I once lamented to Rusty Osborne about how my youth basketball team did not follow instructions. He turned to me and said, "Brian, all you can do is tell them what to do, once they get out there it is up to them."

Basketball is just a game. Sports analogies are overused but they have merit. Parents can give advice and try to protect their children but eventually the child needs to learn how to play.

It has been painfully obvious reading opinion pieces lately that there simply is not much interesting going on. There is always a temptation to regurgitate the same tired ideas and positions which has been on display as well.

All kinds of things have gone through my mind. In all honesty I have not had the will to get all the links ready to do a typical piece.

In gastroenterology one of the toughest conditions to treat effectively is gastroparesis. It is a condition with poor stomach activity leading to delayed emptying. In the United States, metoclopramide, adrug with a black box warning, is the standard choice when a pharmeceutical intervention is neeeded.

Physicians have to utilize the services of various entities. The most obvious is the service provided by hospitals. Imaging centers, surgery centers, and other physician groups also fall into the category.

A common complaint about managed care among patients is it limits choices. A patient has to stay within a network or be penalized. Some patients choose to pay a premium and go outside a network.

People are always making fun of my phone. One individual launched the attack then looked up Kato Kaelin on her smart phone. Boy, did that make me feel primitive.

Texting only entered my life a couple of years ago. It comes in handy if I am doing a procedure and my office needs to make me aware of important information. It actually has a practical application beyond the teenage gossip rounds.

2012 is bearing down on us. I do not think the world will end as some believe the Mayans have predicted.

It can be always be fun to try and predict what will happen so here are some things I see happening in politics over the next year:

1. We will see a big name third party candidate for president.

The Constitution of the United States grants the right of travel to members of Congress. The language applies to when they are performing their duties.

On November 17, 2011 Providence Alaska Medical Center (PAMC)stopped hiring people who use tobacco. The message from PAMC was that they wanted to show they were a leader when it came to health.

The health consequences of smoking are well known. There are also increased problems with missed work due to the habit. PAMC felt these costs were enough to justify the decision.

Alaska and the Municipality of Anchorage allow this kind of discrimination by a private employer.

Don Young made "Captain Zero" a well known nickname for Sean Parnell. He pounded the point home when debating Parnell by running circles around our verbally challenged governor. This is not a particularly difficult task since Gabrielle Ledoux, better named LeDud, made Parnell look foolish as well.

Our lone Alaska US Representitive does not have much tact. Every Alaskan knows it and many Alaskans love him for it.

During the health care debate I went to a meeting where Senator Mark Begich came to discuss health care issues with physicians. Imagine asking the industry about the problem? Who does he think he is, Governor Parnell trying to find out concerns of the oil industry?

Marky Mark never ceases me to amaze me with how little he knows. At one point he talked about how the Veteran's Administration (VA) was a perfect example of how pharmaceutical expenses could be managed. Colleagues around me groaned.

There is a twitter feed tracking arrests made at "Occupy" protests across the country. The count was 3,658 when I checked. Most of the arrests are for trespassing but there are assaults, vandalism and other violent crimes in the mix. Anchorage has made its contribution.

I came home one day in college to my dorm and heard shouting as I walked up the stairs. The one word I kept hearing as I got closer was, "Oreo!" There were three African American students who were blocking another African American student from going down the hallway.

I saw a few flakes of snow in Anchorage a few weeks back. I went the the American College of Gastroenterology(ACG) meeting before the recent snowfall so I still have not seen it stick to the ground. There were flurries here Saturday though.

Medical meetings slowly change the hot issues. The biggest gastroenterology topics the past few years have been quality of colonoscopy, the rising problem of Clostridium Difficile, and changes in treatment for Hepatitis C.

The 1988 Presidential election was the first one in which I was allowed to vote. I was registered in my home state of California but was off at college in New Hampshire.

New Hampshire has the first presidential primary in the country and gets a lot of attention. Every candidate wandered by Dartmouth at some point. I made an effort to go see every single one of them speak.

If 10% is enough for God, then 9% should be enough for the federal government.

-Herman Cain

Herman Cain was nothing more than that pizza guy who is running for president a few months ago. Now, he has become a force by pushing his 9-9-9 plan.

Back in the summer of 1989 my brother Jeff and I returned home for the summer to a city we had never known, Temecula, CA. It was a booming area and my dad was making his first attempt to escape the world of managed care. Years later he would flee to Alaska.

Any NFL fan knows that October is National Breast Cancer Awareness Month. The pink scattered across the uniforms of players screams it every week.

The use of mammography in women before age 50 caused a stir two years ago. New United States Preventitive Health Task Force (USPHTF) also recommended against self breast exams at that time.

One of the top soccer teams in San Diego County in the mid 1980s was at Torrey Pines High School. One of their better players lived a few houses up the street from me. His junior year some members of the team decided to drink alcohol on the bus just before the playoffs.

The school brought the hammer down and those players were not allowed to play. Torrey Pines made an early exit.

It is not exactly a paperwork issue like what happened at Chugiak but it makes a point. A team sometimes has to take responsibility for the actions of its members.

Warren Buffett has more money than God. Most estimates put his net worth at around $50B.

Mr. Buffett thinks that people who earn over $1M per year should be taxed at a higher rate. $1M is .002% of $50B. Or to put it another way that person making $1M in a year would have to work 50,000 years to make $50B. Who knows how long it would take if you adjust for taxes?

Quarterback Tom Brady has Super Bowl rings and is married to a super model. So it is okay for him to make a super gaffe. Brady has called for Patriot fans to start drinking early and get "lubed" up for the Pats opening game in Foxboro.