logjam

My advice is just choose the place you'll feel happiest at for 4+ years. Think carefully about social support in terms of positive family and friend interactions.

Choice of schools doesn't matter much - how interested and excited you are to learn is the critical factor, and the environment and your own situation influences that heavily.

You can get an outstanding education at any of those schools, regardless of department.

Whether you get a B.S. or B.A. won't matter. Don't forget to broaden your education and follow your interests wherever they lead - learn a foreign language in depth, take many humanities classes, take science classes outside the engineering track, learn how to write, draw, teach, etc. Enjoy yourself and the hard work will just naturally flow.

I studied engineering and biochemistry, but the classes outside my technical majors proved more valuable over time than anything else.

No.

Ellen Degeneres or The Voice or any of the other false equivalences you're desperately reaching to make is not the professional technical workplace.

If you run in any of my technical circles, put on a technical presentation, or otherwise represent at a technical conference, and you make "jokes" that are sexual innuendos of any kind or are otherwise unprofessional....

You will be gone. Gone.

Count on it.

The tech world created these shitty circumstances for women and this shitty little drama because we males in that world have behaved abominably. Over decades.

Guess what? Now we're going to start demonstrating that we can be professional, or heads are going to roll. Continually.

Count on it.

The irrational venom and utter cowardice of those who attacked this woman and her supporters, including here on HN, shouldn't be surprising, but somehow it still is.

Tech? I would have thought better of arguably among the most "rational" humans. Yet another lesson in how close to the surface very primitive emotions lie.

And tech remains a cesspool of mysogyny.

People trying to excuse racism and sexism by claiming "they're funny" are the real jokes.

Hi georgeorwell. I just went through your one comment above.

You just told somebody who complained of getting death threats because of his comments here to watch how he comments so "his life might get a bit easier?"

I can't imagine anything more cowardly that you could have possibly posted.

> Okay, let's get this straight: capitalism drives efficiencies in markets. Efficiencies drive innovation.

[citation needed] - please stop trying to argue from your own polemics you'd have us believe are axioms.

"The Country That Stopped Reading" vs "The proportion of the Mexican population that is literate is going up, but in absolute numbers, there are more illiterate people in Mexico now than there were 12 years ago."

In other words literacy is increasing.

And that's where I stopped reading Toscano's vapid screed.

These are medical residents, not students.

Residents have already graduated medical school and are training in their medical specialty.

/pedant

MD here. The headline on your webpage: "For serious medical conditions, you need direct access to the world’s best researchers." [my emphasis added]

Pardon my skepticism, but that sentence and the rest of your not-functioning-very-well website smell of nothing more than an attempt to ripoff very vulnerable people, and other marketing bullshit.

But do please prove me wrong - kindly link to the world-class research your docs and researchers have done thus far.

I'm a little unclear on the concept here, because this doesn't sound at all like Kickstarter.

Microryza sound like nothing more than middlefolk between my research and funding sources. They "vet"? And their domain knowledge in my field is...?

Am I missing the idea? Why do I want another layer between me and a funding source?

Pharma gives gifts to physicians because giving gifts works to sell pharma's products.

When I was in medical school and residency, it was a standard thing that lunches were all sponsored by pharma. These were usually nice catered meals brought in by some pharm rep. The price was at least listening to a sponsored (biased) speaker, or a five minute sales pitch. Sometimes an office's or deparment's prescribing numbers for a particular drug were actually tracked and discussed, as if we were in a sales meeting and we were or were not meeting the pharmaceutical reps quota for sales. Dinners were even more elaborate, commonly held at some swank restaurant, with a paid physician (shill) brought in to present "research" about that company's drugs.

My attendings were offered tickets to desirable sporting events, or paid travel to medical conferences that just happened to be in Tahiti. There was that wink and nudge: of course you would be using your own clinical judgment about the effectiveness of the drug being pushed. Of course the freebies had no effect on your judgement. Of course the published positive results reported at sponsored conferences and in sponsored journals constituted all the data and all the trials of that particular drug.

If you had qualms about big gifts or even meals, a pharma rep was always ready to give you a gift of the latest textbook (embossed with the name of a drug and/or pharma company) or maybe a sponsorship to the latest conference: after all, augmenting your education would only benefit your patients, right? What could possibly be wrong with that?

Physicians are increasingly and rightfully refusing to accept gifts of any kind from pharma. It was unethical then and remains unethical now. Many med schools and residencies have now rightfully banned pharma reps from any contact.

We need more and better regulation, not less.

Ask your doctor if he or she accepts gifts. If they do, or if you see product advertisements of any kind in the office (to include pens, notepads, pharma-labelled equipment, drug/product brochures), find yourself another doctor.

I was half-dozing on a Southwestern flight when a stewardess came on the PA system calling for any physician to identify themselves.

I spoke up, and the crew directed me toward the back. They already had this incredible medical kit opened in the aisle. I mean they had everything....ACLS drugs, defibrillator, suction, a complete mini-pharmacy, and what looked like a few plastic-7 wound and/or trauma kits at the least. I mean, I was practically drooling over this high-tech kit.

Of course, it was also at that moment that I started frantically running through cardiac code algorithms in my head, and pondering exactly how long it had been since I'd actually dealt with a code in a hospital, with plenty of trained staff, lab support, etc.

Of course, it wasn't any kind of life-and-death situation at all - a young person very stressed and anxious about relocating and the actual conditions of the flight, who'd been hyperventilating, hadn't eaten or had anything to drink for many hours, near-syncopal, etc etc.

I tried my hardest, but couldn't think of a single thing to use out of the medi-kit. I wanted to use it.

I just sat down next to her and listened, which is 90% of medicine anyway.

Southwest was great - gave me two round-trip tickets to anywhere for taking a few minutes to talk.

A colleague at University of Hawaii wrote a paper about dealing with psychiatric emergencies in the air. One thing that stuck out in the paper was the interesting phenomenon of what he called "honeymoon psychosis", with one of a young newly married couple away from home for the first time, possibly on their first flight, all leading to some interesting disturbances on those long pan-Pacific flights.

Well, my fourth year of med school I did basically the same things, with the same responsibilities for the same number of hours as I did my first year of residency....and paid tuition for the privilege.

Residency (and the 4th year of med school?) is cheap labor for American hospitals, coupled with brutal working conditions - ACGME's 80 hour work week restrictions were winked at throughout my training, and I suspect still are a lot. Making decisions after being on your feet 30+ hours is pretty much like making decisions drunk - not sure that four years of that was optimal for anybody, particularly patients.

And yeah, we had "protected time" for didactics in residency - it was there that most of us developed the ability to fall asleep instantly.

> If it is legal it is no scam. Making patients pay as much as legally possible is legal.

Really.

M.D. in U.S. here. Your profile page says you're an M.D., too.

Please reassure me that you are not a licensed physician and that you have no patient care responsibilities.

However, if you do see patients (or ever have), please comment on your medical licensing board's "belief system" on unethical (but legal) practices (even "business practices") as they pertain to the practice of medicine.

Maybe we're just having a little language breakdown here. Your parent comment sounds like you advocate for the use of "unqualified personnel" if it improves the profit margin. You comment below about "massaging the bill". Just above you seem to be winking and nudging your way to the idea that it's ok "legally" exposing your patients to the risks of certain tests like chest x-rays even if they're driven more by your own pocketbook or client's pocketbook (or your own paternalism) than by what's best for the patient, or perhaps what the patient chooses.

Unless there's some misunderstanding here, your actions are taking place in the wrong field. Medicine isn't a business.

Trying to turn it into a shady profit center is driving your actions toward grave difficulties with ethics, if not "legality".

Clearly, allowing easier access to voting is evil. No, definitely we should make it harder for those least able to afford it....working class people... to take time off from work and stand in line to vote.

/sarcasm

I don't understand how a question with an unsupported/uncited premise equivalent to "do you still beat your wife?" constitutes "an excellent question".

Uh, no.

I and all physicians and our office staffs get back complete eligibility information for ALL possible care from a single query from existing insurance co queries: eligibility for all surgical, laboratory, radiological, inpatient hospitalization, partial hospitalization, psychiatric care, etc etc; along with deductible, copay, balance, etc etc.

Doctors have to refer patients around - we need to know which specialists accept what insurance and can see our patients. The insurance companies want us to know that. It's in their interest to let us know that. They let us know that. Already.

Could you explain how your query of the insurance company's information would be more complete than the insurance company's query of its own information?

On second thought, go have a nice day. I realize I am asking for technical information and getting sales spiel in return.

I'm a family medicine doc in a practice with several other docs. Why do you ask?

I already read your site's security pages, which in large measure do NOT address the questions I've asked here.

However, I believe you're right - neither I nor the software folks I consult with here in Bay Area will be interested in using your tool. Good luck to you.

No, actually your reply doesn't describe your security practices at all. Why are you retaining live data at all?

Forgive me, but just claiming "we certainly would not expose your patient's data" is hollow at best - I take the responsibility for protecting my patient's health information very seriously, as do most physicians, and it is ultimately our responsibility to do no harm in that regard.

Not saying this is true of you guys, but there are a lot of incentives out there for "mining" and even selling health info. At the very least, storing health data on multiple, geographically disparate servers, logging access, retention policy, etc is a nightmare waiting to happen.

So actual patient data is being stored and manipulated, and manually "stripped" so that it can be posted (in effect) to the web? Again, I don't want to misunderstand you, but you feel comfortable doing this? I wouldn't.

Please provide your backup, retention, deletion, access logging, etc., policies on that data you are manipulating.

Am I understanding that an audit two months from now (you log your access and use of this data as required by HIPAA, right?) will indicate that this data was "stripped" and shared?

I would be very very cautious about thinking that "stripping" data like this isn't very prone to error, and to not realizing that storing and sharing this kind of data without a lot of care and thought could create huge problems.

Many many. I just discussed this with our office manger - checking eligibility is not a problem for us (nor would it be for most practices in my opinion) using web services already in place....and especially not free vs a dollar per 20 queries.

I'm not actually a fan of insurance companies, but please explain why I would want to pay for the hassle of dealing with Yet Another third-party and at the same time expose my patient's protected health info to Yet Another layer of risk?

I don't get this.

I'm a physician, and every insurance company to which I submit claims already has a web service in place to check eligibility...at no charge. Already.

There aren't many interface differences between insurance companies: you typically enter two identifiers, usually either an id number or last name, and birth date. You get full eligibility info immediately.

There's nothing difficult about it. We almost never call insurance companies to get eligibility info - web querying is already in place, and has been for a while.

What problem, at 5 cents for each API CALL (c'mon, really?) is this solving? Why would I want to pay to pass my patient's protected health information through yet another layer (and store? see my comment below about this company's offer of a data "sample") of potential privacy loss?

Just curious - how is it that you have claim data? In fact, how is it that you (if I'm not misunderstanding) are storing any actual live data whatsoever?

Just to clarify...you have some data with patient identifiers already "removed"...or are you stripping it yourselves before sharing?

If the latter (which I hope is not true), how would a third-party like you obtain identifiable data? Why would a third-party providing an eligibility API end up storing data (particularly claim data) of any kind to offer to share?

Utter nonsense. Reread what you just wrote. You somehow seem to really want us to believe, say, that because lemon growers choose California as a startup site and that California doesn't have single payer and Canada does, healthcare policy doesn't matter to startups.

We can do better than that. Here are some entrepreneurs explaining what they love about single payer:

http://biznik.com/articles/the-canadian-healthcare-experienc...

http://www.shindigital.com/blogpost/18

Here's an MIT economist explaining how "job lock" resulting from the need to maintain health insurance cripples the American economy and entrepreneurship:

"The type of universal health insurance coverage policy proposed by President Obama will clearly promote the freedom of workers to leave their jobs to start new companies. By solving a major impediment to mobility in the U.S. labor market, a larger government goes hand in hand with more business development. The next John Galt may owe a debt of gratitude to this pioneering effort in universal coverage."

http://www.washingtonmonthly.com/features/2009/0905.gruber.h...

Here's INC magazine touting Obamacare (not single payer, but infinitely better than what "the market" has given us) as good for entrepreneurs:

http://www.inc.com/kimberly-weisul/affordable-care-act-and-e...

> ...I refuse to support Groklaw... will not start trusting anonymous reporting and support of Groklaw

> I have supported everything Groklaw has done to this point.

Kindly do two things for us: stop talking out of both sides of your mouth, and, instead of ineffectually waving your hands, point to specifically what Groklaw got wrong on this issue.

I've long maintained that time estimates should not be a programmer's task, at least in most shops. That's one of the few things that a "manager" should do and do well: insist on realistic and as-precise-as-possible requirements, collect metrics over time to make rational estimates, and shield the team from eternal corporate stupidity.

> Quite honestly I grow tired of seeing any famous person or brand name on HN. It's almost always an indication of time-wasting nonsense ahead.

Quite honestly your standards seem wildly inconsistent: http://news.ycombinator.com/item?id=4113928

Not that the standards of the rest of us are always consistent, but it's interesting to reflect on why linguist Chomsky on a tech/semantic subject might trigger one emotional reaction while Reagan advising on love triggers another....all here on a tech blog, eh?

Confusing.

"Pandering"? What possible definition of "pandering" are you using? This is an article about the origins of a technical communications medium, origins which apparently have some relation to semantics, commented on by the most eminent linguist I know of.

And since you're being all meta here and everything, and since you took the time to influence what's on the front page in this case, it's curious you apparently had no problem with yesterday's front page post which contained pertinent hacker news like...wait for it....the letter from divorced Ronald Reagan advising his son on marriage - a post you commented in and happened to take the time to include an Amazon affiliate link in.

Obsessive thought in a psychological sense is often a symptom of anxiety. The intense focus of the obsession may be completely unrelated to the source of anxiety. Often a compulsive behavior provides relief for the anxiety, without, of course, ever addressing the root anxiety.

I don't see the "major upgrade" here. As a doc you can already use Square to process payments, and you can look up "real time insurance information" easily already via the web.

Breathless pronouncements from a supposed technical company that physicians will use their app because it "makes them feel modern" are a trifle annoying. Docs will consider using an app like this when (if ever) it is demonstrated that input/dictation of specialized vocabulary is robust on pads, and when (if ever) there is something at all good to say about trusting a commercial third party to store a practice's protected health information remotely, eg when (if ever) questions about security, access levels and logging, deletion, and backup policies of remote data storage of protected health info are fully addressed.