Primary Care = Good

Here's a little summary of Barbara Starfield's presentation at thei year's WONCA.

 'Grand lady' of public health proclaims: The best care is primary care — FP Report

 … For example, in the United States, a "20 percent increase in the number of primary care physicians is associated with a 5 percent decrease in mortality (40 fewer deaths per 100,000)," she said. But the benefit is even greater if the primary care physician is a family physician. Adding one more FP per 10,000 people "is associated with 70 fewer deaths per 100,000, which is a 9 percent reduction in mortality," she said.

This year, we have seven students out of ~125 4th year students who will going into family medicine – the fewest in 15 years. Somehow, they are not getting the message that this is important .. and they are not getting the message that this is good fulfilling work. The message that they hear – from misinformed specialists – is that "family medicine is dying." ugh.

Medical Podcast version 0.5

Ok …  to celebrate the ~ 5 year anniversary of my weblog (1st post was 11/14/1999) .. I couldn't help but try the newest thing .. podcasting.  It's hard.  Much harder than writing a weblog .. and it's gonna take me a while to get better at this.  Listening to the 1st five minutes (I couldn't bear to listen to more!) .. I found my voice to be all-too soporific.  I'm not really so dull.  Really I'm not!   So .. here it is.  I'm using the Coral Cache to minimize the bandwidth hit on my server .. we'll see how that goes.

Goals for future versions:

  1. Make it shorter  (U=V/W)
  2. Be less sleepy (don't do it at midnight)
  3. Share some information that is useful and (maybe?) insightful

Gmail goes POP, flu vaccine delivery

So Gmail now will allow POP and SMTP .. which is very cool .. so I could get gmail from my treo …   but it's not working.  I've set it up right (I think) .. but so far, I can't connect to the gmail pop or smtp servers … hmm .. I'll post a note when I get it workin.

.. and last week I delivered some flu vaccine to Albany Medical Center since they didn't have any .. and we did .. so now the patients with Cystic Fibrosis will be vaccinated this winter:

Flu Vaccine Delivery

BloggerCon III – Medicine

I'm listening now to the Medical Blogs session at BloggerCon .. which was just posted .. and it's darn interesting.

I never knew Matthew was from Across the Pond .. but now I do .. and I continue to be impressed with his intellect.

Lisa is impressive as well — with a well spoken "patient perspective"

Enoch, of course, did a great job facilitating.  Oops .. Enoch pronounced my name wrong  .. it's Reider ..  say it like the trucks ..

Overall .. it's interesting to hear ..

More on usability

The "Fitts Law" quiz that Bruce (aka "tog") developed doesn't seem like it would have anything to do with user interface design for an EMR .. but it does.  An example:

Explain why a Macintosh pull-down menu can be accessed at least five times faster than a typical Windows pull-down menu. For extra credit, suggest at least two reasons why Microsoft made such an apparently stupid decision.


Microsoft, Sun, and others have made the decision to mount the menu bar on the window, rather than at the top of the display, as Apple did. They made this decision for at least two reasons:

  1. Apple claimed copyright and patent rights on the Apple menu bar
  2. Everyone else assumed that moving the menu bar closer to the user, by putting it at the top of the window, would speed things up.

Phalanxes of lawyers have discussed point 1. Let's deal with point two. The Apple menu bar is a lot faster than menu bars in windows. Why? Because, since the menu bar lies on a screen edge, it has an infinite height. As a result, Mac users can just throw their mice toward the top of the screen with the assurance that it will never penetrate and disappear.

Unless, of course, I'm testing them at the time. I did a test at Apple where I mounted one monitor on top of another, with the menu bar at the top of the lower display. The only way the user could get to the top monitor way by passing through the menu bar enroute.

I then gave users the task of repeatedly accessing menu bar items. When they first started out, they penetrated into the upper screen by around nine inches on average, just because their mouse velocity was so high. Then they learned they had to slow down and really aim for the menu. By the time they adjusted, their menu-access times became so ponderously slow, they took around the same time as the average Windows user.

The other "advantage" usually ascribed to a menu bar at the top of each window is that they user always knows where to look for the items pertaining to the task they are carrying out. This is silly. Users may do various tasks within a given window, and the menu items may change. Not only that, but a great many perverse applications exist, particularly in the Sun world, where the menu bar you need to access is not even in the window in which you are working! That is truly bizarre and mind-bending.

Microsoft applications are beginning to offer the possibility, in full-screen mode, of a menu bar at the top of the display. Try this out in Word or Excel. It is much faster. Microsofts general cluelessness has never been so amply displayed, however, as it is in Microsoft Visual Studio, which has a menu bar at the top of the screen with a one-pixel barrier between the screentop and the menu. Talk about snatching defeat from the jaws of victory.

Tog has been writing about usability since the early 1980's.  He used to write a column in the Apple Developer's newsletter that I would turn to right away as soon as the newsletter arrived in the mail.   Ahhh … the mail.  Not much of value arrives in the little white truck anymore …