are you gonna stick to your guns if you get sick or injured?

believe me, most people in medical school learn that they are NOT better than everyone else. because you take some of the top people out of college and put them in the same class. and then for another 3-6 or more years after medical school there is always someone else ahead of you who you work for.

I am sorry you had a bad experience. as a physician I know that I cannot draw blood as well as a phlebotomist, I can't run an MRI machine better than a trained tech, I don't know the surgical tools as well as a scrub nurse, and I wouldn't have the faintest idea how to run most blood tests or stain path samples. In turn, I don't deride a pharmacist for not knowing details of a disease process or fault a CT tech for calling a code blue for vasovagal syncope. Maybe I'll get frustrated when something isn't done quickly enough, but if I just get an explanation of why it happens and see that the other person is working as hard as I am, I'll understand.

I'm a resident in radiology where the bulk of our job is to create the reports for imaging studies. We use TalkTech, which is based on Dragon/Nuance, I'm not sure what engine (though I'm almost certain it's not the latest).

It does a pretty good job when the conditions are right - but if you're gonna mumble, or say things that are out of context, or have a bunch of background noise, the computer just isn't going to pick it up well. I've had decent success with Google Voice, though most people calling me are from a business or office where it's quiet, not from the street or something. And I think they've all had mild accents.

I've found that things like Siri or Google Mobile for the iPhone that use voice translation do a fantastic job considering they are trying to transcribe things that aren't in context. At work, dictation works much better if you use complete sentences or at least sets of phrases that are in context. If you pick a word with one syllable and try to get it to work, you may have a lot of trouble.

Although I did blow off a voicemail from someone I didn't recognize when Google Voice wrote "your application for life insurance" (which I have not applied for, so I assumed it was a telemarketer) when the person said "your application for licensure" (as in my recent application for my state medical license).

Doctors don't need bad handwriting to keep secrets. And bad handwriting is not going to keep someone who wants to sue you from doing so. It does help to prevent mistakes when you can read the previous doctor's note (even if it's from an ophthalmologist whose notes are just a long string of acronyms in English and Latin). I don't know what this guy's agenda is other than to get his name out by putting out proof against common sense.

I'm guessing it wasn't an obvious fracture, the ED is pretty good at picking up most fractures on their own. Or else they were looking specifically for something like a hidden scaphoid fracture which mandates much more aggressive treatment.

Your point is taken, though. Without computers management of that patient probably wouldn't have changed. Except that if a homeless guy shows up like that, they say wear this splint and see the orthopedist tomorrow, and it turns out he needs quick surgery but he never shows so he has some bad outcome, the ED is now liable for not keeping him there.

JDicom works, there are many other stand-alone DICOM viewers. I've used a command line program, I think dicom2 or something, that would extract images directly from the DICOM file into a regular image format. DCM4che is a fairly large open source collection of utilities which may also have something useful, though I am only now getting familiar with it.

There are a couple native linux GUI viewers but none of them were particularly good in my opinion.

And they usually aren't.

I'm a radiologist and computers have definitely improved patient care and saved the hospital money (or alternatively made the hospital more money) in our field. From digitized images and the ability to outsource to overnight coverage to voice recognition to get turnaround for finalized reports in an hour it has undoubtedly worked. And that's with in most cases only fair implementation of a computer system.

With most hospitals, the problem is that they like to do a piecemeal transition. Digitize a subset of notes and vital signs, half the time what you need isn't there so you have to look through the paper chart AND the computer chart. Or the vital signs are only half in the computer and half on a chart, so nurses double their workload. And when it's set up, they do it with an IT-centric interface that doesn't make intuitive sense to most users. When I use them I can see through my background in computer science and engineering why things are done a certain way, but it doesn't make any sense to physicians, nurses, etc.

Then they add in a new piece, such as more vital signs (but in a different section), some dictated notes, some linking to the outside. Outpatient notes are digitized, inpatient notes are still handwritten, etc. ED notes are separate, with their own system. It's a complete mess. This method is a waste of money and time, all for the sake of early deployment of a suboptimal system and minimal re-training of the staff to use a new system.

The VA had a decent attempt with CPRS. They digitized everything - from physician admission notes to clergy notes. At least everything is in one place, but people are overwhelmed with data and it's too easy to copy and paste incorrect or inaccurate information. The interface is also suboptimal (graphing lab values involves selecting a range of tests, building a worksheet, etc. much like you'd expect an engineer to make it for maximum flexibility, but minimal ease of use). And connecting to other VA systems is hit or miss.

Perhaps the best method is to build a new hospital from the ground up. All patient records get digitized (scanned, at least, if not run through some OCR). Have a tightly integrated medical record system developed in collaboration with health care practitioners. That would save the hospital money, in the long run, compared to them starting from scratch with paper records.