Thursday, December 21, 2017

Lights and Latkes

At Touro Synagogue December 16, 2017

Lights and Latkes


As told to Aaron Ginsburg

Now listen bubbele, I know you like to write things, and then talk about them, and hear other people talk about them, but, Mr. Ginsburg, step back. Now it’s my turn.
You’ve heard the expression, “The Mountain came to Mohammed.” I saw it for myself on Shabbos, but this time, Brooklyn came to Touro Synagogue. In addition to Brooklyn, Stamford, Albany, and London were represented.
At 9:15, I arrived at Newport's Touro Synagogue. (Honey, I like to sleep late on Shabbos.) Prayer was paused pending the imminent arrival of a minyan. Soon we began the Barchu, followed by singing Kal Adon, which is my arrival benchmark.
Vey iz mir, because of Hanukah we recited the full Hallel. I thought we would never get out of shul. Fortunately, our Rabbi, Marc Mandel came to the rescue after the Torah service, and we made up for lost time.
Have a told you about our rabbi? With a sweet name like Mandel..I can’t help it, I think of mandelbrot when I hear his name, he is a great guy. Most importantly, he knows how long a sermon should not be. When he gives a Dvar Torah, a word of Torah, he counts the words, and he doesn’t like high numbers.
Rabbi Marc Mandel began by reading from an article by Mrs. Chaya Batya Neugroschl, Head of School, YU High School for Girls. I think they call her “Mrs.” for short.

She quoted Ramban our magnificent sage with the distinguished beard. How can someone with a beard like that not be full of wisdom?

ִמִצְוַת נֵר חֲנֻכָּה מִצְוָה חֲבִיבָה הִיא עַד מְאֹד וְצָרִיךְ אָדָם לְהִזָּהֵר בָּהּ כְּדֵי לְהוֹדִיעַ הַנֵּס וּלְהוֹסִיף בְּשֶׁבַח הָאֵל וְהוֹדָיָה לוֹ עַל הַנִּסִּים שֶׁעָשָׂה לָנוּ
The precept of lighting the Chanukah lamp is exceedingly precious, and one should carefully observe it in order to acclaim the miracle, ever praising and thanking God for the miracles which he has performed for us. Hilchot Chanukah 4:12 
In Hasmonean times, the Mrs. said, Hanukah was one of many mini-festivals celebrating the victories of the Maccabees. After the second Temple was destroyed, only Hanukah remained. I guess someone decided those extra Monday holidays were taking up too much time. 
Why Hanukah? Perhaps because light represents wisdom and learning. Our Rabbis usually look for the spiritual aspect of things, and downplay the military side of the story. The Maccabees with their military prowess and tough guy approach were inconvenient. The Rabbis were following in the footsteps of the Prophets, who also were not fans of the Kings. 
Nowadays, the miracle of the lights shares the billing with a heavier event, the miracle of the latkes. Of course, my latkes are as light as a cloud, a cumulonimbus cloud. 
Alan Rosen, a visitor from Albany pointed out the special Haftarah’s famous phrase, “Not by might, but by my Spirit,” rebukes the Maccabees.
לֹ֤א בְחַ֙יִל֙ וְלֹ֣א בְכֹ֔חַ כִּ֣י אִם־בְּרוּחִ֔י אָמַ֖ר יְהוָ֥ה צְבָאֽוֹת׃
“Not by might, nor by power, but by My spirit—said the LORD of Hosts.”
Rabbi Mandel described a famous debate between Hillel and Shammai on how to light the Hanukah candle, "Shamai said, look to the future, that's why he starts with 8 candles. Hillel looks to the present, that's why he starts with 1 candle."
I think Hillel and Shamai were kind of silly. What about you? Fortunately, Rabbi Mandel pulled a rabbi out of a hat.

In our lives, Rabbi Mandel said, we need to both take care of today, and plan for tomorrow. And we should let the light of Torah guide us in both!
How succinct! How wise! Oh, and did I tell that Rabbi Mandel knows how to carry a tune?
Visitor David Lipshitz said, “There are two days of our life that we have no control over, yesterday and tomorrow, so we need the best that we can today, and start the process over tomorrow.”
The Greenpoint Shul
At Kiddish, I overheard  Alan Perlmutter mention his shul, Brooklyn’s Greenpoint Shul. My ears perked up. 
The previous week at the Union of Reform Judaism URJ 2017 Biennial convention in Boston, I visited the vendor booths. I spoke with  Avi Zuckerman. Avi came up with a make your own Yad project for B’nai Miztvot. What a clever way to bring a memorable, tangible Jewish focus to a celebration which often is less than spiritual. One good Yad deserves another! Let's give  Avi a hand!

I told Avi how much I enjoyed Touro Synagogue, and he told me about his shul, the Greenpoint Shul.
I pulled out Avi’s business card, and of course visitor Adam Perlmutter knew him well.
Adam told me an Avi story. Avi went to a restaurant in Boro Park, which is noted for its large Ultra-orthodox and Hassidic community. He sat down, and asked the waiter if the restaurant had a hechsher (Kosher certification). The answer was, “Yes, of course.” Avi said, “ Nu, so where is it?” (the hechsher should be conspicuously posted). The waiter got a little exasperated, and said, “It’s right there on the wall.” Avi said, “It's hard to read.” By now the waiter was visibly upset. He took the hechsher off the wall. Avi glanced at it and said, “I’ve never heard of the Rabbi who signed this document. Are you sure this hechsher is valid?” What happened after that, I don’t vant to tell you.
I wasn’t going repeat the following, but I can’t resist. When I contacted Avi for more details, he wrote, “Adam is a dear friend so whatever Adam tells you cut 80% off and throw it away then divide the 20% left in half, than shrink the leftovers to minimal, and you got the truth. LOL.” When Adam introduced the story, he said exactly the same thing about Avi!
Talk about friendship!
The Greenpoint Shul was built in 1902. As Jews moved away, the shul managed to hang on thanks to a dedicated Rabbi. Times have changed, and Jews have returned. Recently the Greenpoint Shul was restored, and Touro Synagogue was the model that the Congregation kept in mind. Touro and Greenpoint are both small Orthodox shuls that make all feel welcome.
David Lipshitz is the son of the Dzirka Rebbe. The Djerkas are one of many Hassidic dynasties. Dzirka, Györke, Hungary, is now Ďurkov, Slovakia. David suggested I use the word “jerk” as a mnemonic device to help remember “Dzirka.” 
While walking in Newport, David recounted, “Someone came up to me and said, ‘Why are you wearing a Halloween costume two months after Halloween.’” David replied, “For me every day is halloween.” 
During a walk in Brussels, a man castigated David for being a f-ing Jew. He ran after him, and said, “Why are you blaming me for something I had no control over? My parents were both f-ing Jews, and I had nothing to do with it!”
At this point, I asked David if he had thought of becoming a comedian.
We all enjoyed the kiddish. David commented that Kiddish was to help people relax and communicate, and that G-d did not need the Kiddish, but we did. 
G-d does not need us to have minyan, nor our thrice daily prayers. These are for us, to lead us to live a better life.
So, bubbele, I want that you should go to many a Kiddish, pray three times a day, and live a better life. And, Mr. Ginsburg, don’t forget to visit me so you can enjoy my latkes! #greenpointshul #jewishnewportri #newportri #tourosynagoguenewport

Friday, December 8, 2017

At Touro Synagogue The Laws of Employment

 The Laws of Employment

At Touro Synagogue, December 2, 2017 

We were a merry, well heated band at Touro Synagogue on Saturday. Our minyan arrived early. We had the usual core of regulars, supplemented by Navy personnel, visitors from New York, and from Newton, MA.

In the Parsha, one of the dramatic events was when Yaakov’s name was changed to Israel…actually, it wasn’t changed, it was just an additional name. 

Yaakov’s name was changed twice, first after a wrestling match (Rabbi Mandel said it was not clear who he was wrestling with), and once by the Almighty. One might wonder if this was an editing mistake. I think the explanation might be that since Yaakov did not know who he wrestled with, it was better to make clear the source, and the higher the better.

Rabbi Marc Mandel spoke about employee-employer relations. He made clear that the obligations run both ways:

“Yaakov’s father-in-law, Lavan, was chasing after him and caught up with him, and Yaakov says to him, ‘What do you want from me? I worked for you for 20 years. I barely slept-and I helped your estate make great profits.’

“The Rambam, Maimonides, learns out from this that just as there are laws as to how an employer should treat an employee, there are also laws about how an employee should treat an employer.

“In the laws of employment, (Maimonides, Mishnah Torah, Laws of Employment, Chapter 13, Law #7), a worker can’t waste time and must work as much as he can. The Rambam says,  'If you are working you can leave out the 4th Bracha of the Benching because it is only a Rabbinic Bracha.’ The Rambam called Yaakov a Tzadik for working so hard.

“What was Lavan’s reaction? Lavan says, ‘Everything you have is mine. You own nothing.’

“How do you think Yaakov felt when Lavan treated him this way?

“We see in today's working world, very often, the workers are not appreciated. They work hard but they're not appreciated. So it goes both ways-in today’s world-The workers must work honestly and diligently and the employers must recognize  and honor the workers for their efforts.

"Shabbat Shalom!"

After services we adjourned to the Kiddish. There was more than enough food for all, which stimulated the conversation.

I got a chance to speak with Mr. and Mrs. Lake, of Newton, Massachusetts. Mrs. Lake is a member of a renowned rabbinical family, the Soloveitchiks. 

Mr. Lake told me he was an immigrant. He came with his family from Plissa in 1938. Plissa is now in Belarus, but at the time it was in Poland. It is close to Glubokie, just 12 miles away. On June 1, 1942, the 412 Jews in Plissa were murdered during the Holocaust. Two survived the massacre, but one of them was subsequently murdered.

"During the 1950s," Mr. Lake said, “I was in the army, stationed in Germany. I brought my wife, and we rented an apartment on the first floor of a house. Fluent in Yiddish, I was able to understand German, and make myself understood. Invited to church, I explained to the landlady, “Ich bin Jude.’  

“Coming home one Friday, I saw that the landlady was on her hands and knees washing my floor. I asked, ‘Why?’ and she replied, ‘It’s your sabbath.’”

The Lakes were invited to a party at the landlord’s apartment. The other guests were the landlord’s friends. Not knowing anyone, Mr. Lake started thumbing through a photo album, and discovered the landlord has been a Gestapo officer. It was a subject Mr. Lake and the landlord never discussed.

Friday, September 29, 2017

Rosh Hashanah 2017 at Touro Synagogue Newport, RI

Rosh Hashanah 2017

At Touro Synagogue, September 22-23, 2017 

[regarding the video, which is at there is a discussion including the lyrics at As sung, the following verse was omitted,
"A year has now passed in misery and fear
Your child is swimming in blood
Innumerable pogroms and war all the time
Butchered without any sin at all
Those without a father, without a mother,
they feel desolate as a stone
We beg you, God, in your holy name,
That this shall never happen again."]

When people meet, they try to find something in common. Do they share the same interests? Who do they know? Where have they been? We know this as playing Jewish geography. I overheard one of our Navy students, “If you are in the Navy, there is an additional  commonality. Have you been to Touro Synagogue? Have you met Rabbi Mandel?” From shore to shore, the reputations of CJI and Rabbi Mandel sail high above the waves!

Among our visitors during Rosh Hashanah were Moshe Bar-Z'ev and his wife, Carol Fuchs. Moshe and Carol both made Aliyah during their youths, Moshe from the United States and Carol from Toronto. Moshe has a special link with Newport, since he can trace his routes to Dokshitz, like many Newporters. They are inveterate travelers, and were in Orlando during the Hurricane Jose. They regaled us with tales of visiting Luxor Egypt.  

To help us concentrate, at Touro Synagogue, we listened to the battle of the Shofars. Rabbi Marc Mandel’s blasts pierced our hearts. Saul Woythaler's shofar is a Stradivarius of shofars, and Saul plays the bassoon. He not only pierced our hearts, but filled the room and perhaps went even higher.  

Rabbi Marc Mandel spoke succinctly on both days of Rosh Hashanah. He focused on two words, on the first day, “צחק” (laughed)  and on the second day, “shanah” (year). 

First Day

Rabbi Mandel started with a famous quote from Shakespeare’s “Romeo and Juliet,” 

“What's in a name? That which we call a rose by any other name would smell as sweet.”  

In the interest of full disclosure, Juliet most likely said, 
“What’s in a name? That which we call a rose,By any other word would smell as sweet.”
She was telling Romeo he should change his name from Montague. To Juliet, names did matter!

“On Rosh Hashanah we have the custom of wishing each other a Shana Tova, a good year. The word shanah means year. But the word shanah has various other meetings.

“Shakespeare said, ‘What's in a name? That which we call a rose by any other name would smell as sweet.’ But names are important.

“Rosh Hashanah has several different names. It is known as Yom Ha-din-the day of judgment. The Mishnah tells us that the whole world is judged on Rosh Hashanah. It is known as Yom Teruah, the day of the shofar. We will make 100 sounds on the shofar. 

“It is also known as Yom Hazikaron, a day of remembrance. Being remembered on Rosh Hashanah? Who is doing the remembering? One answer to this question is: God remembered Sarah on Rosh Hashanah, and she was able to have a child, as she was promised.

“Let's remember–How did Sarah react when she heard that she was going to have a child at her old age? What was her reaction? She laughed. She was laughing! And when her child was born-what did she name him? Yitzhak, which means laughter, to laugh.

“Some philosophers believe that the essence of humor lies in its incongruity. We laugh at things that surprise us because they seem out of place.

“That's why Sarah laughed-it seemed impossible for her to have a child-she was an older person at the time. 

“But why are we focusing on humor on Rosh Hashanah of all days? Rabbi Sampson Rafael Hirsch, rabbi in Frankfurt, Germany during the 1800s noted that in Hebrew, the word for laughed, צחק, is very similar to the word for scream, צעק. We have two virtually identical words for two opposite emotional expressions. There could be an important lesson for us on this New Year. 

“When we look at the world around us we could either scream or laugh. When we look at the world and see North Korea with its nuclear arsenal, or the threats that climate change and global warming post to our planet, we want to scream.

“But, we can also look at the world and see how much medicine has improved the lives people all over the world, and how rapid change in technology are making the world better–we want to laugh.

“Rosh Hashanah tells us to be like Sarah and laugh. When Sarah heard that she was going to have a child at her late age, she could have screamed and said, “Who is going to take care of this child? How will I survive the birth of this child?” But she didn't scream. She laughed. 

“And that’s who we have to emulate-as we begin the New Year, full of challenges and worries and concerns-let us be like Sarah the woman of valor – and let us laugh and be optimistic as we begin the year of 5778. Shana Tovah!”

Second day

“On Rosh Hashanah we have the custom of creating each other with the phrase Shanah Tovah!  Shanah means year, and Tova means good. We wish each other a good year. But the word Shanah has other meanings too.

“The prophet Malachi wrote, describing God (Malachi 3:6,
 אֲנִי יְהוָה, לֹא שָׁנִיתִי   ‘I, the Lord, do not change.’ The word  שָׁנִה means to change. But we are obliged to change. That is the essence of the High Holy Days. Rosh Hashanah is when we commit to change. 

“So what holds us back from changing? It’s the very same word, שָׁנִה, which also means to repeat. The Jewish collection of laws is called Mishnah, because when they studied it, they repeated it so many times-they knew it by heart.

“Human beings are creatures of habit. We repeat the same things over and over again. So we have two opposite powers at war with each other-change and repetition. We want to be different and we want to change, but we are programmed to repeat. 

“How do we win this battle? For one thing, we sound the shofar. When was the shofar sounded? During wartime it was a rallying call. This is an existential war that we are all fighting and the battle in earnest on Rosh Hashanah. 

“What else do we do during Rosh Hashanah to help us win the battle? We pray together. Longer and more intense prayer are supposed to stir us up and create the desire for change.

“That's really all we can do on Rosh Hashanah. We rally and pray together to emotionally support each other, as individuals and as one nation.

“Let us hope and pray we win the battle, and if we do, we will be partnering with God to repair this fragile and vulnerable world. Shana Tova.”

Jewish Newport wishes you victory in the existential battle we fight with ourselves. Shana Tova!

Monday, September 25, 2017

Yam Tov and Shana Tova

Yam Tov and Shana Tova

At Touro Synagogue September 15-16, 2017

On Friday many of us enjoyed a Shabbat dinner after services at Touro Synagogue, thanks to an anonymous benefactor. The food was not the only attraction. A visiting group from Israel led by coach Israel Altman, Yam Tov (Good Sea) was in Newport to sail with "Sail to Prevail," which is led by Paul Callahan. The group had a very busy week in Newport, and Friday night dinner was a much more relaxing affair. 

The visitors were gravely affected both physically and mentally by military service or experiencing terrorist incidents. Recovering from a wound can take years, and from the trauma of going from health and strength to sickness and dependency also takes a long time to heal. 

Many people worked together to make the visit of Yam Tov a success.

Sailing is one way to help people readjust. Sailing with others means team work…and being with similarly affected people…but working on something unrelated also helps the healing process. Our guests shared their experiences and impressions of Newport. 

On Saturday, Rabbi Marc Mandel spoke briefly about the double parsha. Rabbi Jeremy Bruce, head of school at the Hebrew High School of New England, where his son Carmi goes, had pointed out the two parshas had contradictory names. Nitzavim means to stand while Vayelach means to walk.

Rabbi Mandel applied this to the High Holidays. “Conceptually,” he said, “they don’t go together. That is the human condition. We try to move but we are frozen.  Teshuva (repentance) is a mechanism to solve this dilemma.”  

During the Yamim Noraim (Days of Awe), we have a chance to decide. Will we remain frozen in our ways, or will we move forward?

Shana Tova Umetuka. A good and sweet year to all of Jewish Newport! Let’s move forward together! Kadima!

Monday, September 18, 2017

Everybody can't sit in the front row!

At Touro Synagogue September 18, 2017
by Aaron Ginsburg BLOG   FACEBOOK

While I am gathering the latest news, I want to thank the seating committee for trying to keep everyone happy. I have my eye on a column half way down to the right so I can daydream but still be in a position to keep an eye on the action on the bima and at the ark...

I want to thank Sherm Palan for making sure I received this form so I get my preferred seat.
Anshei Emuna Congregation
During the last holiday season, many individuals expressed concern over the seating arrangements in the synagogue.
In order for us to place you in a seat which will best suit you, we ask you to complete the following questionnaire and return it to
the synagogue office as soon as possible.

1. I would prefer to sit in the... (Check one)
___ Talking section
___ No talking section
2. If talking, which category do you prefer? (Indicate order of interest)
___ Stock market
___ Sports
___ Medicine
___ General gossip
___ Specific gossip (choose one)
___ The rabbi
___ The cantor
___ The cantor's voice
___ Fashion news
___ What others are wearing
___ Why they look awful
___ Your neighbors
___ Your relatives
___ Your neighbors' relatives
___ Presidential Election
___ Other (e.g. single guys/ girls)
3. Which of the following would you like to be near for free professional advice?
___ Doctor
___ Dentist
___ Nutritionist
___ Psychiatrist
___ Child psychiatrist
___ Podiatrist
___ Chiropractor
___ Stockbroker
___ Accountant
___ Lawyer
___ Criminal
___ Civil
___ Real estate agent
___ Architect
___ Plumber
___ Golf pro [tentative; we're still trying to find a Jewish One]
___ Other
4. I want a seat located (Indicate order of priority)
___ On the aisle
___ Near the exit
___ Near the window
___ Near the bathroom
___ Near my in-laws
___ As far away from my in-laws as possible
___ As far away from my ex-in-laws as possible
___ Near the pulpit
___ Near the Kiddush table
___ Where no one on the bimah can see/hear me talking during services
___ Where no one will notice me sleeping during services
___ Where I can sleep during the rabbi's sermon [additional charge]
5. I would like a seat where:
___I can see my spouse over the mechitza
___ I cannot see my spouse over the mechitza
6. Please do not place me anywhere near the following people:
(Limit of six; if you require more space, you may wish to consider joining another congregation.) 
Your name:________________________________
Building fund pledge: $________________________

Saturday, September 9, 2017

The Exaltation of Ululation

At Touro Synagogue September 2, 2017
by Aaron Ginsburg BLOG   FACEBOOK

On September second over 60 members of the Danesh and Hakim families, originally from Iran, visited Touro Synagogue for an aufruf. It was a joyous occasion.  The video has the same spirit that we experienced.

The Exaltation of Ululation 
to the tune of the theme song from "The Sound of Music"

The shul is alive with the sound of ruach,
A sound we have heard for a thousand years.

The Danesh and Hakim families fill the shul with ululation,
To wish Jessica and Danny simcha and mazel tov.

We gladly join them to celebrate,
The aufruf of Danny Hakim,
On this very special day.

From the balcony to the bimah,
Our voices rise up to the sky!

To make that long wavering high pitched sound,
Resembling a trilling howl,
We make a high pitched noise,
With rapid movement of the tongue and uvula.

We shower the groom, 
With candy and raisins,
For sweetness and fruitfulness in the days to come.

As they create a bayit
Like so many before them,
Jessica and Danny join B’nai Yisrael
L’dor v’dor, l’dor v’dor.

B’nai Yisrael=the children of Israel

L’dor v’dor=from generation to generation
The poem can be sung to the theme from “The Sound of Music.”  

Friday, September 1, 2017

George Washington and Morton Glasser

George Washington and Morton Glasser

At Touro Synagogue August 26, 2017

Rabbi Marc Mandel welcomed everyone and made brief remarks,

“This week, millions of Americans witnessed a rare event-a total solar eclipse. As reported in Business Insider, Rabbi Martin Hier, my neighbor in Los Angeles, had this to say about the eclipse. ‘The moon is 400 times smaller that the sun, yet the moon had the capacity to do a complete eclipse on the sun. Now that should teach us about bigots and haters who started out as small groups.’ He said that fanatics and bigots can darken our planet. The United States ‘caught on late’ to the Nazi movement in Europe in the 1930s. ‘Let’s not catch on late now.’

“Rabbi Hier is delivering an important message. We have to be on guard because, even though George Washington wrote to our community in 1790, ‘That the United States gives to bigotry no sanction and to persecution no assistance,’ things don’t always turn out that way. 

“In fact Gordon Wood, who used to be a professor at Brown University, points out that George Washington was exaggerating, because in 1790 it was only the national government that had forsaken all religious tests and qualifications, but a majority of the states still had an established church and many of them continued to discriminate against some religious denominations.

“In our society today, there are those who are not tolerant and are not interested in a society that embraces all cultures. And what about the worlds of social media? On Facebook and Twitter people can write whatever they want-and very often there is no tolerance at all for other people, just anger and hatred and even threats. So we need to be careful about the future. The Talmud says that an eclipse can be a warning of things to come.

“Let us hope and pray that the upcoming year will bring us blessings and success and let us continue to work together, with all people of good will, to build a just society where all people can sit peacefully under their fig trees, with none to harm them.”

The Kiddish was sponsored by Drs Irene and Morty Glasser in honor of their family. Dr. Morton Glasser spoke about how the Generations Family Health Center in Connecticut, where he is the Chief Medical Officer, has helped people rid themselves of their addictions to prescription opiates for chronic pain and/or refrain from initiating the use of prescription opiates for chronic pain. The use of prescription opiates is one of the many causes of the current US drug epidemic.

It’s a weighty topic. Dr. Glasser traced the abuse of prescription opioids to a couple of things. There was a belief, since discredited, that prescription opioids had a low abuse potential, and there was a belief that pain was under-treated.  

Drug companies knew a good thing when they saw it. They funded the American Academy of Pain Management and the American Pain Society. The number of pain clinics increased. Medical guidelines were published in 1998 and 2004 that were widely adopted and made the use of opioids a standard pain treatment. Under the guidelines, a doctor could be accused of malpractice if he failed to prescribe. 

A chart posted in doctors offices and emergency rooms explained to patients a way to describe their pain on a scale of 1-10 with a smiley face at one end and a sad face at the other end. People who were addicted quickly learned how to manipulate the system to get their meds.

The result of all of this was a large increase in the number of prescriptions for opioids, and of people addicted to them.

Dr. Turner, an emergency room doctor visiting from Florida, confirmed what Dr. Glasser said. The visiting doctor mentioned that many of the deaths from opioids are among former addicts who relapsed. They overdosed themselves  by going back to their original dosage, not realizing that their bodies were no longer acclimated to high doses.  Both doctors agreed that patients who became addicted to prescription narcotics often turn to illegal drugs such has heroin and illicit versions of fentanyl, which are much less expensive than prescription drugs if they are not covered by insurance. 

About 5 years ago, Dr. Glasser realized that his clinic was overprescribing opioids. He gave the clinic’s doctors six months to wean their patients off.  The patients were in an uproar at first, but eventually felt much better. They would be offered alternate methods of treatment including physical therapy, non-opioid pain medications, and TENS (Transcutaneous electrical nerve stimulation) units.  About 27% of the patients left the practice to try to obtain the medications elsewhere, but many of them eventually returned. 

From  "The Medical Merry-Go-Round, A Plea for Resonable Medicine," by Morton Glasser and Gretel Pelto, 1980
Dr Glasser and his clinic were a bit ahead of the curve, and there were complaints from emergency rooms that his clinics lack of prescribing put more pressure on the ERs.