As someone who made the professional healthcare to tech career crossover, I feel exactly the same way. Email me.
The world has changed. People are tried and sent to prison over video chat, surgeons remotely control surgery.
Telemedicine improves the quality of life for millions of people, allowing them access that they wouldn't have had in the past. It provides decreased morbidity and mortality as a whole.
17.10 was the absolute most buggy software that I have installed from Canonical. I tried it on Dell hardware (+ Apple Hardware, + A VMware VM on X64 + VirtualBox on OSX, etc) that does just fine with Fedora, Arch, Gentoo, and it was constantly prompting me to send error reports, killing processes, etc. I just flipped from using the "latest" vs the LTS versions at home because of this version, specifically.
Not the worst Ubuntu version, but I had a lot of issues with the default protocol being Wayland [1].
This broke a few programs I use, [2] mainly the screenshot application "Shutter". Most users don't realise it became the default, so their apps just stopped working... bad decision in my opinion.
Me too :) I think it was easier for Longmont as it's part of "Longmont Power and Communications" - they were able to run a lot of fiber in existing infrastructure, and right of way was essentially a non-issue.
power companies seem to be in the best position to offer awesome internet. a local provider here has 1000/1000 for $99/mo. but unfortunately they haven't laid fiber in all of the neighborhoods, especially the older ones. so it's only the newer subdivisions that are getting it. :/
i'd be all over it. one less bill to worry about too. (just bundle internet + power)
I have used amwell with great success, recently. I have no affiliation with them, and I am paying them for their services, but my experience was top notch, and I have a PCP through them. I have yet to get my insurance to process automatically, but I just paid with their FSA VISA card and I'm doing an offline bill to submit. Many states REQUIRE covering telemedicine, even for Medicare/Medicaid in some cases.
"Professional Extenders" are everywhere, and it hasn't caused anything to become cheaper. If you show up at an urgent care, just expect that you will be treated by a LPN and a PA or a NP. A Family Practice physician's salary is about comparable to a Sr. Engineer at many tech companies (~160k), and they can have significant malpractice insurance overhead and insane hours. A PA or NP still makes 6 figures, so the "savings" just aren't there.
If you've ever had to attend something like Physical Therapy, you'll see the actual PT (a MS/Doctorate level professional aka DPT) about twice. Once for an eval, and once for a discharge. An "aide" will guide you through all the other exercises, and they make very significantly less than a PT.
The savings are mysteriously gone, even adding lower-salaried professional extenders.
> “Professional Extenders" are everywhere, and it hasn't caused anything to become cheaper.
This needs the caveat of “to American consumers”. The NHS seem to be heavily moving in that direction, and I suspect “cheaper” is no small part of that
"professional extenders" are often "profit extenders", as the supervising physician can enable his / her practice to see more volume and better match revenues and costs (ie have lower cost labor do lower revenue / acuity work). the "savings" from this often end up accruing to the owner of the practice. increasingly this owner is a large hospital system, but they take this delegation a step further, using lower cost primary care as a way to increase volume to higher acuity / reimbursed hospital procedures.
Prescriptions have been available with delivery or mail order service for at least the last ten years. I have worked for at least two private pharmacies (in different states) who offered delivery service, and several of my classmates went to work for the mail-order fill companies as the "stare and compare" pharmacist checker.
The "Caremark/CVS" insurance that I have for prescriptions allows me to go to Target/CVS for covered medications, but I also have the option to mail-order (from them, of course). I also have Aetna Health Insurance just by chance (we have a choice of 3 companies @work).
Amazon is going to buy drugs in major bulk (Walmart, or Mail-order-pharmacy style), and likely will charge low "dispensing fees" (because robots will do most thigs). CVS is looking to be the "other other Walmart" of pharmacies. I have worked (as an intern) in many pharmacies, and I've seen several buyouts. At this point in time, I'm very happy that I made the leap from PharmD to SRE/DevOps about 11 years ago. Pharmacists will be robots in <5 years IMHO.
>Amazon is going to buy drugs in major bulk (Walmart, or Mail-order-pharmacy style)
All pharmacies, electronic and brick-and-mortar, go through one of 3 wholesalers: Cardinal, AmerisourceBergen, or Mckesson. It's, "which retailer can drive distribution?"
Speaking from the US, it's too bad that pharmacists are so disempowered here. I was just in France, and my friend came down with an eye infection. He went to a pharmacist, who just gave him antibiotics and told him to come back in three days if it didn't go away.
We both agreed it would never have been so easy in the states.
While I agree that kind of ease of access to an Rx that would have otherwise required a doctor’s office visit sounds great, antibiotics is probably a bad example. Over-prescription of antibiotics is a known problem. Was your friend seen by a PA or nurse or something? Maybe that model makes sense but I hesitate to give pharmacists the added power of diagnosis.
No. To be clear, I don't make these regulatory decisions, I'm just relaying the reality of the situation. It's very difficult to have these discussions with people that don't even know the basics about the industry under discussion.
Is it even legal to dispense drugs without a pharmacist? The same way that a nurse practitioner is only legally permitted to do so much before a doctor is required.
The pharmacist “supervises” te process. Mail order has been doing this for 20 years. There used to two big ones... Caremark and Express Scripts. Now CVS, the Comcast of drugs, swallowed both up.
Hospitals do this too. In some cases 2-3 pharmacists can cover 10-12 hospitals for off shift dispensing needs.
With the black horse cavalry running the country, we’re going to see lots of M&A activity like this.
Pharmacists must directly supervise dispensing. Many hospitals use a central-fill pharmacy where the prescriptions are filled for many hospitals.
The problem with these mergers is they allow health plans that further disadvantage other pharmacies or providers. Once those other options are eliminated we’ll see prices rise. Do people actually want the Home Depot’s of healthcare rather than the equivalent of the local hardware store? We’ll see I guess.
Optical insurance has been like this for a long time. For example, EyeMed is owned by Luxottica, who owns the majority of eye wear retailers in the USA.
Evidence suggests that they've used their monopoly to artificially inflate prices quite dramatically.
No, it isn't. I worked for CVS for about 8 years, though not as a pharmacist. Some of this information could be Indiana-specific, however:
A brick and mortar pharmacy must have a pharmacist on-site to dispense drugs. Not only are they supposed to do a final check on prescriptions filled, but they must be available for patient question and sometimes medicine requires advice from a pharmacist before it can be dispensed. In addition, there are some stricter laws for certain controlled medications and these checks must be done by a pharmacist. If the pharmacist gets sick or in a car accident on the way to work, the pharmacy can't legally open (they can section the pharmacy off with its own locks to keep the convenience store open).
Where would MAC address capture occur on the network? MACs are local to L2 traffic, so once a frame turns into a packet and is routed, the sMAC of your PC is no longer present in the data. If you're on your home network, this has no impact what so ever.
Actually, this is no longer true. An autoconfigured IPv6 address can leak your MAC address, depending on your settings, as one mechanism for autoconfiguration embeds your MAC address right into your IPv6 address.
I have Fibre to the Home at 1Gb/sec, but so far, they do not support IPv6. That's something interesting for me to look into though, so thank you. I was providing ADS-B flight data to a website, and then I realized that they were posting my MAC, my NAT'd IP, and my GPS location to the world. That L7 will get ya every time.
