Perhaps what you mean by closed source is that the appropriate practice of
medicine requires an extensive vocabulary which is beyond the scope of the
average person. Far from being closed source, physicians are open source,
as they believe in the scientific method, that is the reproducibility of
experimental results. The real problem with medical software development
is that the scientific method of inquiry is rarely used in its development.
Science is sacrificed for the sake of economical software development.
Software development hasn't gotten to the where it is exposed to rigorous
testing.
Only validated survey instruments applied in well-defined and limited
populations can be said to be scientific. Almost all validated survey
instruments in medicine have been formulated by physicians. Unfortunately,
most computer programmers are not "computer scientists," whereas earnest
efforts by scientific "allopathic" physicians to create software instruments
would have to be subjected to validation studies. The computer programming
aspect of validation studies is usually trivial. It is the system analysis
and validation of medical software which is the non-trivial aspect in the
current era. These functions are best performed by young physicians who are
increasingly data aware. In my field, the reason that those of us with
coding skills don't perform much software development is that the
opportunity cost is too high. And who among us wants a pay cut?
All the Best---Rhett Drugge, M.D.
Internet Dermatology Society
http://telemedicine.org
----- Original Message -----
From: John S. Gage <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, May 09, 2001 9:51 PM
Subject: Disenfranchised doctors
> Actually, that's an interesting point. Doctors have dealt in closed
source
> for centuries (just like lawyers): the Latin names etc. The web is to
some
> extent undoing that: medical advise/info websites are among the most
> popular. And I guess that doctors, leaning on closed source medicine,
> would embrace closed source software: birds of a feather.
>
> But I think there is a germ of truth in what I said. Third party payors
> run the show these days, and they really only want to put the occasional
> doctor in jail as an example, and stiff the rest as much as possible. The
> first question doctors' offices ask new patients these days is, "What is
> the name of your insurance carrier?" Wrong answer and the phone goes
> dead. (Obviously, I am talking about the great old US of A here). This
is
> guaranteed to drive a wedge between the physician and his/her patient. In
> countries with universal health insurance, either there is a parallel
> system with private insurance or doctors are screaming about poor working
> conditions and patients are screaming about long waits for service or
> both. Am I wrong?
>
> The point is that separating domain experts from the creation of domain
> software just continues the problem. And don't tell me about all the
> consultants that inject domain knowledge into expert systems. That's been
> going on for decades and has gotten...nowhere.
>
> John
>
> At 09:16 PM 5/9/01, you wrote:
> >Hi,
> >
> > > Physicians are the most disenfranchised group in society. Open
> > > source must change that.
> >
> >That's the joke of the day, for sure. Disenfranchised? Doctors?
> >
> >It has taken several decades to pull them down from their previous divine
> >status (together with priests etc), to become professionals that at least
to
> >some extent are accountable to their customers.
> >
> >Regards
> >
> >calle
>
