The BE&HM Series ~ Part IV: Ionic Compounds, Elements & Oxidation State Defined

In the last post, I discussed the Group A, aka the Main Group, elements.  The chemical behavior of atoms  -- how they react/combine with other atoms in "the environment" -- is determined by the way electrons are configured orbiting about the nucleus.  All Main Group elements (with the biochemically relevant exception of hydrogen) share a valence shell (outermost shell) with 8 "vacancies" for electrons.  Having a filled valence shell with 8 electrons is the preferred energy state for these atoms -- this is called the Octet Rule -- and these atoms react/combine in order to satisfy this rule.  The atoms in each group (or column) contain the number of electrons in the group number, thus Na is in Group IA has 1e, C in Group IV has 4 e's, and Br in Group VII has 7 e's.

The Group IA and IIA elements lose electrons to form cations to meet the Octet Rule when the next lower filled shell now becomes the valence shell.  The Group VIA and VIIA elements have mostly filled shells and will gain electrons to completely fill them.

In this installment I'll discuss how different atoms combine to form unique substances called compounds.   One type of compound, ionic, will be discussed in detail, and the formation of an ionic compound shall be used to introduce the concept of oxidation state.

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BLOGSCAN: Key Opinion Leader Admits to being a Marketer

Without any notable shame, and as a guest blogger on KevinMd.  The post was about other physicians can become big-time KOLs by using social media, and refers to another post which indicates that pharmaceutical companies look for physicians who are big prescribers of their products and have a lot of influence to, guess what, help market their products.  Although the blogger refers to ethics more than once, how it is ethical to trade on the trust physicians get for their professional vows to put patients first to market products (that may not always be good for patients) remains beyond me.

ADDENDUM (27 August, 2012) - See also comments by Dr Howard Brody on the Hooked: Ethics, Medicine and Pharma blog.  

An Even Bigger Golden Parachute for Captain Outrageous

In 2009, I first posted about the amazingly colorful leadership and governance problems at a small hospital system in Massachusetts. 

Background: Northeast Health System

The story of Northeast Health System then included  leaders who solicited money from the community but concealed what they were doing from the same community, an adolescent pregnancy pact after the hospital system refused to provide confidential birth control information at the high school clinic it ran, a hospital vice-president accused of art theft, various cuts, some concealed, of medical services, accusations of conflicts of interest affecting the board of trustees, and no-confidence votes by nurses and physicians. Finally, Stephen Laverty, the CEO held responsible for much of the mess, resigned and things quieted down a bit.  However, he left a system in deficit, leading to further lay-offs, (e.g., see this story in the Boston Globe).  And the vice-president accused of art theft was also "arraigned on bribery and larceny charges" (also per the Boston Globe.)

Nonetheless, in 2010, it was revealed that Mr Laverty left with a golden parachute worth more than $1 million.  But wait, now there is more.

A Guilty Plea
In May, 2012, per the Salem News,

A former associate vice president at Beverly Hospital pleaded guilty yesterday to soliciting bribes and kickbacks from hospital contractors and stealing valuable paintings and other antiques while overseeing a $50 million renovation of the facility.

Paul Galzerano, 60, was sentenced to serve 18 months of a two-year jail term on four larceny counts and two years of probation on two counts of commercial bribery during a hearing yesterday at Salem Superior Court.

Yet More Severance Payments


But wait, there is even more. Yesterday, the Gloucester Times reported about Mr Galzerano's former boss,

Nearly four years after he resigned under fire, former Northeast Health System CEO Stephen Laverty is still collecting big paychecks from his former employer.

Laverty was paid $573,348 in severance in 2011, the second year in a row he has received buyout money from Northeast, the parent nonprofit corporation to Beverly Hospital and Gloucester’s Addison Gilbert Hospital, and a corporation that was essentially merged with Lahey Clinic to become the new Lahey Health System under an agreement that gained the necessary state approvals earlier this year.

Laverty's total severance payments have reached "more than $1.56 million over those two years." Whether the payments have ended is not clear. Attempts to discover why payments continued and became so large revealed only,

Beverly Hospital released a statement Monday saying, 'We cannot comment on Mr. Laverty or the terms of any agreements between the company and past employees.'

Summary

For a relatively small hospital system, Northeast Health System has produced an enormous example of the perverse incentives given to top executives of health care organizations. Mr Laverty has been made a millionaire despite what the Gloucester Times called in its news article a "tenure plagued by acrimony and controversy," and leadership previously described in a Gloucester Times editorial as "arrogant, dictatorial," and a history of what only can be described as outrageous management failures. Furthermore, the money he received came not from rich stockholders, but from a struggling community hospital system.

The ability of top executives of many, probably most health care organizations to collect bloated paychecks out of proportion to, if not despite their performance attracts the wrong people to lead these organizations, and provides incentives for even the right people to lead badly. 

Until we make health care leaders accountable, and until their incentives reflect their ability to uphold the health care mission, expect more unaccountable leadership that subverts the health care mission, and hence continually rising costs, declining access, and deteriorating quality. 

racing out the door for meetings today, but i wanted to leave you with some pretty things to help start your day....

Qadha dan Qodar

Bismillahirrahmanirrohim

Apa pun yang terjadi di dunia dan yang menimpa diri manusia pasti telah digariskan oleh Allah Yang Maha kuasa dan Yang Maha bijaksana.

Semua telah tercatat secara rapi dalam sebuah Kitab pada zaman azali.
- Kematian,

- kelahiran,
- Rizki,
- Nasib,
- Jodoh,
- Bahagia, dan celaka telah ditetapkan sesuai ketentuan-ketentuan ilahiah yang tidak pernah diketahui oleh manusia.

Dengan tidak adanya pengetahuan manusia tentang ketetapan dan ketentuan Allah ini, maka ia memiliki peluang atau kesempatan untuk berlomba-lomba menjadi hamba yang saleh-muslih, berusaha keras untuk mencapai yang dicita-citakan tanpa berpangku tangan menunggu takdir, dan berupaya memperbaiki citra diri.

Dengan bekal keyakinan terhadap takdir yang telah ditentukan oleh Allah swt., seorang mukmin tidak pernah mengenal kata frustrasi dalam kehidupannya, dan tidak berbangga diri dengan apa-apa yang telah diberikan Allah swt.

Ia akan berubah menjadi batu karang yang tegar menghadapi segala gelombang kehidupan dan senantiasa sabar dalam menyongsong badai ujian yang silih berganti.

Ia juga selalu bersyukur apabila kenikmatan demi kenikmatan berada dalam genggamannya. Perhatikan beberapa ayat Allah dan hadits Rasul berikut ini.

“Tiada suatu bencana pun yang menimpa di bumi dan (tidak pula) pada dirimu sendiri melainkan telah tertulis dalam kitab (Lauhul-Mahfuzh) sebelum Kami menciptakannya. Sesungguhnya yang demikian itu adalah mudah bagi Allah“
(QS.57 Al-Hadiid :22)

“(Kami jelaskan yang demikian itu) supaya kamu jangan berduka cita terhadap apa yang luput dari kamu, dan supaya kamu jangan terlalu gembira terhadap apa yang diberikan-Nya kepadamu. Dan Allah tidak menyukai setiap orang yang sombong lagi membanggakan diri.”
(QS.57 Al-Hadiid :23)