L.A.'s revamped teacher evaluation system getting mixed grades

Third-grade teacher Kelly Vallianos wanted to find an engaging way for her students to learn about measuring perimeters. One idea — to have students design a restaurant floor plan — was too difficult, she feared.

But with the help of colleagues, she found a way to tailor that fifth-grade idea to her younger students at Dominguez Elementary School, who excitedly sketched out an imaginary pizzeria.

Vallianos credits the Los Angeles Unified School District's new teacher evaluation system for sparking deeper and more collaborative conversations with administrators, who she said gave her ideas to make the lesson work.

The district's new performance reviews have come under fire by United Teachers Los Angeles, which opposes the controversial element of using student test scores as one factor in measuring teacher effectiveness.

But largely lost in the debate is the fact that the system's centerpiece is a new classroom observation process that, despite some drawbacks, is being praised by many as a better way to help teachers improve.

"It's a more reflective, much more well-rounded process," said Vallianos, who has been teaching for 19 years.

Teachers are ranked on a scale on instruction, lesson plans, classroom environment and dozens of other criteria. A highly effective teacher, for instance, will be able to intellectually engage all students and prompt them to lead their own discussion topics. An ineffective teacher will generate all questions and most answers, involving just a handful of students.

During observations, administrators type notes into their laptops and later rate each of 61 skills. Principals and other administrators conducting the observations must pass a test to ensure they are fairly and accurately scoring instructors. Conferences with teachers before and after the classroom visits are required.

The method is meant to make observations more useful, uniform and objective, using evidence rather than opinions. But it's an elaborate process and has provoked widespread criticism that it takes too long for principals who are already overwhelmed with increasing workloads. And those who can't type well take even longer, administrators say.

"The technology is creating great difficulty and frustration," said Judith Perez, president of the Associated Administrators of Los Angeles. "It feels like an immense amount of pressure on people without alleviating their workload."

Teachers union President Warren Fletcher agrees that a better system is needed; UTLA has designed its own. He said "the jury is still out" on the district's observation process but added that it shares some common elements with the union's proposal.

The new system also includes evidence of student achievement — which could be in the form of test scores — feedback from students and parents, and the teacher's contributions to the school community.

The new observations were tested last year on a voluntary basis with about 450 teachers and 320 administrators; this year, every principal and one volunteer teacher at each of the district's 1,200 schools are expected to be trained.

Officials have not yet announced when the system will be used for every teacher — or when the ratings will begin to count for decisions on layoffs, tenure or pay. But in a video shown at the training sessions, L.A. Supt. John Deasy made the stakes clear.

"We have perhaps no greater responsibility than assuring that every student in this district is taught by an effective teacher in a school led by an effective leader," he said.

Many educators agree that the current evaluation system — known as Stull for the state law that created it — doesn't promote that goal of top-notch teachers for every student. Criticized as a perfunctory checklist of expectations that doesn't help teachers improve, the system awarded 99.3% of L.A. Unified teachers the highest rating in 2009-10 — even though only 45% of district students that year performed at grade level for reading and 56% were proficient in math.

The new system has given teachers like Lisa Thorne a boost. Thorne, a math teacher at Hamilton High School, said the new process is "unwieldy" but far more helpful in homing in on her strengths and weaknesses.

After the self-evaluation part of the process, Thorne chose to focus on improving her work with small groups of students, prompting her to try such techniques as using a three-dimensional pegboard to teach geometry. And she started a new computer-based class to help struggling ninth-graders master algebra. Administrators had seen her use the techniques with older students during a class visit and were impressed enough to give her the green light, she said.

"I would definitely say the new system is an improvement, because it's more specific about what they're looking for," Thorne said. "It helps to get the conversation going with administrators."

Eduardo Solorzano, principal of San Fernando Middle School, agrees. In particular, he said, the focus on careful note-taking has given him specific examples to use in helping teachers improve.

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Hobbits, superheroes put magic in NZ film industry

WELLINGTON, New Zealand (AP) — A crate full of sushi arrives. Workers wearing wetsuit shirts or in bare feet bustle past with slim laptops. With days to go, a buzzing intensity fills the once-dilapidated warehouses where Peter Jackson's visual-effects studio is rushing to finish the opening film in "The Hobbit" trilogy.

The fevered pace at the Weta Digital studio near Wellington will last nearly until the actors walk the red carpet Nov. 28 for the world premiere. But after "The Hobbit: An Unexpected Journey" hits theaters, there's more work to be done.

Weta Digital is the centerpiece of a filmmaking empire that Jackson and close collaborators have built in his New Zealand hometown, realizing his dream of bringing a slice of Hollywood to Wellington. It's a one-stop shop for making major movies — not only his own, but other blockbusters like "Avatar" and "The Avengers" and hoped-for blockbusters like next year's "Man of Steel."

Along the way, Jackson has become revered here, even receiving a knighthood. His humble demeanor and crumpled appearance appeal to distinctly New Zealand values, yet his modesty belies his influence. He's also attracted criticism along the way.

The special-effects workforce of 150 on "The Lord of the Rings" trilogy a decade ago now numbers 1,100. Only five of Weta Digital's workers are actual employees, however, while the rest are contractors. Many accept the situation because movie work often comes irregularly but pays well. Union leaders, though, say the workers lack labor protections existing in almost any other industry.

Like many colleagues, Weta Digital's director, Joe Letteri, came to New Zealand in 2001 to work on the "Rings" trilogy for two years. The work kept coming, so he bought a house in Wellington and stayed.

"People come here because they know it's their chance to do something really great and to get it up on the screen," he said in a recent interview. "And you want to do it in these next two weeks, because the two weeks after the movie's finished are useless."

Jackson, who declined to be interviewed for this story, launched Weta in 1993 with fellow filmmakers Jamie Selkirk and Richard Taylor. Named after an oversized New Zealand insect, the company later was split into its digital arm and Weta Workshop, which makes props and costumes.

Loving homages to the craft are present in Weta Digital's seven buildings around the green-hilled suburb of Miramar. There are old-time movie posters, prop skulls of dinosaurs and apes, and a wall of latex face impressions of actors from Chris O'Donnell to Tom Cruise.

Its huge data center, with the computing power of 30,000 laptops, resembles a milk-processing plant because only the dairy industry in New Zealand knew how to build cooling systems on such a grand scale.

Little of Weta's current work was visible. Visitors must sign confidentiality agreements, and the working areas of the facilities are off-limits. The company is secretive about any unannounced projects, beyond saying Weta will be working solidly for the next two years, when the two later "Hobbit" films are scheduled to be released.

The workforce has changed from majority American to about 60 percent New Zealanders. The only skill that's needed, Letteri says, is the ability to use a computer as a tool.

Beyond having creativity as a filmmaker, Jackson has proved a savvy businessman, Letteri says.

"The film business in general is volatile, and visual effects has to be sitting right on the crest of that wave," Letteri says. "We don't get asked to do something that somebody has seen before."

The government calculates that feature films contribute $560 million each year to New Zealand's economy. Like many countries, New Zealand offers incentives and rebates to film companies and will contribute about $100 million toward the $500 million production costs of "The Hobbit" trilogy. Almost every big budget film goes through Jackson's companies.

"New Zealand has a good reputation for delivering films on time and under budget, and Jackson has been superb at that," says John Yeabsley, a senior fellow at New Zealand's Institute of Economic Research. "Nobody has the same record or the magic ability to bring home the bacon as Sir Peter."

"You cannot overestimate the fact that Peter is a brand," says Graeme Mason, chief executive of the New Zealand Film Commission. "He's built this incredible reputational position, which has a snowball effect."

Back in 2010, however, a labor dispute erupted before filming began on "The Hobbit." Unions said they would boycott the movie if the actors didn't get to collectively negotiate. Jackson and others warned that New Zealand could lose the films to Europe. Warner Bros. executives flew to New Zealand and held a high-stakes meeting with Prime Minister John Key, whose government changed labor laws overnight to clarify that movie workers were exempt from being treated as regular employees.

Helen Kelly, president of the New Zealand Council of Trade Unions, says a compromise could easily have been reached. She says the law changes amounted to unnecessary union-busting and a "gross breach" of employment laws.

"I was very disappointed at Peter Jackson for lobbying for that," she says, "and I was furious at the government for doing it."

Weta Digital's general manager Tom Greally compared it to the construction industry, where multiple contractors and mobile workers do specific projects and then move on.

Animal rights activists said last week they plan to picket the premiere of "The Hobbit" after wranglers alleged that three horses and up to two dozen other animals died in unsafe conditions at a farm where animals were boarded for the movies. Jackson's spokesman Matt Dravitzki acknowledged two horses died preventable deaths at the farm but said the production company worked quickly to improve animal housing and safety. He rejected claims any animals were mistreated or abused.

Jackson's team pointed out that 55 percent of animal images in "The Hobbit" were computer generated at Weta. The People for the Ethical Treatment of Animals (PETA) have asked Jackson in the future to create all his animals in the studio.

Controversies aside, the rise of Weta and the expat American community in and around Miramar is visible in everything from a Mexican restaurant to yoga classes. On Halloween, which in the past was not much celebrated in New Zealand, hundreds of costumed children roamed about collecting candy. Americans gave the tradition a boost here, but the locals have embraced it.

The National Business Review newspaper estimates Jackson's personal fortune to be about $400 million, which could rise considerably if "The Hobbit" franchise succeeds. Public records show Jackson has partial ownership stakes in 21 private companies, most connected with his film empire. He's spent some of his money on philanthropy, helping save a historic church and a performance theater.

For all his influence, Jackson maintains a hobbit-like existence himself, preferring a quiet home life outside of work. In the end, many say, he seems to be driven by what has interested him from the start: telling great stories on the big screen.

___

Follow Nick Perry on Twitter at http://twitter.com/nickgbperry

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Indian Prostitutes’ New Autonomy Imperils AIDS Fight

Kuni Takahashi for The New York Times

Sex workers in Mumbai’s long-established red-light district, where brothels are dwindling.

MUMBAI, India — Millions once bought sex in the narrow alleys of Kamathipura, a vast red-light district here. But prostitutes with inexpensive mobile phones are luring customers elsewhere, and that is endangering the astonishing progress India has made against AIDS.

Indeed, the recent closings of hundreds of ancient brothels, while something of an economic victory for prostitutes, may one day cost them, and many others, their lives.

“The place where sex happens turns out to be an important H.I.V. prevention point,” said Saggurti Niranjan, program associate of the Population Council. “And when we don’t know where that is, we can’t help stop the transmission.”

Cellphones, those tiny gateways to modernity, have recently allowed prostitutes to shed the shackles of brothel madams and strike out on their own. But that independence has made prostitutes far harder for government and safe-sex counselors to trace. And without the advice and free condoms those counselors provide, prostitutes and their customers are returning to dangerous ways.

Studies show that prostitutes who rely on cellphones are more susceptible to H.I.V. because they are far less likely than their brothel-based peers to require their clients to wear condoms.

In interviews, prostitutes said they had surrendered some control in the bedroom in exchange for far more control over their incomes.

“Now, I get the full cash in my hand before we start,” said Neelan, a prostitute with four children whose side business in sex work is unknown to her husband and neighbors. (Neelan is a professional name, not her real one.)

“Earlier, if the customer got scared and didn’t go all the way, the madam might not charge the full amount,” she explained. “But if they back out now, I say that I have removed all my clothes and am going to keep the money.”

India has been the world’s most surprising AIDS success story. Though infections did not appear in India until 1986, many predicted the nation would soon become the epidemic’s focal point. In 2002, the C.I.A.’s National Intelligence Council predicted that India would have as many as 25 million AIDS cases by 2010. Instead, India now has about 1.5 million.

An important reason the disease never took extensive hold in India is that most women here have fewer sexual partners than in many other developing countries. Just as important was an intensive effort underwritten by the World Bank and the Bill and Melinda Gates Foundation to target high-risk groups like prostitutes, gay men and intravenous drug users.

But the Gates Foundation is now largely ending its oversight and support for AIDS prevention in India, just as efforts directed at prostitutes are becoming much more difficult. Experts say it is too early to identify how much H.I.V. infections might rise.

“Nowadays, the mobility of sex workers is huge, and contacting them is very difficult,” said Ashok Alexander, the former director in India of the Gates Foundation. “It’s a totally different challenge, and the strategies will also have to change.”

An example of the strategies that had been working can be found in Delhi’s red-light district on Garstin Bastion Road near the old Delhi railway station, where brothels have thrived since the 16th century. A walk through dark alleys, past blind beggars and up narrow, steep and deeply worn stone staircases brings customers into brightly lighted rooms teeming with scores of women brushing each other’s hair, trying on new dresses, eating snacks, performing the latest Bollywood dances, tending small children and disappearing into tiny bedrooms with nervous men who come out moments later buttoning their trousers.

A 2009 government survey found 2,000 prostitutes at Garstin Bastion (also known as G. B.) Road who served about 8,000 men a day. The government estimated that if it could deliver as many as 320,000 free condoms each month and train dozens of prostitutes to counsel safe-sex practices to their peers, AIDS infections could be significantly reduced. Instead of broadcasting safe-sex messages across the country — an expensive and inefficient strategy commonly employed in much of the world — it encircled Garstin Bastion with a firebreak of posters with messages like “Don’t take a risk, use a condom” and “When a condom is in, risk is out.”

Surprising many international AIDS experts, these and related tactics worked. Studies showed that condom use among clients of prostitutes soared.

“To the credit of the Indian strategists, their focus on these high-risk groups paid off,” said Dr. Peter Piot, the former executive director of U.N.AIDS and now director of the London School of Hygiene and Tropical Medicine. A number of other countries, following India’s example, have achieved impressive results over the past decade as well, according to the latest United Nations report, which was released last week.

Sruthi Gottipati contributed reporting in Mumbai and New Delhi.

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Toyota on track to become world's bestselling automaker again

Toyota Motor Corp. appears poised to regain its position as the world's largest automaker, a remarkable turnaround after years of safety recalls, huge federal fines and the Japanese earthquake last year.

In short order, surging sales have put that all in the rearview mirror.

Toyota is likely to sell 9.7 million vehicles this year, surpassing second-place General Motors Co. by more than 1 million vehicles and setting a record for annual auto sales. That's generating huge profits, with earnings tripling in the latest quarter to $3.2 billion and sales surging almost 20% compared with a year earlier.

The U.S. — where Toyota's reputation suffered most through the recalls — is now a cash cow. Through the first 10 months of the year, the Japanese automaker sold more than 1.7 million cars and trucks in the country, a 30% gain and more than double the industry growth rate.

"Toyota has done some smart things," said Rebecca Lindland, an analyst with IHS Automotive. "They have concentrated a lot of time and effort on the U.S., which is incredibly important because they make so much money here."

The Japanese automaker has launched 11 new or completely redesigned models in the U.S. in the last year, including new station wagon and commuter versions of its popular Prius hybrids. On Wednesday, the first day of the Los Angeles Auto Show, it will launch a new-generation RAV4 sport utility vehicle. The current model is an aging vehicle facing stiff competition from newly redesigned offerings such as Ford Motor Co.'s Escape and Honda Motor Co.'s CR-V.

Toyota has ramped up its factories in the U.S., opening a Corolla plant in Mississippi and expanding pickup truck manufacturing in Texas. And at the urging of Chief Executive and founding-family member Akio Toyoda, the automaker is looking to inject some panache into its historically bland styling, especially for its Lexus luxury division.

Toyota now accounts for 14.4% of the U.S. auto market, up from 12.6% during the first 10 months of 2011. In retail — not including rental and fleet sales — the Toyota brand is the biggest in the U.S., outselling GM's Chevrolet.

Lynne Thomas, a Santa Monica resident who works in the restaurant industry, bought a Toyota Prius C hybrid in October after considering other fuel-efficient vehicles including the Smart fortwo, Fiat 500 and Volkswagen Jetta.

"I love the mileage. I'm getting more than 50 mpg," Thomas said. "It fits my lifestyle completely. It is easy to park in this crazy city. I can put my bike in the back and drive somewhere and do an amazing bike ride. It works really well in stop-and-go traffic."

The company is expanding its factory network in the U.S. as part of a strategy to manufacture in regional markets and blunt the profit-eating consequences of the Japanese yen's strong exchange rate with the dollar. It has put $1.4 billion into U.S. factories and equipment in the last year, adding more than 2,700 jobs, on top of the 1,300 positions created in the U.S. the previous year.

The expansion comes after Toyota's controversial decision to close the New United Motor Manufacturing Inc. plant in Fremont, Calif., displacing nearly 5,000 workers in early 2010. Toyota shut the plant after GM, as part of its bankruptcy reorganization, pulled out of joint manufacturing there.

Toyota also is shipping more U.S.-built vehicles abroad. In the first 10 months of this year, it exported 74,000 U.S.-built cars to Canada and Mexico and 29,000 to overseas markets. It is sending Kentucky-built Camrys to South Korea and Indiana-built Sequoias to Saudi Arabia. Exports of U.S.-built Toyotas are on track to rise more than 50% this year.

Just three years ago, Toyota was the second-largest auto seller in America, with 17% of the market, and was closing in on a crippled GM, which was struggling with the stigma of bankruptcy and a federal bailout. But Toyota was derailed in a series of embarrassing recalls. In one high-profile accident, an improperly positioned floor mat in a sedan from Toyota's Lexus luxury division may have trapped the accelerator — causing the car to race down California Highway 125 near San Diego at more than 100 mph. The car crashed and burned, killing off-duty California Highway Patrol Officer Mark Saylor and three members of his family.

That crash led to a safety investigation and recall of 3.8 million Toyota and Lexus vehicles to fix the floor mat problem. After a Los Angeles Times series on unintended sudden acceleration, Toyota issued millions more recall notices to fix sticking gas pedals and other issues. Then, two years ago, Toyota paid record federal fines of nearly $50 million for failing to promptly inform regulators of defects and for delaying recalls. At one point it had to halt much of its production of new cars in the U.S. to fix recalled vehicles.

Just as the automaker started to recover, it was hobbled by last year's earthquake and tsunami in Japan, which upended Toyota's manufacturing even on American soil. Toyota's share of U.S. auto sales slid to 12.9%, well below GM's and Ford's.

Several factors have helped Toyota survive the recalls and disaster-related production shutdowns, said James E. Lentz, CEO of Toyota Motor Sales, the automaker's U.S. marketing arm.

First, there was "the loyalty of our consumers as we went from the financial crisis to the recalls to the tsunami," he said. "They stayed with us for the entire time."

Lentz is thankful for customers such as Evan Rabinowitz of Sherman Oaks, who bought a Camry sedan in August.

"I didn't look at anything else because I never had an issue with my 2008 Camry. Going back to Toyota was a no-brainer," said Rabinowitz, who owns a fabric business. He said his previous Toyota was recalled twice to fix pedal issues, but that work was done quickly and well and didn't dissuade him from purchasing another Camry.

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Dave Roberts brings diversity to the San Diego County supervisors

DEL MAR — In January, when he joins the San Diego County Board of Supervisors, Dave Roberts will be the only Democrat among four Republicans, the first Democrat on the board in more than two decades.

He will also be the first new supervisor in 18 years. And he will be the only one who is not a graduate of San Diego State. He has three degrees from American University in Washington, D.C.

He's also gay and married to a retired Air Force master sergeant. The two are adoptive parents to five former foster children, ages 4 to 17, who call them Daddy Dave and Daddy Wally.

With Roberts' election to a district representing a portion of San Diego and several seaside communities north of the city, diversity has arrived for the Board of Supervisors, long one of the region's most homogenous governing bodies.

"I'm going to bring some unique characteristics," Roberts, 51, said with a laugh during a family outing on the beach here.

Roberts hopes to concentrate on the same issues he focused on while serving on the Solana Beach City Council, where he is currently deputy mayor: regional fire protection, expansion of the San Dieguito River Park and "sensible" growth.

Roberts is a Democrat in the style of Republican-leaning northern San Diego County: fiscally conservative. He worked as a budget analyst for the Department of Defense and as a corporate vice president for the La Jolla-based defense contractor SAIC. He was a Republican until some in the GOP took exception to a gay man working in the Pentagon.

"The Republicans wanted me to be fired," Roberts said. "That's when I changed political parties."

Some of his first experience in government came from working as a staffer to Sen. Lowell Weicker, a Republican from Connecticut. "I learned from working for Sen. Weicker that you can make change if you're in the right place," Roberts said.

In 2009, Democratic party officials encouraged Roberts to seek the party's nomination to face incumbent Brian Bilbray (R-Carlsbad) in the 50th Congressional District.

On the verge of declaring his candidacy, Roberts was alerted by social workers about two children who needed a "forever" home. He decided that the adoption process took precedence over his political career.

Now there are five children in the two-story home in Solana Beach once owned by singer Patti Page: Robert, 17; Alex, 12; Julian, 8; Joe, 5; and Natalee, 4. Three of the children have taken the last name Roberts, and two took his spouse's last name, Oliver.

"We don't like double names," Roberts said.

Roberts and Wally Oliver, 55, have been together for 14 years. They had a commitment ceremony in 1998 and married in July 2008 in the brief period when county clerks in California were allowed to issue same-sex marriage licenses.

The family may soon expand.

"Wally would like a baby," Roberts said. "We're not Jewish, but we believe in the Jewish proverb: 'If you can save one soul, you can save the world.'"

During his race against a Republican opponent, Roberts was endorsed by the retiring incumbent, Pam Slater-Price. He has also begun discussions with Supervisor Dianne Jacob, possibly the most fiscally conservative member of the board.

He also looks forward to working with Supervisor Bill Horn, an ex-Marine who supported Proposition 8, the measure to ban same-sex marriage, and has said he opposes gays in the military. "He says things from time to time that remind me of my father," Roberts said.

For all of their fiscal conservatism, the supervisors have not dabbled much in social issues in a way that might satisfy some elements in the GOP. The board took no position on Proposition 8. Health clinics in gay neighborhoods and AIDS prevention programs are funded without controversy.

Roberts may be different in another respect from his colleagues: He will not be assigning a staff member to send out his Twitter messages. He sends out his own tweets — lots of them, on topics political and personal.

Last week, among many tweets, was one announcing that he has hired his predecessor's chief-of-staff, praising him for his "broad experience, management style and network of contacts."

And the next tweet: "Took the kids out for frozen yogurt at Seaside Yogurt in Del Mar for a treat."

tony.perry@latimes.com

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Secret message found with carrier pigeon may never be deciphered

British man finds carrier pigeon skeleton in his fireplace with unbreakable secret code (Reuters)

Before military forces had secure cell phones and satellite communications, they used carrier pigeons. The highly trained birds delivered sensitive information from one location to another during  World War II. Often, the birds found the intended recipient. But not always.

A dead pigeon was recently discovered inside a chimney in Surrey, England. There for roughly 70 years, the bird had a curious canister attached to its leg. Inside was a coded message that has stumped the experts.

The code features a series of 27 groups of five letters. According to Reuters, nobody from Britain’s Government Communications Headquarters has been able to decipher it. The message was sent by a Sgt. W. Scott to someone or something identified as “Xo2.”

A spokesperson remarked, “Although it is disappointing that we cannot yet read the message brought back by a brave carrier pigeon, it is a tribute to the skills of the wartime code-makers that, despite working under severe pressure, they devised a code that was indecipherable both then and now.”

The bird was discovered by a homeowner doing renovations earlier this month. In an interview with Reuters, David Martin remarked that bits of birds kept falling from the chimney. Eventually, Margin saw the red canister and speculated that it might contain a secret message. And it seems as if the message will always be secret.

Carrier pigeons played a vital role in wars due to their incredible homing skills. All told, U.K. forces used about 250,000 of the birds during World War II.

Wireless News Headlines – Yahoo! News

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Marc Anthony comes to aid of Dominican orphanage

SANTO DOMINGO, Dominican Republic (AP) — Singer Marc Anthony is coming to the aid of an orphanage in the Dominican Republic.

A foundation run by Anthony with music and sports producer Henry Cardenas plans to build a new residence hall, classrooms and a baseball field for the Children of Christ orphanage in the eastern city of La Romana. Anthony attended the groundbreaking ceremony Friday with his model girlfriend Shannon de Lima.

Children of Christ Foundation Director Sonia Hane said Anthony visited the orphanage previously and decided to help. His Maestro Cares Foundation raised $200,000 for the expansion on land donated by a sugar company. The orphanage was founded in 1996 for children who were abused or abandoned or whose parents were unable to care for them.

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Wealth Matters: Dealing With Doctors Who Accept Only Cash

A FEW weeks ago, my wife and I were at our wits’ end: our 4-month-old daughter wouldn’t sleep for more than an hour at a time at night. We had consulted books and seen our pediatrician, but nothing was working. So my wife called a pediatrician who specializes in babies who struggle with sleep problems.

The next day, he drove an hour from Brooklyn to our house. He then spent an hour and a half talking to us and examining our daughter in her nursery. He prescribed some medicine for her and suggested some changes to my wife’s diet. Within two days, our baby was sleeping through the night and we were all feeling better.

The only catch was this pediatrician did not accept insurance. He had taken our credit card information before his visit and given us a form to submit to our insurance company as he left, saying insurance usually paid a portion of his fee, which was $650.

A couple of weeks later, our insurance company said it wouldn’t pay anything. Here’s how the company figured it: First, it said a fair price for our doctor’s fee was $285, about 60 percent less, because that was the going rate for our town. Then, it said the lower fee was not enough to meet our out-of-network deductible.

While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.

Last year, I wrote about doctors who catered only to the richest of the rich and charged accordingly. But after my experience, I became interested in doctors for the average person who take only cash. What pushes a doctor to go this route, often called concierge medicine? And how hard is it to make a living?

As to why doctors decide to switch to a concierge practice, the answer is almost always frustration.

“About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit,” said Stanford Owen, an internal medical doctor in Gulfport, Miss. “At 2 a.m., I woke up and said, ‘This is it.’ ”

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

“When I decided to abandon insurance, I didn’t want to lose my patient base and make it unaffordable,” he said. “I have everything from waitresses and shrimpers to international businessmen. It’s a concierge model, but it’s also the personal doctor model.”

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

At the other end of the spectrum is David Edelson, who runs a practice called HealthBridge in Great Neck, N.Y. In addition to five doctors, the practice has a full fitness center and provides the services of a personal trainer, nutritionist, acupuncturist, sleep expert and stress-management consultant.

“The current model for primary care is broken,” Dr. Edelson told me. “Either I can go down with the ship, sell my practice to a hospital or take my practice in the wrong direction. Or I can develop a better mousetrap, which is more time dealing with patients and their care.”

Dr. Edelson has reduced his own practice to 300 patients, from more than 3,000. Of those, 250 pay $1,800 a year for concierge services and 50 others receive scholarships. He estimated that from the combination of the membership fee for the extra services and what gets billed to insurance for typical care, he will make $600,000, and more of that will end up in his pocket.

“We’re bringing in the same fees but we’re reducing our overhead,” he said. Fewer patients means fewer medical assistants, receptionists and staff members to deal with insurance.

But of the five doctors in the practice, he is the only one to go fully concierge. Another, William Klein, is testing the model, with 15 percent of his patients in the concierge program. Dr. Klein said he was hedging his bets because he was not sure what the new federal health care law would mean for primary care physicians.

Weren’t some patients getting shortchanged by this hybrid model? He said he saw no difference in care.

“It’s like paying for first class and not coach,” Dr. Klein said. “Everyone is getting to the same destination, but some people have a better seat.”

This approach to medicine is not without risks for the doctors and downsides for patients.

This article has been revised to reflect the following correction:

Correction: November 23, 2012

An earlier version of this column gave an incorrect middle initial for Mr. Harris. It is M., not V.

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Online options multiply for holiday greeting cards, party invites

We've all received them — cheesy holiday greeting cards and party invites with messages like, "Ho ho hope you have a very merry Christmas."

Pre-written mass-produced cards are getting passed over in favor of a slew of new options, both digital and paper, created online via websites or apps. The expanded offerings come as card companies gear up for the busiest time of the year.

Planning on throwing a holiday party? Evite last month launched Postmark, the West Hollywood company's first new offering since its 1998 launch. The digital-only invitations are being touted as premium products that are more visually attractive — think digital glitter effects and cutout angels — than typical text-on-rectangular-background evites.

Customers can choose from a variety of envelope colors and coordinating patterned liners, write their own unique message and incorporate their own photos. Unlike Evite's free invitations, the products from the Postmark line cost money: For $12, users can send 75 personalized e-invitations with a coordinating designer stamp, for example.

Hans Woolley, president of Evite, said the idea for Postmark came from users who said they wanted the ease and convenience of digital evites with the style of designer paper invitations.

"It's a new manifestation of the medium," he said. "We want to inspire you, break the mold a little bit, reinvent the category. It's like a juxtaposition of old and new."

If you still like the idea of a physical card, premium e-card company Paperless Post last month expanded its selection to include paper products. Paper by Paperless Post lets customers access the company's website to create holiday cards and other products that are then printed on stationery in thick and double-thick card stock.

Cards from the Paper by Paperless Post line start at $1.10 including envelope; production of custom cards takes three to seven business days, with deliveries to buyers via FedEx.

Siblings James and Alexa Hirschfeld, who co-founded Paperless Post three years ago, said they decided to roll out paper products ahead of the busy holiday season after realizing customers didn't want to be limited to online-only cards and invites. Despite having to pay more for products from the Paper line, customers don't seem to mind, they said.

Even technology giant Apple Inc. last year launched its homegrown Cards app, free in the App Store, which customers can use on their mobile devices to make letterpress cards personalized with text and photos. Physical versions of the cards can be sent directly to recipients within the U.S. for $2.99 and internationally for $4.99, saving the hassle of buying stamps and a trip to the post office.

The online card industry is a competitive space, and the next few weeks are "going to be the most intense time of the season," said Heather Maddan, chief storyteller at Shutterfly. The photo printing company has rolled out 600 new holiday card designs for the season, including 60 new religious card designs, and introduced a large 6-inch-by-8-inch photo card format. Photos can be uploaded from Instagram or other sources, and finished cards can be shipped to the buyer or directly to recipients.

Traditional card makers are also trying to stay ahead by offering apps to send custom holiday greetings. The Hallmark Go Cards app enables users to send greeting cards and photo cards with personal touches straight from their iPhone or iPod Touch. Hallmark will then mail the card anywhere in the U.S. for $3.49.

andrea.chang@latimes.com

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Middle East shifts may weaken Iran's influence with Palestinians

CAIRO — Iran for years has supplied Hamas with weapons as part of its own struggle against Israel, but the conflict in the Gaza Strip reveals a shift in regional dynamics that may diminish Tehran's influence with Palestinian militant groups and strengthen the hand of Egypt.

The longer-range missiles fired by Hamas over the last week — believed to be modifications of Iran's Fajr 5 missiles — startled Israel by landing near Jerusalem and Tel Aviv. A front-page story in Iran's conservative daily, Kayhan, boasted: "The missiles of resistance worked." Tehran would not confirm the weapons' origin, except to say it sent rocket "technology" to Hamas.

Instead, Foreign Ministry spokesman Ramin Mehmanparast told reporters: "What is important is that the people of Palestine must be equipped to defend themselves, and it is the responsibility of all countries to defend the rights of the people of Palestine."

But the Gaza fighting erupted during a new era in the Middle East brought about by the rise of Islamist governments, notably in Egypt, that have replaced pro-Western autocrats. The political catharsis has spurred anti-Americanism, which Iran relishes, but it also has upset Tehran's regional designs.

In Syria — which along with the militant groups Hamas and Hezbollah has been Iran's proxy opposing Israel — a revolt inspired by the "Arab Spring" could force President Bashar Assad from power and bring in a government less friendly to Tehran. Hamas angered Iran by opposing Tehran's continued support of Assad and siding with the Syrian rebels, who are mostly fellow Sunni Muslims.

Iran's immediate concern in Gaza is keeping Hamas from strengthening its ties to Arab capitals. This may be difficult, as evidenced by the fact that Egypt's Muslim Brotherhood, which inspired the founding of Hamas and now is in charge of the Egyptian government, played a key role in brokering the cease-fire announced Wednesday.

Egyptian President Mohamed Morsi is likely to press the militant group not to further agitate the region — and Egypt's many domestic problems — with sustained violence against Israel. But Egypt has been criticized for tacitly arming Hamas by not tightening its border with Gaza to stop weapons smugglers from Libya and Sudan.

"The Iranians [had] better understand the paradigm is shifting in the Middle East," said Nabil Fahmy, former Egyptian ambassador to the U.S. and founding dean of the School of Public Affairs at the American University in Cairo. "Hamas needs Cairo tremendously. It really has no other interlocutor to deal with Israel."

But he added that the region is so fluid and unsettled that it is too early to predict winners and losers: "If there are peaceful resolutions, this will lead to a reduced Iranian role. If, on the other hand, you have an increased use of violence," he said, "then ultimately any player that has been supportive of a more aggressive posture will gain ground."

Iran characterized Hamas' rocket fire on Israel as part of an effort to keep the government of Prime Minister Benjamin Netanyahu off balance. Netanyahu has threatened to attack Iran's nuclear program, and some suggest the airstrikes on Gaza have been a warm-up exercise. Tehran viewed the Gaza conflict as a means to distract Israel and further inflame anti-Jewish sentiment in a region tipping increasingly toward Islamists.

"Hamas' ties with Muslim Brotherhood and Egypt's current government are different from its ties with Iran," said Nader Karimi, a journalist and political analyst in Tehran. "In peace, when diplomacy is needed, Hamas is closer to Egypt at the expense of Iran. But when it's at war with Israel, Hamas' relations with Iran are more important."

Khaled Meshaal, Hamas' political chief, acknowledged as much after the cease-fire was announced Wednesday. "Iran played a role in this achievement as well," he said. "We have differed with Iran on the Syrian issue, but we agree against the oppression and occupation of Zionists."

The Muslim Brotherhood in Egypt "let down Hamas in the current war," said Hamid Reza Taraghi, a conservative Iranian analyst who criticized Cairo for not opening Egypt's border with Gaza to supply Hamas with arms. "Hamas now realizes that Iran is the genuine supporter of the Palestinian cause."

Former Egyptian President Hosni Mubarak was suspicious of both Hamas and Iran. Mubarak, a close U.S. ally, had no formal ties with Iran for decades. Morsi visited Tehran last summer and indicated a change in tenor, even as he has angered Iran by condemning Assad's mass killings of Syrians.

But Egypt's domestic problems, including economic turmoil, the battle over a new constitution and gas and water shortages, are his steepest challenges. Morsi also is attempting to stem increasing instability in the Sinai Peninsula, where resurgent militant groups, some believed to be aided by Hamas, have killed Egyptian security forces and launched attacks at Israel.

Trouble in the Sinai jeopardizes Egypt's 1979 peace treaty with Israel but plays into Iran's efforts. Analysts suggest that Cairo will work to rein in Hamas, and other rivals of Iran including Sunni Muslim Persian Gulf nations such as Qatar will also be more deeply involved. The emir of Qatar, Sheik Hamad bin Khalifa al Thani, visited Gaza in October and promised $400 million in aid.

Egypt, however, poses the biggest obstacle to Iran's plans in Gaza. Morsi and the Muslim Brotherhood regard Cairo as the unquestioned regional mediator between the Palestinians and Israel.

"Egypt has historic, geographic and religious ties with Palestine and Gaza. These ties cannot be bought," said Sadegh Hosseini, an expert on Iranian politics. "Gaza is the backyard of Egypt. In recent years, we have seen that ideologically Hamas is another branch of the Muslim Brotherhood."

jeffrey.fleishman@latimes.com

Times staff writer Fleishman reported from Cairo and special correspondent Mostaghim from Tehran.

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