Which is the real smart thing to do. Depends on the vendor who sold the equipment and what the internet requirements are. Sometimes there is no choice which sucks.
A lot of university research labs use a high percentage of Macs. Labs I have personally seen (couple dozen easily) usually have a ~80% (macs)/20% (pc) split. A lot of reasons they use them is the lack of issues PC's bring with them. My wife's lab is 90% macs and the only PC machines she has are the ones that came scientific equipment she bought because some vendors don't develop for macs.
I have seen a lot of PCs hooked up to scientific equipment go down because a windows update failed, anti-virus software causing problems, etc. making those machines (some of them $1M+) be completely useless for long periods of time. In fact I have NEVER seen a scientific piece of equipment down that was run by a mac because the mac itself had issues.
So yes macs cost more only if compared to a single point of time. The hidden/soft costs of PC's come up in the medium/longer run.
Also why did Grandma need the 2500 version of the iMac? You can buy one for $1100. Unless grandma was hardcore into games or data processing?
Thanks for the position clarification. As I said wasn't trying to troll or anything.
Sure the overthrow of one government can lead to a worse off state but at least the option exists to overthrow a bad one to gamble on the future. And people shooting themselves in the foot with poor leadership selection will never go away unless we can fix stupid.:-)
But I am still curious as to your answer. If voting fails to remove the undesired government what recourse is there left that wouldn't involve the need for violence that would work? Or what if the citizens dont even have the right to vote (see NK as an extreme example). What non violent options do they have?
Ultimately if people where more involved in politics we might get some better outcomes. However I think we are past the point of no return on that. I mean I look at our 2 options right now and think this is it? Crap.
I doubt 99% of the citizens are prepared for war. Hell most only have enough food to last a few days. Then it gets even worse.
But serious question for you. If your position is (and I might not be 100% correct so I am not trying to be a troll or anything) people shouldn't have guns (or very very limited on everything gun related) and based on your statement above "If the Founding Fathers had intended citizens to be able to overthrow the government, maybe they wouldn't have made it a treasonous offense right in the Constitution" what recourse in your view does the citizenry have if the government no longer represents the will of the people / becomes something bad like history has shown happens?
If the government is to the point they don't give a rats ass about the citizens then voting won't do anything. So what solutions exist if the citizens aren't armed?
Maybe but at this point in time I don't know if it really matters anymore. Either we will do a constitutional convention and address the issues in some manner or ultimately I think we will see a civil war of some sorts in our lifetime.
Course the odds of a convention I think are near zero.
Because, IMHO, ultimately that is one of the scenarios that the 2nd amendment covers. I am in the military and this type of scenario planning is done all the time. So yes I understand that this scenario involves citizens (military and not) killing each other.
At a very high level the debate of the 2A boils down to a person’s view on the purpose of the amendment:
Do the citizens of a country have an inalienable right to: a) over throw a government which becomes evil (which does mean civil war), and/or b) to defend themselves in instances where no government exists or where the rule of law cannot currently be enforced (i.e. New Orleans after Katrina when no LEO/Military were present and some of the LEO present where the ones doing the robbing/killing) and/or, c) if the country is invaded/occupied/conquered fight back, and/or d) the country collapses on itself because of financial ruin, and/or e) some combo of above?
If a person’s answer to the above is yes then one can easily defend/understand their position that citizens will need access to weapons. The cons of this is that some people will have access to weapons who shouldn’t and who will do evil things with them.
If a person’s answer is no then one can easily defend/understand their position that citizens should not have access to weapons. The con here is that is the citizens must believe that none of the defined scenarios above WILL EVER happen or if it does then the government will protect them (even from itself or even if the government no longer exists).
The discussions I have had with very anti 2A people is that they have a fundamental belief that in TODAYs world citizens don’t need guns but don't think about about TOMORROWs world. All things change and all things die. How the country/government looks today will not look the same in 1, 10, 100, 200, etc. years. Do you (generic you) believe that none of the scenarios I mentioned at the top will ever happen? Based on the history from the start of civilization one of things WILL happen. I would prefer when it does that the citizens have the means to at least try to defend themsevles
The argument is “Do you believe people with AR-15s” can defend against the US military? The answer is yes, no, and it depends. Let’s look at some numbers and assumptions (not perfect I know )
There are about 3M active personal across all branches of the military.
Not all 3M are combat roles. Tooth to tail ratios will come into play.
There are probably around 160M people fighting age (Ages 18 – 65).
There about 12M veterans
The continental US is much larger than Iraq and Afghanistan. This makes logistical support much harder
Defending is a lot harder than attacking.
The unknown of outside powers
Based on the above I believe that the citizens would win. 3M is not a lot of troops to hold a country as large as the US. And holding cities and key infrastructure takes a massive amount of troops, will, and logistical support. Iraq and Afghanistan have clearly shown that a technological inferior enemy can still “win” (think of overall money/lives lost/state of the countries now/etc) and the populations and size of the countries are much smaller.
Then you have tooth to tail rations to think about. If you don’t know what this is it means for a Combat Role (X) there needs to be (Y) amount of support staff for that combat role to be used/be effective. The current ratio for infantry is 1:7. Meaning you need 7 support people for that 1 infantry person to be effective. For fighter plans the ratios are much higher (I have seen figures 1:50. Maintenance, arms, flight planning, etc,).
So let’s say a f-15 pilot (or drone pilot) is ordered to bomb fellow citizens. If the pilot says yes and the support says yes the mission can happen. If the pilot says no and the support says yes the mission can’t happen (who is going to fly the plane the guy who refuels the aircraft?). If the pilot yes and the support says no the mission can’t happen (i.e. that one pilot is not getting the plane all ready to go). If the pilot says yes and not all 50 say yes then the mission can happen but at reduced efficiency.
Also if the military is used on the civilians the question becomes what percentage of the military will obey the order? 100% would not support the order, nor would 100% jump to the other side. So somewhere in between which means the military would be operating at a reduced efficiency. Plus defending something is a lot harder than attacking it. The defenders have to be alert 100% of the time while those attacking only have to be alert when they attack. If the US military is trying to defend a lot of critical infrastructure at once (electric, water, cities, food, ammunition, fuel, etc). The amount of combat troops they will have to launch attacks will be greatly reduced.
Sure you could maybe do conscription but history/data has shown that conscripted troops are less effective and could cause larger parts of the population to turn against you.
Also high tech weaponry (like drones, tanks, HIMARs, etc.) require huge logistical support. Disrupting that support (given size of country, number of civilians, etc) would probably not be as difficult as people think it is. Then you have to think about ROE. A lot would also depend of the ROE used and how evil the government is. Don’t care about your cities/population then artillery/bombing runs/etc. can start to mess up cities at the cost of the people hating you more. Decide the ROE is to spare cities and people then your artillery/bombers/etc are pretty useless.
I think the key comes down to which sides the citizens decide to support. The veterans will be able to provide military experience and tactics for those who oppose the military. The military itself will fracture. And who knows what the outside powers will do? Of course they will get involved but in what fashion (selling arms, sending over troops, taking land, etc).
Those people do exist. The ones at WWDC were acting like fake, soulless versions of those people to get the check boxes. It was cringeworthy to say the least. Maybe pandering? I am not sure if you watched it yet but the general reaction to it was obvious pandering.
Or maybe it was too scripted and so forced that made it come off awful/soulless/*insert a better phrase if you can think of one*. I mean look at the woman who did the apple music demo. Let us get the audience to rap along. Really?
I don't even know what to think about these "innovations" and demos. Between the horrible fake scripts, diversity check lists (gay guy, old guy, mom, hipster indian, fat woman into fitness, etc), and many ideas that are "new" (only if you define new as a first on apple and not a first in industry) I really wonder if Apple as finally lost it? Glad they renamed OS X to mac OS cause that will improve security, reliability, etc.
As I type this on my 2011 macbook pro (OS X 10.11) I wonder what I will do when I need to finally upgrade. Stick with apple just because it is what I know or finally jump to something else. And based off the multiple forums I am reading I am not the only one.
And you need to throw in the type of jobs created vs. lost. Having a 100k job replaced by another 100k job is ok (even if the jobs are 100% different). Having a 100k job replaced with a 30k job is NOT ok.
Point of diminishing returns
I look at a lot of the consumer technology and I see very little which impresses me. Sure each year smart phones in general get faster, better screens, a few things IMHO are gimmicks (force touch, finger print reading, etc), but we don’t get anything that says this new technology will make your life easier. Usually we get technology for technology’s sake.
I can now skip 2 or 3 generations of tech and not be a big deal. Where a long time ago I remember going from the 286 to the 386 and being like damn! Or going from EGA to VGA. Etc.
I know I am not the target market anymore and companies (like Apple) are making gobs of money so my opinion doesn’t mean to much if weighed against their bottom lines. I feel like consumer tech could go in so many useful directions but instead all we get is incremental upgrades that are all really disappointing.
My wife and I have apple products (my wife gets a top of the line macbook pro every 2 years from her grants..so “free” in some sense for us and I get her hand me downs) but even she is starting to say nothing interesting is coming out. I look at the new iPads and think if they had OS X on them and allowed me to dock them to external keyboards, monitors, etc. I would buy one in a second. Instead we get these half ass incremental upgrades. I am not sure why but more than likely it is because Apple makes a but load of cash on them so why change?
Assume you have 50k in your car. Cop stops you and "takes it". Options are:
1. Give up and the 50k is gone. You lose.
2. Fight in court were legal fees and time lost will surpass the original 50k. You lose.
3. Fight the cop and get killed/go to jail. You lose.
4. Kill the cop. You will be hunted down and either killed or jailed. You lose.
There isnt one scenario in which a citizen has a successful ending. So a citizen who interacts with a cop in this situation always loses.
I am honestly surprised more scenario 4s havent occured.
CIA, Saudis To Give "Select" Syrian Militants Weapons Capable Of Downing Commercial Airliners (link below). And we know all the arm drops the CIA has done hoping they get in the "right" hands has never landed in ISIS hands. Proxy war anyone? CIA payback for Ukraine or making the US look bad in Syria or....
http://www.zerohedge.com/news/...
1. Understanding your current capacity by phase (initiation, requirements, dev, etc) by Role is critical. if you don't have this you are screwed from the start.
2. before you launch each project have you done discovery to understand business and IS hours needed to complete the project? Costs, ROI, CBA, etc. Basically do you understand the full costs (as best as you can at this point) vs. what you are getting?
3. Do you constantly go back to #2 as you complete each phase? If not you might be doing projects that no longer bring value.
4. Do you understand your strategies to help pick the projects regardless of their cost/benefits? For example if your goals are to win market share but all your projects focus on operational improvements you might have a problem?
5. Building off of #4 do you know all your strategies and what percentage you are focused on for each one? 50% operational improvement, 25% win the market, 10% shake up the market, etc.
6. Do you revisit all of the above as market changes? This should be done quarterly at least.
7. Do you understand how bringing in contractors helps your capacity model? It doesn't matter if you bring in 50 java developers but your bottle neck to testing.
8. Does leadership understand all of the above? are they educated and given data to show the above?
As an FYI a lot of hospitals and insurance companies already offer care and disease management. It costs less if you can a) either prevent the disease or b) manage it better. But what the data shows is just that they aren't as effective as they need to be because of lack of patient cooperation.
Fun (sad) fact: We ran a pilot that offered free health insurance to a pilot group if people if they went to see a nutritionist once a month and went to the gym few times a month. The calculated effort on the members part was around 10 hours a month. Everyone in the pilot who already took care of themselves did what was asked. Those who didn't already take care of themselves none of them did it or stuck with it. Even for free insurance. Program is being tweaked to see if we can make it better but those initial results were not encouraging.
As for the Hippocratic oath we'll have to agree to disagree. My view is a doctor should use his time on patients willing to make changes to get better. THis leads to better outcomes, more time for the doctor to see more patients, and less overall medical costs. We have data that shows that. I just don't see what a doctor can do if their patient refuses to make the needed changes (quit smoking, better eating, etc).
But I never said they were perfect nor did I say they never make mistakes. There is a difference between let's talk about options vs. i read on the internet that XYZ will kill me so it must be true. vs. fraud that some doctors do.
If my doctor believes in X and I believe in !X it would seem to be a better move for me to find a doctor who thinks like I do vs. wasting people's time and energy. Why would I, as a patient, want to waste my time if every time I talk to them it's the doctor's way or the high way (and vice versa).
But my experience in the healthcare field (backed by a lot of data) is that there is a growing minority that just don't follow what there doctors ask of them. I'm not even talking about controversial things, simple things like you have type 2 don't drink soda and work out and people will just not do it. So why should we bother wasting time on them if they won't help themselves.
A big medical expense savings could be care/disease management. Preventing people for getting type 2 if they show the pre-stage symptoms or how to manage it better if they get it. Do you know why most of these programs fail or fail to achieve the savings? The patient won't put in the effort even when financial compensation is offered.
Given the shortage of nurses, doctors, etc. At some point firings makes 100% sense.
I can see this spreading to people who don't take their pills, don't follow instructions to drop weight and/or exercise, etc.
it's understandable i think. I'm sure they are a lot of new patients who would love to get on a doctor's schedule sooner than later. And a few doctor friends of mind complain about the waste of time and energy on patients (especially those who are obese or have type 2) who just refuse to do anything to better themselves.
Managing your health requires that you actively participate in bettering yourself. I don't care if you are working with an MD, Chiro, new age healer, etc. If you won't do anything to take care of yourself why should you expect people to waste their time on you?
Slashdot Mirror
Great so my current receiver, tv and console are out of date. Time to throw it all away and buy new stuff for 8k!!!!
Which is the real smart thing to do. Depends on the vendor who sold the equipment and what the internet requirements are. Sometimes there is no choice which sucks.
A lot of university research labs use a high percentage of Macs. Labs I have personally seen (couple dozen easily) usually have a ~80% (macs) /20% (pc) split. A lot of reasons they use them is the lack of issues PC's bring with them. My wife's lab is 90% macs and the only PC machines she has are the ones that came scientific equipment she bought because some vendors don't develop for macs.
I have seen a lot of PCs hooked up to scientific equipment go down because a windows update failed, anti-virus software causing problems, etc. making those machines (some of them $1M+) be completely useless for long periods of time. In fact I have NEVER seen a scientific piece of equipment down that was run by a mac because the mac itself had issues.
So yes macs cost more only if compared to a single point of time. The hidden/soft costs of PC's come up in the medium/longer run.
Also why did Grandma need the 2500 version of the iMac? You can buy one for $1100. Unless grandma was hardcore into games or data processing?
Thanks for the position clarification. As I said wasn't trying to troll or anything.
:-)
Sure the overthrow of one government can lead to a worse off state but at least the option exists to overthrow a bad one to gamble on the future. And people shooting themselves in the foot with poor leadership selection will never go away unless we can fix stupid.
But I am still curious as to your answer. If voting fails to remove the undesired government what recourse is there left that wouldn't involve the need for violence that would work? Or what if the citizens dont even have the right to vote (see NK as an extreme example). What non violent options do they have?
Ultimately if people where more involved in politics we might get some better outcomes. However I think we are past the point of no return on that. I mean I look at our 2 options right now and think this is it? Crap.
I doubt 99% of the citizens are prepared for war. Hell most only have enough food to last a few days. Then it gets even worse.
But serious question for you. If your position is (and I might not be 100% correct so I am not trying to be a troll or anything) people shouldn't have guns (or very very limited on everything gun related) and based on your statement above "If the Founding Fathers had intended citizens to be able to overthrow the government, maybe they wouldn't have made it a treasonous offense right in the Constitution" what recourse in your view does the citizenry have if the government no longer represents the will of the people / becomes something bad like history has shown happens?
If the government is to the point they don't give a rats ass about the citizens then voting won't do anything. So what solutions exist if the citizens aren't armed?
Maybe but at this point in time I don't know if it really matters anymore. Either we will do a constitutional convention and address the issues in some manner or ultimately I think we will see a civil war of some sorts in our lifetime.
Course the odds of a convention I think are near zero.
Because, IMHO, ultimately that is one of the scenarios that the 2nd amendment covers. I am in the military and this type of scenario planning is done all the time. So yes I understand that this scenario involves citizens (military and not) killing each other.
At a very high level the debate of the 2A boils down to a person’s view on the purpose of the amendment:
Do the citizens of a country have an inalienable right to: a) over throw a government which becomes evil (which does mean civil war), and/or b) to defend themselves in instances where no government exists or where the rule of law cannot currently be enforced (i.e. New Orleans after Katrina when no LEO/Military were present and some of the LEO present where the ones doing the robbing/killing) and/or, c) if the country is invaded/occupied/conquered fight back, and/or d) the country collapses on itself because of financial ruin, and/or e) some combo of above?
If a person’s answer to the above is yes then one can easily defend/understand their position that citizens will need access to weapons. The cons of this is that some people will have access to weapons who shouldn’t and who will do evil things with them.
If a person’s answer is no then one can easily defend/understand their position that citizens should not have access to weapons. The con here is that is the citizens must believe that none of the defined scenarios above WILL EVER happen or if it does then the government will protect them (even from itself or even if the government no longer exists).
The discussions I have had with very anti 2A people is that they have a fundamental belief that in TODAYs world citizens don’t need guns but don't think about about TOMORROWs world. All things change and all things die. How the country/government looks today will not look the same in 1, 10, 100, 200, etc. years. Do you (generic you) believe that none of the scenarios I mentioned at the top will ever happen? Based on the history from the start of civilization one of things WILL happen. I would prefer when it does that the citizens have the means to at least try to defend themsevles
Crap I didnt reply to the parent poster...ugh
The argument is “Do you believe people with AR-15s” can defend against the US military? The answer is yes, no, and it depends. Let’s look at some numbers and assumptions (not perfect I know )
There are about 3M active personal across all branches of the military.
Not all 3M are combat roles. Tooth to tail ratios will come into play.
There are probably around 160M people fighting age (Ages 18 – 65).
There about 12M veterans
The continental US is much larger than Iraq and Afghanistan. This makes logistical support much harder
Defending is a lot harder than attacking.
The unknown of outside powers
Based on the above I believe that the citizens would win. 3M is not a lot of troops to hold a country as large as the US. And holding cities and key infrastructure takes a massive amount of troops, will, and logistical support. Iraq and Afghanistan have clearly shown that a technological inferior enemy can still “win” (think of overall money/lives lost/state of the countries now/etc) and the populations and size of the countries are much smaller.
Then you have tooth to tail rations to think about. If you don’t know what this is it means for a Combat Role (X) there needs to be (Y) amount of support staff for that combat role to be used/be effective. The current ratio for infantry is 1:7. Meaning you need 7 support people for that 1 infantry person to be effective. For fighter plans the ratios are much higher (I have seen figures 1:50. Maintenance, arms, flight planning, etc,).
So let’s say a f-15 pilot (or drone pilot) is ordered to bomb fellow citizens. If the pilot says yes and the support says yes the mission can happen. If the pilot says no and the support says yes the mission can’t happen (who is going to fly the plane the guy who refuels the aircraft?). If the pilot yes and the support says no the mission can’t happen (i.e. that one pilot is not getting the plane all ready to go). If the pilot says yes and not all 50 say yes then the mission can happen but at reduced efficiency.
Also if the military is used on the civilians the question becomes what percentage of the military will obey the order? 100% would not support the order, nor would 100% jump to the other side. So somewhere in between which means the military would be operating at a reduced efficiency. Plus defending something is a lot harder than attacking it. The defenders have to be alert 100% of the time while those attacking only have to be alert when they attack. If the US military is trying to defend a lot of critical infrastructure at once (electric, water, cities, food, ammunition, fuel, etc). The amount of combat troops they will have to launch attacks will be greatly reduced.
Sure you could maybe do conscription but history/data has shown that conscripted troops are less effective and could cause larger parts of the population to turn against you.
Also high tech weaponry (like drones, tanks, HIMARs, etc.) require huge logistical support. Disrupting that support (given size of country, number of civilians, etc) would probably not be as difficult as people think it is. Then you have to think about ROE. A lot would also depend of the ROE used and how evil the government is. Don’t care about your cities/population then artillery/bombing runs/etc. can start to mess up cities at the cost of the people hating you more. Decide the ROE is to spare cities and people then your artillery/bombers/etc are pretty useless.
I think the key comes down to which sides the citizens decide to support. The veterans will be able to provide military experience and tactics for those who oppose the military. The military itself will fracture. And who knows what the outside powers will do? Of course they will get involved but in what fashion (selling arms, sending over troops, taking land, etc).
Those people do exist. The ones at WWDC were acting like fake, soulless versions of those people to get the check boxes. It was cringeworthy to say the least. Maybe pandering? I am not sure if you watched it yet but the general reaction to it was obvious pandering.
Or maybe it was too scripted and so forced that made it come off awful/soulless/*insert a better phrase if you can think of one*. I mean look at the woman who did the apple music demo. Let us get the audience to rap along. Really?
I don't even know what to think about these "innovations" and demos. Between the horrible fake scripts, diversity check lists (gay guy, old guy, mom, hipster indian, fat woman into fitness, etc), and many ideas that are "new" (only if you define new as a first on apple and not a first in industry) I really wonder if Apple as finally lost it? Glad they renamed OS X to mac OS cause that will improve security, reliability, etc.
As I type this on my 2011 macbook pro (OS X 10.11) I wonder what I will do when I need to finally upgrade. Stick with apple just because it is what I know or finally jump to something else. And based off the multiple forums I am reading I am not the only one.
And you need to throw in the type of jobs created vs. lost. Having a 100k job replaced by another 100k job is ok (even if the jobs are 100% different). Having a 100k job replaced with a 30k job is NOT ok.
Point of diminishing returns I look at a lot of the consumer technology and I see very little which impresses me. Sure each year smart phones in general get faster, better screens, a few things IMHO are gimmicks (force touch, finger print reading, etc), but we don’t get anything that says this new technology will make your life easier. Usually we get technology for technology’s sake.
I can now skip 2 or 3 generations of tech and not be a big deal. Where a long time ago I remember going from the 286 to the 386 and being like damn! Or going from EGA to VGA. Etc.
I know I am not the target market anymore and companies (like Apple) are making gobs of money so my opinion doesn’t mean to much if weighed against their bottom lines. I feel like consumer tech could go in so many useful directions but instead all we get is incremental upgrades that are all really disappointing.
My wife and I have apple products (my wife gets a top of the line macbook pro every 2 years from her grants..so “free” in some sense for us and I get her hand me downs) but even she is starting to say nothing interesting is coming out. I look at the new iPads and think if they had OS X on them and allowed me to dock them to external keyboards, monitors, etc. I would buy one in a second. Instead we get these half ass incremental upgrades. I am not sure why but more than likely it is because Apple makes a but load of cash on them so why change?
Add to that the OPM breach. Good thing all my data AND finger prints were compromised.
Assume you have 50k in your car. Cop stops you and "takes it". Options are: 1. Give up and the 50k is gone. You lose. 2. Fight in court were legal fees and time lost will surpass the original 50k. You lose. 3. Fight the cop and get killed/go to jail. You lose. 4. Kill the cop. You will be hunted down and either killed or jailed. You lose. There isnt one scenario in which a citizen has a successful ending. So a citizen who interacts with a cop in this situation always loses. I am honestly surprised more scenario 4s havent occured.
CIA, Saudis To Give "Select" Syrian Militants Weapons Capable Of Downing Commercial Airliners (link below). And we know all the arm drops the CIA has done hoping they get in the "right" hands has never landed in ISIS hands. Proxy war anyone? CIA payback for Ukraine or making the US look bad in Syria or.... http://www.zerohedge.com/news/...
This assumes all life must look like us. Why can't their be "life" on planets that would cook us alive? Pretty narrow view if you ask me.
Do you have one?
1. Understanding your current capacity by phase (initiation, requirements, dev, etc) by Role is critical. if you don't have this you are screwed from the start.
2. before you launch each project have you done discovery to understand business and IS hours needed to complete the project? Costs, ROI, CBA, etc. Basically do you understand the full costs (as best as you can at this point) vs. what you are getting?
3. Do you constantly go back to #2 as you complete each phase? If not you might be doing projects that no longer bring value.
4. Do you understand your strategies to help pick the projects regardless of their cost/benefits? For example if your goals are to win market share but all your projects focus on operational improvements you might have a problem?
5. Building off of #4 do you know all your strategies and what percentage you are focused on for each one? 50% operational improvement, 25% win the market, 10% shake up the market, etc.
6. Do you revisit all of the above as market changes? This should be done quarterly at least.
7. Do you understand how bringing in contractors helps your capacity model? It doesn't matter if you bring in 50 java developers but your bottle neck to testing. 8. Does leadership understand all of the above? are they educated and given data to show the above?
That would at least help your discussions.
How many times should I shake it before it is considered playing with your mouse? :-D
Whiskey!
As an FYI a lot of hospitals and insurance companies already offer care and disease management. It costs less if you can a) either prevent the disease or b) manage it better. But what the data shows is just that they aren't as effective as they need to be because of lack of patient cooperation.
Fun (sad) fact: We ran a pilot that offered free health insurance to a pilot group if people if they went to see a nutritionist once a month and went to the gym few times a month. The calculated effort on the members part was around 10 hours a month. Everyone in the pilot who already took care of themselves did what was asked. Those who didn't already take care of themselves none of them did it or stuck with it. Even for free insurance. Program is being tweaked to see if we can make it better but those initial results were not encouraging.
As for the Hippocratic oath we'll have to agree to disagree. My view is a doctor should use his time on patients willing to make changes to get better. THis leads to better outcomes, more time for the doctor to see more patients, and less overall medical costs. We have data that shows that. I just don't see what a doctor can do if their patient refuses to make the needed changes (quit smoking, better eating, etc).
But I never said they were perfect nor did I say they never make mistakes. There is a difference between let's talk about options vs. i read on the internet that XYZ will kill me so it must be true. vs. fraud that some doctors do.
If my doctor believes in X and I believe in !X it would seem to be a better move for me to find a doctor who thinks like I do vs. wasting people's time and energy. Why would I, as a patient, want to waste my time if every time I talk to them it's the doctor's way or the high way (and vice versa).
But my experience in the healthcare field (backed by a lot of data) is that there is a growing minority that just don't follow what there doctors ask of them. I'm not even talking about controversial things, simple things like you have type 2 don't drink soda and work out and people will just not do it. So why should we bother wasting time on them if they won't help themselves.
A big medical expense savings could be care/disease management. Preventing people for getting type 2 if they show the pre-stage symptoms or how to manage it better if they get it. Do you know why most of these programs fail or fail to achieve the savings? The patient won't put in the effort even when financial compensation is offered.
Given the shortage of nurses, doctors, etc. At some point firings makes 100% sense.
I can see this spreading to people who don't take their pills, don't follow instructions to drop weight and/or exercise, etc.
it's understandable i think. I'm sure they are a lot of new patients who would love to get on a doctor's schedule sooner than later. And a few doctor friends of mind complain about the waste of time and energy on patients (especially those who are obese or have type 2) who just refuse to do anything to better themselves.
Managing your health requires that you actively participate in bettering yourself. I don't care if you are working with an MD, Chiro, new age healer, etc. If you won't do anything to take care of yourself why should you expect people to waste their time on you?
may cause cancer..... ;-)
Sheep herding?