Exactly! A more eloquent statement of my point. I like the neighbor
analogy, since this list serves that purpose admirably. So, I'm off to
configure Vista.
K.S. Bhaskar wrote:
Mike --
I am entirely sympathetic to your plight. In Pennsylvania where I live,
doctors in droves are retiring or moving elsewhere for these reasons.
That said, your post makes a strong case in a different way for the use
of open source free software - with OSFS, you have the choice of doing
it yourself or of buying support, just like with home repairs. When I
fixed a toilet tank at home that wouldn't stop running last weekend, I
had a choice of doing it myself, hiring a plumber, or calling on a
neighbor for help. It wasn't free in the sense that I had to pay with
my time (either then, or in the future in terms of helping my neighbor
with something else) or pay with my money, but it was free in the sense
that I had the freedom to decide how I wanted to pay.
With closed source software, that freedom to choose how to pay for it
doesn't exist.
-- Bhaskar
On Thu, 2005-09-22 at 07:17 -0500, Mike Schrom wrote:
Bhaskar,
Don't get me wrong I'm not saying that the concept of paid support
is
wrong. But, developers can operate within a 'business model' and set
a
price for your services based on your costs. Those of us in medicine
don't have that option. All of our reimbursements are limited, either
by
law (i.e. medicare/medicaid) or by contract (HMO/PPO), which we
could
reject, but at the risk of our patients going elsewhere ("you don't
take
my insurance"). We can't raise fees. Our costs are not controlled.
If
the support contract goes up we either pay or go without, but
employees
expect raises, if the phone co., electric co. or the landlord raises
charges, we pay. The Gov't also has a history of hitting us with
unfunded mandates. Many of us are still reeling from the costs of
HIPAA implementation. While I'm enthusiastic about the positive
effects
on health care, I'm afraid that EHR may be the next unfunded
mandate.
Unfortunately, some of us still have to keep within a shrinking
budget.
And, some of us have had really lousy experiences with 'support
contracts' in the past. I'd be delighted to have someone come into
my
office and install an EHR system, but as you posted elsewhere, no
one
gives out warrantees, and I can't afford another expensive mistake.
So,
the only practical way I can implement an EHR is as OSFS, installed
and
supported myself with help from volunteers.
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