularly if the physician or practice or hospital owns “the works” ( an imaging machine, for example). The equipment has a huge up-front cost that has to be recouped, of course, and a tech has to be paid, but once that overhead and operating cost is covered their is an incentive to USE the imaging machine. The theory is that testing is done (in part) because it’s profitable.
The salary system works differently. Physicians are paid a salary no matter what testing they ordered or approach they took.
The Mayo Clinic is a prominent example of a salary model (rather than fee for service) that came up frequently during the debate, The Cleveland Clinic is another.
kay
Glidwrith:
Here’s the President of Mayo on your question:
Dr. DENIS CORTESE (President, Mayo Clinic): Well, thank you for having me and look forward to the discussion.
WERTHEIMER: Dr. Cortese, the most interesting thing that you do, I think, at Mayo is to put your doctors on salary. Is this one of the reasons, do you think, why you have a good record on costs?
Dr. CORTESE: I think it’s one of several factors that we have in place that are designed, specifically designed, to reduce the potential conflict of commitment for our physicians so that they…
WERTHEIMER: Could you just sort of explain why it would be a conflict or not a conflict?
Dr. CORTESE: Well, if your salary or the amount of money that you are paid varies depending on how much you do to people, there can be a conflict of interest for a physician because if they end up doing less, keep people healthier, they may actually make no money. And what we’ve tried to do at Mayo Clinic is to reduce the conflict of commitment as the salary approach – build around what’s still best for patients.
WERTHEIMER: I wonder if you have a tough time recruiting doctors. I mean if you just leave aside greed, lots of young docs graduate from medical school with big debt and they need to catch up with their contemporaries.
Dr. CORTESE: We do pay close attention that are salaries are based at a competitive level that we can recruit and retain people. The turnover rate is below two percent. It’s quite a low turnover rate. And you’d say, well, okay, then we must be either pay them an awful lot of money or there’s something else that keeps people here.
Cathie from Canada
Hmmm — considering Pasquinale’s research (#32) maybe my comment (#2) wasn’t so far off the mark.
Maybe the hospitals this jerk deals with ARE considering withdrawing his privileges and maybe this whole “refusing patients” thing is just a preemptive strike — would it be wrong to speculate? Why, it would be wrong not to!
Cain
@geg6
Even better… wingnuts react and start doing wingnut welfare and start taking him on their doctor because he “gave it to the liberals” and then suffer the long wait times and all the other complaints they have about him. I’m hoping some top right wing blogger does it.
One one hand they’ll complain about long wait lines, soshulism etc, but are totally willing to put up with all that from their crazy private doctor and then declare “GREATEST HELTH CARE IN THE WORLD!”
(health is purposely misspelled. :-)
EDIT: damn too bad he’s not a general practitioner.
cain
Mike G
You forgot the final stage of the Repig martyrdom assembly line — Dr. Assclown will have his own talk show on Fox News ranting against the healthcare bill. It’s coming.
mcd410x
Just another new kid in town …
digitusmedius
As a member of that particular professional club, let me assure everyone out there that Dr. Cassell’s ignorance on such things is not at all unusual. In my experience, most fellow physicians are grossly ignorant of most things outside their narrow field, and I include myself in that assessment. Of course, the egos involved in my tribe often drive its members to think they can instantly understand everything presented to them. I’m really a bit surprised that Dr. Cassell folded so quickly in admitting that he was ignorant and used the laziest and most unreliable source for his notions on the law.
Triassic Sands
Where the hell did this come from? In the clip I saw of the doctor he said he wouldn’t refuse to treat anyone, he’d just prefer to have lefties go to a different doctor.
Has he said somewhere else that he is going to turn patients away?
Personally, if I lived in his area, I’d be grateful for the heads up from the doctor that he doesn’t want to treat me. I wouldn’t want to be treated by anyone who is such an asshole and I sure as hell wouldn’t want to contribute a dime to his livelihood.
Wolfdaughter
What is not stated specifically in posts above, although it’s implied, is that the Grenada medical school is where medical students go who can’t get accepted into medical schools in our 50 states.
I am retired medical librarian. I used to work on the reference desk in the library serving the University of Arizona School of Medicine. One day I dealt with a young woman who was very better and vociferous. Her fiance was having trouble getting accepted into any regular U.S medical school, despite having, according to her, a 4.0 average and a “perfect” MCAT score. She was trying to find addresses, admissions requirements, etc., of schools outside the U.S., including the one in Grenada, and how easily someone graduating from one of those schools could become licensed to practice in the U.S. She also gave me to understand that her fiance was very bitter and not easy to get along with.
I served on a committee which interviewed prospective medical students for admission to the UA Coll Med. I had interviewed many applicants over 12 years. I tried to get her to understand that many of these applicants had 4.0s and excellent MCATs, and so other criteria had to be brought into play. IOW, it isn’t enough just to have a 4.0 and a “perfect” MCAT score to get admitted. She paid no attention to me.
After reading about this physician (I hope if any of my Florida friends have been seeing him, they change urologists), I can’t help but wonder if he was this gal’s fiance?
licensed to kill time
I think this growing trend of refusing to do your job because you disagree with someone’s politics or because of your religious beliefs is very dangerous. Remember how people got all enraged over Muslim cabbies refusing to drive people who had liquor bottles in their luggage or cashiers refusing to swipe pork products? How is this any different?
Hart Williams
@licensed to kill time
The Doctor is a White Republican. That’s what makes it different and compelling and noble. Didn’t you know that?
asiangrrlMN
I may be in the minority, but I would much rather know this kind of thing before I see a doctor so I can take my business elsewhere. I am just glad this doc is not in a highly-specialized area in which there may be two or three doctors country-wide.
licensed to kill time
@Hart Williams D’oh!
Randy P
@Triassic Sands
He said that AFTER people started asking about whether he really meant it. It started when he posted a sign on his office door that said.
“If you voted for Obama . . . seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years.”
When people started pressing him on it, he said that hey, he didn’t actually turn anyone away and if somebody went to seek urologic care elsewhere, it wasn’t because he forced them to.
priscianus jr
Lord keep me and my family safe and far away from doctors anywhere near as stupid, self-unaware, intellectually dishonest, and professionally unethical as this pathetic specimen of humanity.
TenguPhule
I don’t think substituting his tongue for his finger is a move upwards.
Will
They made a movie about this guy and his Grenada medical school training:
http://www.imdb.com/title/tt0088765/plotsummary
Bob K
I think I read somewhere that when you look at him on a rating scale for doctors he comes out at like 1.2 out of 5. In other words this pathetic excuse for a human being decides to become a specialist so he can make the most money and his patients are just so much meat passing through his office that he can make money off of. Perfect country club rethuglican PO$
Kyle
In my experience, most fellow physicians are grossly ignorant of most things outside their narrow field
This is my experience working IT in a hospital. Doctors, in many cases, have big egos encouraged by their training and heirarchical position in the medical workforce, and think they are experts at everything because they have achieved an M.D. Not that I blame them so much — to graduate medical school you have to be relentlessly single-minded to the point where you miss out on other aspects of life — but the God Complex gets annoying. The good ones realize soon enough that they don’t know everything about IT or other non-medical subjects and drop the ego flexing.
This doctor jerk sounds like a real teabag personality — swollen ego, aggressive loudmouth, self-righteous, proudly ignorant and never wrong.
Glidwrith
@kay: Thanks for the clarification. I did have the two confused, which is really embarrasing since I watched a good chunk of the health care debate. The hell of it is, I’d always thought doctors were paid a salary and the fee-for-service was basically the costs involved. Silly me.
kay
Glidwrith-
It’s completely understandable. We didn’t talk very much about what health care costs. Not insurance. Health care.
If I could do it over again, have this debate again (hah! – I promise not to, dear God, not that again!) I would start not with insurance but with health care.
Not just physicians or the much-discussed Big Pharma, either. The whole sector. The medical device and equipment industry. The hospital and nursing home industry.
Or billing. Or records. How in the hell did we end up allocating public money to upgrade record-keeping on behalf of a for profit industry? Why didn’t the health care industry upgrade their own records systems, like every other industry had to do in the last 25 years?
My personal opinion is that we were simply not ready to talk about health care because it’s too personal and scary and it’s a huge sector of the economy with a lot of middle class jobs dependent on maintaining the status quo, so instead we decided to discuss health insurance. Health insurance is important, but it’s only one piece of a really big picture. Health insurance isn’t 1/6 of the economy. Health care is.
Maybe next time around we’ll be ready to look at health care :)
.
Glidwrith
Urrgh – spell check “embarrassing”
chrome agnomen
typical wingnut–doesn’t know what he’s talking about, and handles peckers for a living.
wag
@ 24
Suck it up and find another surgeon. I’m a doc, and cannot stand anyone who brings their Bible into the exam room. WTF is a bone doc doing with a Focus on the Family Abstinence poster on his wall? Focus on your damn area of speciality and leave the bedroom out of it.
mclaren
Isn’t that guy’s behavior a violation of the hippocratic oath?
Seriously — why hasn’t the AMA yanked this guy’s license to practice medicine?
@Kay:
Bingo.
The general public really, seriously, does not want to accept the fact that most doctors don’t practice evidence-based medicine, and as a result prescribe lots of treatments and tests that not only don’t work, those expensive treatments and tests actually make things worse. See “Beliving in treatments that don’t work,” New York Times, 2 April 2009.
The general public really, seriously, does not want to accept the fact that the medical-industrial complex in America is run from top to bottom by corrupt collusive cartels (from the AMA to sweetheart contracts with nondisclosure pricing clauses among medical devicemakers, to hospitals with anti-competitive arrangements with the labs and private clinics run by doctors who work at that hospital, to insurance cartels that monopolize whole regions of the country) which stamp out a free market for medical care and eliminate competition among health care providers, and thus produce prices up to 10,000% higher than for identical health care in Europe.
The general public really, seriously, does not want to accept that fact that most hospital have “007s,” incompetent doctors who are “licensed to kill” but whose ineptitude gets covered up by the rest of the medical profession (ask any nurse and if she’s honest, she’ll tell you the doctors to stay away from in any hospital — the doctors with chronic drinking problems, the doctors with drug addictions, the doctors who rush through their surgeries to get out on the golf course in time to tee off).
The general public really, seriously, does not want to accept the fact that medical record-keeping in America still languishes in the 19th century of handwritten illegible paper forms filed on shelves precisely in order to cover the mind-boggling markups of hospitals and doctors and medical devicemakers, the lethal incompetence of a small percentage of doctors, and the corruption and collusion by doctors and hospitals and clinics and labs and imaging services and insurers and medical devicemakers that jacks up costs to astronomical levels for reasons of pure greed.
The general public really, seriously, does not want to accept the fact that the AMA artificially restricts the number of doctors in America to keep their salaries 2x to 5x what doctors earn in Europe.
And so when people discuss health care “reform” in America they chatter emptily about “reducing paperwork” in the health insurance industry. That’s a microscopic cause of high health care costs in America. The real causes of sky-high health care costs in America are systematic, and arise from the collusive corrupt health-care cartels that dominate the industry, the fact that doctors don’t practice evidence-based medicine and persist in prescribing expensive dangerous treatments that actually hurt patients instead of helping them, and a bunch of strange mindsets in America like the “heroic intervention” model in which teams of super-skilled surgeons will spend millions of dollars and hundreds of hours on a dozen surgeries to separate conjoined twin babies, rather than spending those millions of dollars on much less glamorous preventive care which would end up saving the lives of many thousands of people.
But remember…every time I point out these documented facts, I’m “ranting,” “raving,” “foaming,” “frothing,” “in need of meds,” “mentally retarded,” “mentally ill,” and so on.
We now return to the regularly scheduled herd mentality of balloon-juice, where inconvenient facts and uncomfortable logic get shouted down in a high-tech lynch mob of groupthink frenzy.
kay
mclaren:
That’s not true, mclaren. You and I have had plenty of go-rounds on health insurance reform and I’ve never called you any of those things.
You don’t offer anything. I suggest expanding Medicaid, and you go over the top and insist Medicaid is doomed to failure. I suggest taxing employer-provided insurance plans and you go nuts and scream that the middle class are being slaughtered, even though you’re fully aware that a HUGE chunk of the “middle class” WORK in health care.
How are you any different than the tea baggers? You insist you want radical change, but object to even the slightest change.
And stop seeing conspiracy everywhere. Health care is an industry like a lot of other industries. It’s not a “free market”, but it’s also not a mass conspiracy to kill people.
Is it true that I don’t think you’re reality-based. You won’t really grapple with any of this, real-world. You just keep insisting it sucks. You offer nothing, and then you offer no way to get there.
kay
You have to make a little noise. I had a nurse in maternity who was insisting I didn’t need an epidural because she had 6 children without pain meds, and “that’s the way God intended it”. I didn’t actually turn out to need the epidural, I just wanted to know if it was available if it got unbearable ( I needed a mental “out” so I wouldn’t panic) but I resented being preached to when I’m in such a compromised position, so I called the hospital and complained when I got home. They had me put it in writing. I don’t know what happened after that, but nothing would have happened if I hadn’t have said anything.
kay
And. mclaren, liberals were the ABSOLUTE WORST in talking honestly about health care, rather than health insurance.
Liberals insisted ALL our problems were the fault of the health insurance industry. Any time anyone even mentioned that maybe we over-treat, that maybe we spend too much on health care, liberals went berserk, and insisted that any attempt to cut costs was a grand conspiracy by health insurance companies and/or Obama to ration care.
Any mention of cost-cutting at all and liberals were the first to scream rationing, with teabaggers close behind.
The fearmongering that liberals did on the excise tax (which I think is a good idea) was unconscionable. Liberals were insisting we retain a HUGE tax break that benefits private insurers, a situation the excise tax was designed to correct, while blaming everything on those same insurers.
Don
The general public really, seriously, does not want to accept the fact that the medical-industrial complex in America is run from top to bottom by corrupt collusive cartels
Because when you start to examine the interaction between corporate money and medicine you have to start examining it in other areas of life as well. And most people seem really uncomfortable with the idea that they need to constantly keep an eye on where other people’s financial interests are.