Tuesday, September 22, 2020

Incompetence, Incompetents, and Incontinence

I clearly have neglected my poor blog. There have been very few new posts in the past year. I'll chalk it up to some patois of melancholy, sloth, feeling stuck in Purgatory, SARS-CoV-2 (mainly the fear of it...we have remained free of illness, thank Heavens!), and maybe a touch of writer's block. But even in its tepid twilight of quasi-existence, people do still read my various random thoughts. I know because I continue to track such things. 

It has come to my attention that an old post from over a year ago has taken the fancy of some IT folk:



In fact, word has reached me that they were not amused. "Dalai is calling us INCOMPETENT!!!" they were heard to say. 

Well, as Oscar Wilde once remarked, "There is only one thing in life worse than being talked about, and that is not being talked about." I suppose that applies to me as much as my new friends. But let's have a look at this.

I've scanned the post over and over, and nary a mention do I find of the word "incompetent" or any variation thereof. Nothing of the sort. Nada. Bupkiss. I did say, and I quote myself: 

"IT has not a clue as to Radiology workflow, not to mention mission criticality."
and
"BECAUSE THEY DON'T UNDERSTAND WHAT WE DO OR HOW WE DO IT but they make decisions about our workflow anyway."

See? No mention of incompetence, or incompetents, whatsoever. Or even incontinence

What I AM saying is that there is a fundamental disconnect, which sadly, my blog has not been able to repair over its 15-year existence. As per Dalai's First Law ("The PACS IS The Radiology Department") we are no better than our machinery. To see the examinations we are here to interpret, the PACS has to work. And it's deeper than that. My time in Africa has taught me that we are incredibly dependent upon infrastructure, not just for the PACS to work, but for all the other stuff as well. It's a real problem when, for example, the power goes out several times per day. Computers and scanners do not thrive in that environment. What if you can't get a part for your CT because Customs won't let it out of holding because, well, just because? Or the security guy at the airport wants you to open a Molybdenum generator? All the way open. (Yes, that really happened. No, it didn't get opened.)

The situation discussed in the original post shows not incompetence, but perhaps ignorance, and I mean that in the nice way. (I could have said arrogance, but I didn't.)  The best-case scenario is that IT doesn't grasp that being without the integrated transcription, and having to dial-in on EVERY SINGLE REPORT over four hours is a huge impediment to patient-care, and patient care is the thing we are ALL here to provide. And we all need each other's help to make that happen. 

An analogy might be in order. Suppose I'm the Chief Electrician for the Enterprise (no, not that one), and I find that there is some wiring in the data-center that is in need of routine maintenance. I could say, "Sorry, boys and girls, gotta do this NOW and take down half your servers during the busiest time of the day, but here's an extension cord so you can keep some of them running..."  OR, I could say, "Sorry, boys and girls, we have this wiring upgrade that must be done soon. How can we work together to make this happen with the least impact upon patient-care?"

This isn't rocket-science, folks. It's simple common sense and us all trying to be good team-players with the goal of helping our real "customers," the patients. 

I think we are all competent enough to do that. 

Wednesday, June 26, 2019

You Can't Hide Your Bottom Line

Dalai's note: There are a number of discussions on Aunt Minnie concerning the acquisition of radiology groups by predatory venture capital operations. And so, with apologies to the Eagles....

Greedy rads just never get the message
That guys in suits are not their new best friends
Big Venture Cap
And they won’t have to worry
They’ll dump their overhead and drive a Benz
Late at night, the reading room gets lonely
I guess selling out young partners has its price
And it breaks your heart to see your talents going
To a predator with soul as cold as ice.
So you tell the junior kids that you’ll protect them
From the guys in suits that want to take you down
But they know that you’re lyin’ as your speakin’
That you’re looking for a payoff to come ‘round


You can’t hide your bottom line
And you’ll never get that big gold mine
No one buys your story line
There ain’t no way to hide your bottom line


In an office park downtown the beans are counting
Finding RVU’s that they are gonna steal
And you sign right on the line anticipating
That you’ll fool them and prevail in this deal
The younger guys think you’re in this together
That you’re only in this for a short while
And you swear that soon you’re going to get a letter
That shows that everybody gets a pile


You can’t hide your bottom line
And you never got that big gold mine
No one buys your story line
There ain’t no way to hide your bottom line


You stand up and drink a hot one from the Keurig
And stare at that endless list there on the PACS
Another night of thinking you’re the bigwig
Just you would know who’s gonna get the ax
You wonder how you ever got so greedy
Big house and cars and snotty private schools
You thought you’d be let off for being needy?
You’ve got to know you look just like a fool
My oh my, you sure know how to wreck things
You set it up so well so carefully
Ain’t it funny how your new gig doesn’t change things
You’re still the same old jerk you used to be


You can’t hide your bottom line
And you never got that big gold mine
No one buys your story line
There ain’t no way to hide your bottom line
There ain’t no way to hide your bottom line
Doctor, you can’t hide your bottom line

Tuesday, June 25, 2019

To My Friends In India Who Happen To Be Affiliate Marketers...

I've never hidden the fact that I track the readership of this blog. It's not that I get all that much traffic, but I do get a big thrill knowing that I have reached people from around the world. Interestingly, in the past few days, DoctorDalai.com has been viewed several thousand times by someone in the Czech Republic. To that poor fellow, I can only say, "Děkuji!"

But as the title above might suggest, I continue to be plagued by "comments" that invariably originate from India. I put "comments" in quotes because these "comments" have nothing to do with the post they "comment" on, but rather are thinly-veiled attempts at SPAM, pushing everything from gambling websites to taxi-services in England. Last night, I even got one from an AI company:


(AI Company) has left a new comment on your post "How IBM Watson Overpromised and Underdelivered on your post "How IBM Watson Overpromised and Underdelivered on ..."": (AI Company) has developed a Interactive Streaming and AI Platform for medical imaging. We own a intellectual property and patent to a new cloud technology platform in medical imaging. At (AI Company) technology and patents covers secure and highly available cloud storage of medical imaging using supercomputing clusters, advanced 2D and 3D diagnostic visualization of medical images using GPU clusters, and the use of Artificial Intelligence in computer aided detection of medical images using genetic algorithm or convolution nueral networks.

Link: Interactive Streaming Artificial Intelligence Platform
Misspellings are theirs. Here is the tracking information on this "comment":

Jubilee Hills, India, Atria Convergence Technologies Pvt. Ltd. Broadband   49.204.222.47

And to make the morning complete, I got another such SPAM comment later on:

Unknown: 7:38 AM (59 minutes ago)to me
Unknown has left a new comment on your post "Driving "Miss Taxi"":

its very good and nice blog

taxi park
bromley superb airport transfer taxi
minicabs bromley
Here's the tracking information on this "comment":

Chennai, Tamil Nadu, India, Airtel Broadband   171.60.225.12  

Here's what's going on. There is a practice out there in the Aether called "Affiliate Marketing". The Wikipedia article is rather long and convoluted, but the gist of it is this:

Affiliate marketing is a type of performance-based marketing in which a business rewards one or more affiliates for each visitor or customer brought by the affiliate's own marketing efforts.[1][2][3][4][5]

More simply:


Affiliate marketing is yet another way for less-than-industrious folks to insert themselves into someone else's revenue stream. Kinda like Enron for dummies.

In the case of my "commenters", they operate under the belief that I will allow their "comments" to be published to my blog, which I DO NOT. If I were to allow it, my innocent readers would then click the links, and the "commenter" would then get some small pittance for each click. That's how this works. Sometimes the "comments" are placed manually, sometimes by 'bots that key on to one word in the blog-post, such as you see above.

Here's what happens when I'm informed about one of these SPAM "comments". First, Blogger.com, the platform where this blog resides, allows me to label the comment as SPAM and keep it from publishing, and that is what I do with each one. Second, I DO click the links, and then contact each and every business involved. I make sure the owner of said business knows that they are wasting their money on the (presumably) cheap marketing, that this is really BAD advertising which brings them nothing but animosity.

I did have one business owner admit to using this bottom-feeder practice, and promised to fire his "affiliate". And he promised that AGAIN when I got another barrage of "comments" leading to his site that originated in, you guessed it, India.

I don't know if it is a language or a cultural barrier, but every single affiliate marketing blog comment spammer I've encountered has come from India. Perhaps this sort of thing is acceptable in that market. I hate to be the one to tell you guys, but it is NOT appreciated here. Not one little bit.

So cut it out. Now. CEASE AND DESIST. You won't make one Rupee from this, and you will likely be removed as an affiliate from the company you try to dump on my blog. Stop this nonsense and find a REAL job.

Thank you.

Addendum:

I got ANOTHER spam from the AI company, and so I'll reveal its name:  http://lifevoxel.com/  One has to worry about a place that has to use this bottom-feeder form of advertising.

Monday, June 03, 2019

IT STILL Doesn't Get It...


Image courtesy msbmax.com

From the IT folks today...

Good morning,
    Due to the Data Center move to the new Data Center, Radiology Dictation will be down tomorrow starting at 11am.
 During this time, radiologists will need to:

1, dial 800-xxx-xxxx
2, enter site #
3, enter dictation ID
4, enter work type
5, enter 2 to dictate

The Medical Transcriptionists can log into the website
 to listen the job and still type reports in.
Please check this ahead of time to not delay patient care.

We expect this to take 3-4 hours to get things up and running and back to normal.


Warm Regards, 
Systems Analyst

At least the PACS itself isn't affected. At least I don't think it is.

Here we see the same old thing I've been writing about since dinosaurs roamed the earth. IT has not a clue as to Radiology workflow, not to mention mission criticality. To fall back on DIAL-IN dictation for four of the busiest hours of the day will spell Disaster with a Capital D. Would it occur to the powers-that-be to do this at night? No. Would it occur to the powers-that-be to set up some sort of mirror system or back-up server? No. BECAUSE THEY DON'T UNDERSTAND WHAT WE DO OR HOW WE DO IT but they make decisions about our workflow anyway.

No doubt this won't go smoothly, but after the requisite grousing, things will go back to where they were, and nothing at all will change.

Guaranteed.



Tuesday, May 28, 2019

Some Amusing Musings About AI

Let us begin with a quote from Yogi Berra:

“It's tough to make predictions, especially about the future.”

Yes, round and round and round we go, and where we stop, nobody knows. The contentious AI discussions on Aunt Minnie continue ad nauseum.

We've been having this very same discussion for YEARS now, with no real change, no resolution, no obvious final answer. And every time Google or some other NON-physician comes up with an algorithm they CLAIM will outdo a radiologist in detecting something somewhere on someone's scan, the sky is immediately declared to be falling. I'm beginning to wonder if I'm caught up in some Groundhog Day remake, where the nightmare won't end until Andie MacDowell falls in love with me (don't tell Mrs. Dalai!) Alternatively, I wonder if I've been trapped in an HGTV marathon wherein every episode has the same 3-act play:
  • AI can identify a cat picture, so we're doomed
  • Self-driving cars kill people, who are just as dead as if they had been killed by a drunk driver but Progress!
  • You can't sue the computer...what would you get? Transistors? But the lawyers will find a way anyway.
I'll repeat what I have said from Day One of this discussion:
  • AI is a TOOL to be used to help radiologists help patients. This is the mantra of every HEALTHCARE company in that space. Google, by the way, is NOT a healthcare company.
  • We radiologists need to be at the forefront of AI development, so it will do what we need it to do, not what some geek from Google tells us it needs to do.
  • AI will NOT replace radiologists in the working lifetime of anyone reading this.
The rest is commentary, gibberish, or both.

Trust me, children, there are things out there that have a far greater likelihood of disrupting your livelihood, such as corporate takeovers, intergroup squabbling, intragroup squabbling, plaintiff whores, bean-counters, rogue administrators, VC entrepreneurs, gossiping physicians, and others too numerous to list. AI is so far down that list as to be a non-issue.

I have begged you all to look at AI through the lens of how it could be used to do what you do better. That would be far more productive than this constant pity-party.

Think about it.