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Comment: Re:Recruiting policy (Score 2) 589

by Sad Loser (#46926643) Attached to: Microsoft Cheaper To Use Than Open Source Software, UK CIO Says
absolutely right
same goes for health
however the common theme is that the way that these organisations work is that there is no structure to pay competent FOSS IT people 50-60k a year to administer the network.

It therefore seems 'cheaper' to pay for Microsoft products and to have a bunch of low grade IT staff who can only cope with Microsoft products on 25-30k a year who end up running the helldesk, which casues more unhappiness.

IT staff are like classic cars. the cheapest classic car will always work out the most expensive.

Comment: Organisational culture (Score 1) 164

by Sad Loser (#46593077) Attached to: Peter Molyneux: Working For Microsoft Is Like Taking Antidepressants

it seems that the piece is about organisational culture and how you preserve a high functioning development team in an a large organisation that becomes too focussed on bottom line and not enough on their customers and growth.

This must be a common problem for IT companies. do you need skunkworks? at the same time there is a piece in the news at the moment about how Jobs slavedrove the iphone team into spectacular creativity. maybe it only works when the driving force is as creative as the people being driven?

it is a bit unfortunate that most of the /. is 'my pain/depression/ side effects is bigger than yours' cock measuring, as it makes it look like people who contribute to /. are very concrete, limited and self-centred, which I find hard to believe.

Comment: methinks he doth protest too much (Score -1, Flamebait) 525

by Sad Loser (#43323147) Attached to: Fighting TSA Harassment of Disabled Travelers

IANAL but IAAD and there are things in this story that sound a bit odd, and looking at his web page it sounds like he has a bit of an agenda
it sounds like he has this condition

http://en.wikipedia.org/wiki/Periodic_paralysis

I am cynical about this situation from experience. Like the most anti-gay republican senators, the most vocal 'disabled' people I have met have turned out to have an interesting secret - in their case some a complete absence of disease (including one member of a paralympic team!).
For the avoidance of doubt, I am not suggesting that this man has anything other than a genuine neurological condition. Just sayin'

Comment: Re:More autism or more diagnosis? (Score 1) 398

by Sad Loser (#39517485) Attached to: CDC Reports 1 In 88 Children Now Affected With Autism In the US
I think this is the key to it.
In the UK having your child labelled as 'autistic' or 'autism spectrum'
a) is more socially acceptable than just being labelled as 'slow' (yes I know this is wrong but this is just the way it is) whereas with autism they have a [poorly defined] disease, which is seen as 'an act of God'
b) opens the door to a lot more state benefits (=money) and extra teaching at school (schools like having more teachers), as the child is counted as being 'disabled'.


While I am glad that more kids are being picked up and are being better supported, I am sure that part of this is the creeping medicalisation of normal human variation, and (even as a doctor) this is not a good thing

Comment: Re:I have an organ donor card... (Score 5, Insightful) 516

by Sad Loser (#39320439) Attached to: When Are You Dead?
IAAD and sometimes diagnose brain death - a lot of this academic debate ends up just scaring people or firing up various religious groups who have a problem with donation (but often have less of a problem with receiving donated organs).

It is good to have this debate, but like abortion, this is an area where people who deal with the messy situations that life provides should get to drive the policy, rather than any particularly flavour of god-botherers.

Comment: Agreed (Score 1) 127

by Sad Loser (#36985178) Attached to: UK Health Service Fears Huge Legal Fight Over Unwanted Contracts

digital radiology works, but is generally a standalone system and poorly integrated.

GP to GP transfers - well that would have happened anyway.

Lorenzo is totally dead in the water. Involved in product testing of modules in last 3/12 - doesn't even get to first base. hopelessly broken.

Yes CERNER Millennium works, but is a maladapted dinosaur, with the same evolutionary potential.

Comment: Re:related? (Score 4, Insightful) 127

by Sad Loser (#36983972) Attached to: UK Health Service Fears Huge Legal Fight Over Unwanted Contracts

I am a senior doctor in the NHS and am one of many trying to unravel some of this unholy mess to work out which bits are workable.

The obvious stuff - own a basic infrastructure, use open standards, manage contracts tightly and locally, encourage a diverse IT culture within and outside hospitals and use competition to drive down price and drive up performance - this just didn't happen. As the parent says - a centralised system specified by obsessive compulsive people who don't touch patients and with an irresistible urge to gold plate everything.

The NHS doesn't even own the N3 network - it rents it off BT.

We are tied down with a vast number of closed systems that will cause untold unhappiness, waste and frustration in years to come - my hospital is about to go live with CERNER, which has a Windows 3.1/ 'visual basic by a first year programmer' look and feel. It takes >30 seconds to authenticate every time you want to do anything (often)! this alone will steal many hours of medical and nursing time waiting.

They as the parent says, the contracts were poorly specified, carved up by the usual management consultancy clowns and their mates, and then just left to fester.

Unfortunately, the people running the whole thing were not equipped with the mental or managerial experience to make it work. There was one head of IT, Richard Grainger, who might have had a chance at doing it properly from the off, but was brought in too late when the carve up had taken place, and ran away as fast as he could. The rest is history.

What they could have done differently?
1. read ' the mythical man month'
2. pay someone to re-engineer VISTA in c++/ c# / java
3. get some people in who are successful doctors, not just the nearest beardy muppet who doesn't want to touch patients any more.

COI: IAANHSD

Comment: Re:Makes a lot of sense (Score 1) 254

by Sad Loser (#36442070) Attached to: Federally-Mandated Medical Coding Gums Up IT Ops
IAAMD, also national data representative for medical college.

this is absolutely right
big taxonomies are are designed by people who don't use them. There is a degree of prick measuring - 'my taxonomy is bigger than yours'
Silly to go to ICD10 when that's already out of date and SNOMED is available.

In the long term, complete EPR with native SNOMED coding is the way to go, but in the meantime give me a small taxonomy with minimal inter-coder variation.

Comment: Re:Cheap, fast and traceable? (Score 1) 167

by Sad Loser (#35537456) Attached to: Ask Slashdot: Setting Up Wireless Voting For Students?
you don't want them voting on every crappy decision. there needs to be some personal disincentive to call a vote about stuff that doesn't matter. look at the mature democracies - they don't have crappy electronic votey things.

if there is a vote, they have to get up out of their seats and go somewhere

you could have a lobby that they have to go through a yes or no channel with a barcoded badge but better (and more geeky)- how about if they have an RFID badge each and then go and stand at the YES or NO end of the debating chamber ( where a sensor picks them up)

Comment: BF Skinner (Score 1) 46

by Sad Loser (#33225654) Attached to: Medical Students Open To Learning With Video Games

This is a pretty vacuous vox pop study that doesn't really tell me anything I didn't know.

The problem with this approach goes back to BF Skinner and his teaching machines in the 1950s. Essentially it is that all the interaction has to be scripted, and if you think about even the large free roaming games like GTA, all the key interactions are pre-determined.
The problem with humans is that they do not act in linear predictable ways, and that is what makes them so interesting, and challenging. A VR environment can not yet portray the level of detail necessary for complex human-human interaction to be realistic.

The problem with medical students is that progressive generations of well meaning medical education 'innovation' mean that they spend less and less time interacting with patients. Only this, structured and supervised properly, is good training for what you want them to be able to do at the end - to interact with patients.

I do see a time in the future when some good learning will be possible in a true virtual environment, but for now, like other simulation based training, it is limited to the relatively few situations when the situation portrayed is adequately realistic and the stuff being taught is simple e.g. Pavlov's dog stimulus-response stuff - things like resuscitation. It is not appropriate for teaching, even less for testing, complex human-human interaction.

[CoI IAAD, have masters in MedEd, and teach in (allegedly) the top medical school in the UK]

Comment: Re:Hypochondria? (Score 3, Informative) 368

by Sad Loser (#32242920) Attached to: Doctors Seeing a Rise In "Google-itis"

IAAD, but an emergency physician so people generally don't have time to look stuff up. Or if they do, by definition, it's not an emergency. And the waiting room is in a Faraday cage, so their iphones don't work either, a very satisfactory arrangement.

When I talk to my GP (family physician) colleagues about this, they say you have to work with it, and this phenomenon always occurred to a certain extent, it's just that in the old days the nutters had to go to the medical libraries, and so were easier to identify. Nowadays, quite rational people look up their symptoms and get things right, and this is good.

There are real medical problems with the internet and increased accessibility of information, but far more than increasing anxiety, I would say worse problems are:
  • Astroturfing by pharmaceutical companies - pressure groups, patient groups with suspiciously slick websites
  • quack cures
  • aggressive libel laws stifling scientific debate which in the old days would have been shielded from lawyers.
  • looneys can find each other and associate more easily, and act aggressively to those who do not share their very strange view of the world - e.g. 'Myalgic Encephalitis sufferers' (an alleged condition that is neither myalgic or encephalitis and it is everyone else who does the suffering).

    Patients usually give you a clue that they are a looney though, which is very helpful. Favoured tell-tale signs are wearing tinted glasses, a soft neck collar or making notes in purple ink or with RANDOM capitalised words, or using one of those obesity scooter things. But if they seem relatively normal, I listen carefully and explain, because quite often they are right.

    BTW, I presume you were referring to this? Although some other conditions can do this as well.

They are relatively good but absolutely terrible. -- Alan Kay, commenting on Apollos

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