Obama Gives Possible Clue As To Who Will Not Be Running Mate

Obama’s campaign announced several staff additions today but the one which received the most notice was the hiring of Patti Solis Doyle to be chief of staff to the vice presidential candidate. This story can be taken different ways, but hopefully it is a sign that Hillary Clinton is not being considered as Obama’s running mate.

As I’ve discussed in several previous posts, putting Clinton on the ticket would be a disaster, most likely making John McCain the next president. Having Clinton as running mate would destroy Obama’s message as a reformer, would give McCain a huge edge among the independents who will probably decide this election, and would make it difficult for Obama to expand the electoral map beyond the old blue states.

Clinton fired Solis Doyle as campaign manager during the primaries. Initially this news was being taken two different ways. One possibility was that an old Clinton aide was being hired in preparation for adding Clinton to the ticket. Fortunately several reports coming out during the day make this interpretation look increasingly unlikely. Apparently the two have not spoken for months, and other Clinton aides see this as a message than Clinton will not be chosen.

“It’s a slap in the face,” Susie Tompkins Buell, a prominent Clinton backer, said in an interview. “Why would they put somebody that was so clearly ineffective in such a position? It’s a message. We get it.” She said it was a “calculated decision” by the Obama team to “send a message that she [Clinton] is not being considered for the ticket.”

CQ Politics has a similar take:

…a Clinton insider, who spoke on the condition of anonymity, told CQ Politics that the subtext is clear.

“Translated subtitles aren’t necessary,” the insider said. “There is no other way to interpret this other than ‘[Expletive] you.’”

I certainly hope these Clinton backers and insiders are right.

Among the other appointments, Stephanie Cutter, John Kerry’s communication director in 2004, will be chief of staff to Michelle Obama. Her job will certainly be to keep Michelle on message and improve her image.

Computerized Medical Records and Medical Costs

While Barack Obama’s health care proposals have been the best of all the major candidates this year, they are not without fault. I’ve been critical before of estimates of cost savings which will pay for expanding health care. FactCheck.org presents data suggesting that Obama is overly optimistic about savings from electronic health records. While Obama’s campaign might be sincere in their predictions, after having seen many of the problems with electronic records I fear they underestimate the difficulties in initiating this as well as over-estimating the benefits.

As the RAND study quoted in the post states, it could take until 2019 for 90% of doctors and hospital to have electronic records. Even this estimate might be overly optimistic considering the weakness in the electronic record systems now available. Even if there were tremendous incentives offered which got every doctor to go electronic despite the current ridiculously high costs there is no guarantee we would save much money.

One problem is in communication. Currently different doctors, hospitals, and labs might have computerized systems but it is hit or miss as to whether they can communicate with each other effectively. Factcheck cites a Congressional Budget Office report which states there are forty different vendors and their products cannot communicate with each other. Plus, all forty vendors over-charge for their products and each seems to have serious flaws.

Sometimes the volume of material turns out to be counterproductive. Often in computerized medical records tons of material looks exactly the same, regardless of significance. It is often difficult to find the important information among all the material which is accumulated over the years. In contrast, an old fashioned paper chart with the important reports at the front, often with pertinent sections underlined, often provides the important information more easily.

The systems available today have numerous weaknesses. For example, today I had a diabetic patient come in the hospital who was also in the hospital last month. Neither I or the nurses on the floor were able to get the hospital’s electronic medical record system to reveal the patient’s insulin dose from the last hospitalization. In the old days we could have had medical records send up the written chart and then we’d find the information very quickly. I had a similar situation with another patient a couple of weeks ago in which information from a previous hospitalization could not be easily obtained. In both cases I wound up turning to my charts at the office. Even there we have a dual system–both a computerized system which is used for sending prescriptions electronically to pharmacies and a paper system. For a number of reasons, my paper system is far more reliable in telling me exactly what medications and doses were used. Perhaps that is why I generally have such difficulty evaluating the medications when I receive copies of electronic records on new patients.

I’m not even convinced that using a computerized system to send prescriptions to pharmacies either reduces errors or lowers the risk of medication reactions even though both are cited as advantages. If I’m preparing a prescription there is always the chance for human error but most likely the prescription will say what I intend. I’ve been using a simple system with a word processor and macros to quickly generate printed prescriptions for years, already eliminating the old problems with handwriting.

With staff going through the charts to enter the old data into the system, as well as responding to electronic requests for refills, there has been tremendous room for error. I’ve caught a number of errors from information entered incorrectly, and I fear that when sending prescriptions is as easy as pushing the send button there is a much higher chance that errors will go unnoticed. The software does supposedly screen for medication reactions, but it is far too flawed to be of value. Interactions between medications are commonly considered in writing prescriptions, often with such interactions actually being desirable, and when every conceivable interaction generates a warning message it becomes likely all will be ignored.

Perhaps over time the state of computerized medical records will improve, but we are not likely to see them either implemented or bring about real cost savings in the near future.

Bad Girls Dominate Showtime on Mondays as Billy Piper Returns to US Television

We’ve been getting brief glimpses of Billy Piper as Rose on Doctor Who this season. The episode shown on the BBC this weekend had a very brief glimpse of her, but the previews show even more. Besides playing a part in the conclusion of this season of Doctor Who, we will be seeing even more of Billy Piper on Showtime. She stars in Secret Diary of a Call Girl. A video introducing her character on the show is below:


Monday must be bad girl night on Showtime. Secret Diary of a Call Girl airs after Weeds, which returns tonight. Mary Louise Parker stars on Weeds as a woman who started selling drugs to survive after her husband died. After burning down her house and neighborhood, she moves to new surroundings and becomes an even bigger drug dealer. A video promoting the show follows:


Bigger Problems for Bloggers than the Associated Press

While the threat of lawsuits from Associated Press might be a nuisance for bloggers in the United States, some bloggers face far graver threats. The BBC reports that the arrest of bloggers has reached a record high:

Since 2003, 64 people have been arrested for publishing their views on a blog, says the University of Washington annual report.

In 2007 three times as many people were arrested for blogging about political issues than in 2006, it revealed.

More than half of all the arrests since 2003 have been made in China, Egypt and Iran, said the report.

The World Information Access cited in this story reports that the average prison sentence was fifteen months and the longest was eight years. The actual number arrested might be much higher due to difficulties verifying arrests and finding the reason for the arrest in some countries. They also claim that “In the last four years, British, French, Canadian and American bloggers have also been arrested.” I would like to see more detail on what the bloggers from these countries were actually arrested for.

Update: Details On Charges Against Arrested Bloggers

The Associated Press vs. The Blogosphere

The Associated Press has created considerable discussion in the blogosphere by trying to restrict quotations of their articles from the blogs. The New York Times reports:

The Associated Press, one of the nation’s largest news organizations, said that it will, for the first time, attempt to define clear standards as to how much of its articles and broadcasts bloggers and Web sites can excerpt without infringing on The A.P.’s copyright…

Last week, The A.P. took an unusually strict position against quotation of its work, sending a letter to the Drudge Retort asking it to remove seven items that contained quotations from A.P. articles ranging from 39 to 79 words.

On Saturday, The A.P. retreated. Jim Kennedy, vice president and strategy director of The A.P., said in an interview that the news organization had decided that its letter to the Drudge Retort was “heavy-handed” and that The A.P. was going to rethink its policies toward bloggers.

Quotations from articles is common in the blogosphere to promote discussion. Ideally quotations should be used as a stepping stone for further discussion but it is not uncommon for bloggers to use a quotation from another source as the bulk of a blog post. I’ll sometimes resort to this when I read something which fits in well with other topics under discussion but I don’t have time to write further when something is seen. Quotations also help keep the blog going when traveling and I can only briefly get to a computer (such as over the past weekend when I resorted to quotations on Saturday and Sunday to prevent the blog from lacking any material).

Ideally the best way to handle such a situation would be a simple link to the article. This would work if blog entries were only read the day they are posted, but it is very frequent for old posts to be read, either through a web search or from people checking the archives. Unfortunately a tremendous number of news articles referred to in old blog posts are no longer available on line. If there is an extended quotation, readers can still get a good sense of the news report which was being referred to.

Quotations from the original article are also of value in giving readers a better idea as to whether they want to read the full article. Hopefully having such excerpts around the blogosphere creates a win-win situation for both bloggers and the original copyright owner. Having links to their material around the blogosphere drives in more traffic. Many newspapers actually encourage links by bloggers by including lists of blogs linking to their stories.

The Associated Press likely is acting within their regal rights to protect their copyrighted work, although it is not clear how much quotation in a blog post would legally be considered fair use. Even if they are right legally, their reputation would suffer if they began initiating law suits against bloggers. This looks more like a desperate attempt of old media to hang out to the past as opposed to finding ways to thrive in the internet.

Should the Associated Press take a heavy hand the most likely result will be that bloggers will quote from other new sources and ignore them. This will help build the credibility of other news sources while decreasing the exposure of the Associated Press among the growing number of people who use blogs and web aggregrators to steer them towards articles worth reading. Having other news services receive frequent links from blogs while they are left out could also result in lowering Associated Press in the results of web searches. Web sites which make money from web advertising might even decide to use news from other sources in order to continue to receive traffic from bloggers linking to their site. Before the Associated Press takes steps to restrict the use of their material by bloggers they should carefully consider the consequences.