Tim Churches wrote: > > Err, what taboo against forking was that? The whole open source > phenomenon is rife with examples of forking. > I had wanted to say something about this for awhile now. It is more or less the case that human social organizations, in the absence of strong hierarchial leadership, tend to get so big and then fork off, or tend to get polarized around a fundamental issue and fork off. Take a look at the Hopi's in S.W. U.S. They are still talking about the issues that caused a group of them to form the new village of Hoatvela (Hotevilla)at the base of third mesa by splitting from Orayvi (Oraibi) village in 1906! Please see the real Hopi web site at http://www.hopi.nsn.us/ before you do a web search and discover all the western mystical interpretations. This is to be expected, it's a human situation. And that's not to say that such splits should not be mediated before they occur, but complete success in preventing a split is probably an unrealistic expectation. On to something else: > > a) doctors tend to have well-developed egos, > > b) doctors tend to be "control freaks" > > c) doctors tend towards individualism rather than collectivism > I wonder if all three of those are not really aspects of the same thing. I would phrase things differently: Individual doctors are both empowered and responsible for decisions at the leaf nodes on any organizational structure. This creates a fundamental tension inside traditional hierarchial organizational structures. (thanks to Ross Anderson for this observation) Individual doctors and individual patients are attempting to maintain (at least in the cultural west) a long standing relationship based on confidentiality, trust and ethical behavior. I strongly believe that these two observations make all the difference in the world in designing and delivering information technology assists to doctors (or clincial professionals, I believe nursing has similar but different issues). So, sad to say, it's not just an issue of getting the tables right, or the information labels right, etc. If it was that simple, we would be much further along folks. One way of dealing with this, and getting back to simpler applications of IT, is to change those two aspects I mentioned: 1) Change the empowerment at the leaf nodes. 2) Change the doctor/patient relationship. I believe that is exactly what has been happening, and more so since the rise of large scale health care organizations. IT's not just that younger professionals are more techically savvy, I believe they have different expectations.. To those of you who think that technology is neutral, it's just a tool to be used or abused, I beg to differ. The means by which technology is constructed and delivered into the structure of work and play can and does change the nature of those things. There is little so called scientific study of this, but what little there is, certainly seems to indicate this is happening.
