The Problem With Music by Steve Albini

This is a classic essay about the current state of the music industry.  It was written probably 8 years ago but continues to be the status quo.  I’ve always felt so badly for up and coming bands who fall victim to all the promises from the record labels.  Sign this contract and you’re dreams will come true…

 Now replace that up and coming band with that primary care resident looking for opportunities upon finishing residency.

It’s a dismal world.

But not for long. 

The Problem With Music by Steve Albini

Scienceline » The Return of Dr. House

The untapped market…

Someday soon, we’ll unveil our business model.  It’s damn near genius.

The healthcare industry and the music industry are in the same boat.  Both can be disheveled by technology.  Unfortunately, the healthcare industry has a tight knit group of people in very high places (even this jackass president’s own family) who are making a hell of a lot of money creating new business models that leech off the inefficiencies of the System.  I, of course, don’t see anyone uprooting this $2.3 trillion dollar industry any time soon.  However, even though I can’t save the System (I wouldn’t want to save a dead horse), I can at least save the consumer…and to me, that is the most important. 

Scienceline » The Return of Dr. House

This is the view from my balcony of this ultra-mod and trendy Orlando hotel.  

This is also the soap included in the room.

If you are wondering why I took such a beautiful photo and also deliberately included my bath soap, wonder no more.  The view from my window is about as pretty as Orlando gets – the view represents the potential technology could bring to the healthcare world – it’s by no means a perfectly beautiful city but at least it’s nice and warm.  The view of the soap represents the technology available to physicians today.  It’s just a damn piece of round soap.  Nobody ever told the designer of this piece of soap that it’s really friggin’ hard to wash your body with a round piece of soap.  This is the reason why Dove, Lever, etc.. shape their soap in contours consistent with the roundedness of the human body – so it’s easy to maneuver in your hand and over your body.  Unfortunately, my bathing experience here in Orlando is similar to washing my body with a slippery hockey puck.  It even kind of hurt.

Staring at all these “rounded soap” screens getting countless demos from the ultra-informative reps for these technology companies hurt much more than that soap hockey puck.  I asked one (from if they were planning on cleaning up the interface to make it more intuitive.  He gave me a very confused look and said “No…you just have to get used to it.  I mean, I’ve been working on this system for years and I wouldn’t have it any other way.”

Translation:  Here’s a soap hockey puck.  Don’t worry, after using it for a month you’ll get used to it and you’ll probably get so used to it, you won’t even remember that contoured soap exists.  You’ll even start buying hockey puck soap at the store.   

I feel sorry for all of you doctors out there looking to invest in technology.  Give me a few months.  The product I produce for you will be prettier than my photography.  And of course, less functional than the bloatware. 

Thanks for listening.  I’m off to the shower.

UPDATE:  I spent more time dropping the soap than using it.  Luckily I’m not sharing a prison cell with Mr. HIMSS. 


I’m in Orlando for the HIMSS conference surrounded by McEverything and Mickey Mousecrap.  Is it just me or is Orlando possibly the worst city in America?

I’m sure the HIMSS conference will be full of wonder.  Wonder as in I wonder how tens of thousands of people across America all collectively think that technology bloat is a good idea and a screen jam packed with useless information somehow makes that information useful?  

200 data points + 15 Tabs + 50 Pull Down Menus = 1 ridiculously confused doctor.  

I’m still looking forward to those few companies out there who are actually innovating.  The problem is…no matter how much you innovate in the world of healthcare IT, very few physician users of this technology believe in it’s value.  I’ve said it before and I’ll say it again, give one person five pieces of crap to choose from and they’ll choose a piece of crap.  Give them a product that has questionable ROI in the face of ever-decreasing salaries and I can understand why it’s so hard to simply sell technology.  

Of course, until someone comes up with a business model that brings in an extra $75,000 per doctor just for using the technology (without selling direct to consumer ads), an intuitive interface that makes total common sense to anyone, with open source standards as the backbone, a HIMSS in Orlando will exist.  


I hope I’m pleasantly surprised.  If anyone is here and wants to grab a drink, please call or text.   

The Doctor Is Online

But of course…this is how everyone communicates in this modern age.  

I’m sure the newspapers a hundred years ago reported an increased use of cars as compared to the horse and buggy.

Here’s a quote from a doctor in that article from year’s past:

“Why should I drive a car when I only get paid to ride a horse?  I mean, patients are lined up in their homes waiting for me to arrive on my horse.  In fact, the hum of a car’s engine would probably scare the poor patients.  And all that steel scares ME!" 

Today’s doctors are like feral children found living in their own little communication wilderness. 

The Doctor Is Online