MacHeist has announced their latest bundle. And, as with each previous iteration, discussion and criticism have ensued. I’d like to weigh in with some thoughts from a slightly different vantage point.

First, a very brief summary. The main accusation against MacHeist has been that it undervalues the work of Mac developers by offering their products for sale at a massively discounted price. Marco Arment describes this. Apologists for MacHeist point out the advantages for consumers (cheap goods) and developers (cash infusion). No one denies that the folks running MacHeist do very well themselves.

This criticism, careful observers of the Mac world know, has evolved over time. A couple of years ago, Gus Mueller pulled no punches in blasting the offering, but this year his Acorn (a wonderful program for which I’ve already paid the regular price) is part of the package. He says all his concerns about underpaid developers have been addressed. I’ll take his word for it. Elsewhere, John Gruber of Daring Fireball, a former critic, has since accepted advertising from MacHeist. Gruber’s not known for kowtowing; obviously his reservations have also been resolved. There is no doubt that MacHeist has made changes with each iteration. For example, developers are now paid a percentage of sales rather than a flat rate. As such, I can accept that these former gadflies feel their concerns have all been addressed, but that the shift in opinion coincides with money changing hands is nevertheless worth noting.

As for me, the whole thing continues to poke at a corner of my conscience.

First, it’s the organizers. Specifics are easily googled (start with MyDreamApp) and I won’t elaborate, but MacHeist isn’t the first experience these folks have had with ethical criticism and hurt feelings.

Second, I still don’t think it’s best for developers. Okay, I get it, they’re adults, they can decide what to do with their software, it’s their choice. Fine, but just because an adult with free will decides to go to a payday lender/loan shark to borrow money doesn’t mean that loan sharking isn’t morally bankrupt. It is. Even if there are people who’ve been happy with their loan shark experience. That’s not an exact analogy of course, but my point is that doing something of my own free will doesn’t rule out the possibility that someone’s taking advantage of me. In fact, isn’t that how con men work; deceiving the mark into freely making a bad decision. One might even argue that the ultimate con man is the one whose victim who doesn’t even know they’ve been had.

Third, in direct response to one of the apologies made in favor of MacHeist, I have actually already planned to purchase The Hit List and Espresso, so I cannot claim that a fraction of the retail price is more than these developers were going to get from me anyway. Nope, those are both right near the top of my Mac Software shopping to-do list.

Finally, Simone Manganelli sums up a part of how I feel. For me, his conclusion is true:

Fundamentally, what it comes down to is that those consumers who are participating in the MacHeist bundle are tightwads.

So here we are, MacHeist 3 has rolled around, and I don’t think any rational person would say it hasn’t gotten more fair to developers with each iteration, but still, as I outlined above, I won’t be buying it with a clear conscience. If you have no misgivings about doing business with this enterprise, then we can, as Arment also put it, respectfully disagree.

But here’s the rub. My conscience was really ablaze with the first MacHeist. Mueller and Gruber are folks I respect and their criticisms rang true. But guess what, temptation got the better of me. I bought the bundle. Great freaking deal for me, right? By MacHeist 2, I had listened to a MacBreak Weekly series of pros and cons, read some new opinions, seen the Daring Fireball ad, and felt that some of the issues had been addressed. Still, it didn’t feel quite right as I punched in my credit card number and made the purchase. Nice bundle, though. Great deal.

Now, round three, and, despite improvements, as outlined above, I can’t purchase this package with a clear conscience. But will I purchase it anyway?

I’m reminded of my all-time favorite Steve Jobs quote, in regards to “stealing” music:

People need to have the incentive that if they invest and succeed, they can make a fair profit. Otherwise they’ll stop investing. But on another level entirely, it’s just wrong to steal. Or, let’s put it another way: it is corrosive to one’s character to steal.

I’m not all that worried about the developers in this deal.

I’m certainly not worried about the folks at MacHeist.

I’m worried about me.

It drives me crazy when TV show medical folks call an injury a GSW. That is the written shorthand for gun shot wound that is used on ER charts or paramedic reports. It’s stupid to say it out loud because gun shot wound is three syllables long and GSW is five. Language like that, along with every single second of the TV series House is proof that the medical consultants on most TV shows are not who you want to see if you get sick.

The Article Skimmer from The New York Times was already my favorite web news interface, but sometime recently, it was updated and now pops the selected article up in a Lightbox type overlay. This is, to me, the nicest online presentation of a newspaper I’ve yet encountered.

When Jonathan Leo, a neuro-anatomy professor, pointed out that a JAMA article not only failed to disclose financial bias but also incorrectly implied that a pharmaceutical therapy was better than a non-drug one, the Journal of the AMA (of which I have not been a member since fresh out of medical school) flashed its true colors:

Leo says he received an angry call from JAMA executive deputy editor Phil Fontanarosa last week, shortly after Leo’s article was published on the BMJ Web site. “He said, ‘Who do you think you are,’ ” says Leo. “He then said, ‘You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry.” Fontanarosa referred a call for comment to a JAMA spokeswoman, who said Leo’s retelling of the conversation was “inaccurate.”

Then, the editor-in-chief of JAMA, as cited by the Wall Street Journal, showed her own lack of class:

“This guy is a nobody and a nothing” she said of Leo. “He is trying to make a name for himself. Please call me about something important.” She added that Leo “should be spending time with his students instead of doing this.”

When asked if she called his superiors and what she said to them, DeAngelis said “it is none of your business.”

Maybe we need Jon Stewart to interview her.

Now that Walmart’s Sam’s Clubs plan to start selling electronic medical records, one has to wonder how long before Vizio gets in on the partnership and starts installing 46″ LCD monitors in exam rooms as part of the package.

What caught my eye about this news, though, was not the Walmart part, but the emr they’ve partnered with, eClinicalWorks. I’m very familiar with this Westborough, MA based company, having not only done consulting work for them in the past, but also been a customer. In fact, the one and only program icon I have ever designed is still used by eClinicalWorks; an adaptation of that icon (with a reflection I lifted from a web tutorial) is used in the badge at the center of this image.

I’m even more proud, however, of having conceived and designed the prototype of the patient-centric dashboard that the product currently uses. While the final functional iteration is not as attractive as the initial prototype, it is nevertheless a unique and useful addition to the software, and I think that the engineers who coded it are as proud of it as I am.

The folks who run eClinicalWorks are friends of mine and a fine group of very hard working individuals. I’m very excited for the potential implications of this news on the company.

I wish I had the option of using eCW as my EMR today.

It’s doubtful that the currently tiny readership of Ordinary Time hasn’t already seen Merlin Mann’s notes about Kutiman’s incredible YouTube creativity, but as much for my own future reference as yours I have to preserve this stuff.

Unsolicited tip for media company c-levels: if your reaction to this crate of magic is “Hm. I wonder how we’d go about suing someone who ‘did this’ with our IP?” instead of, “Holy crap, clearly, this is the freaking future of entertainment,” it’s probably time to put some ramen on your Visa and start making stuff up for your LinkedIn page.

And, from the department of Aphorisms that are Freaking Brilliant but New to Me (ATAFBBNTM) comes this gem:

Remember: the only person who can sit on your ass is you.

That’s exactly why I’m writing again.

Pediatrician Anne Armstrong-Coben offered a bit of editorial comment on electronic medical records in the New York Times last week. Almost all of her comments raise issues which are, I agree, areas of concern. The electronic medical record our hospital and medical school are using, while elegant in some ways, is clunky in others and the cluttered output of its notes makes it particularly susceptible to Armstrong-Coben’s hypothetical point about how difficult it is to read the note after it’s created.

Now a chart is a generic outline, screens filled with clicked boxes. Room is provided for text, but in the computer’s font, important points often get lost. I have half-joked with residents that they could type “child has no head” in the middle of a computer record — and it might be missed.

Electronic medical records are not the panacea that the federal government would have us believe, nor are they as clever or usable as computer geek doctors like me assume they should be. Further, don’t forget privacy issues; you don’t want your whole health history trusted to 2009′s state of the art version of a national electronic chart. This could make Facebook privacy concerns look trivial by comparison. And while the web is evolving sets of microformats, medical informatics is mired in a messy muck of interoperability called HL7, a set of standards that don’t seem to understand what standard even means.

Still, when I was seeing a patient for an ER follow-up this morning, I was able to review all his labs and view his CT scan reports and images in less than 60 seconds. I asked him what the ER thought was wrong with him, he wasn’t really sure, but 15 seconds later I was reviewing the ER doctor’s chart from Jan 28. I ordered a follow-up lab and the by the time the results popped into my inbox scarcely an hour later, he might not even have made it back home. Electronic medical records are far from mature or ready for unified national rollout, and they are indeed fraught with their own set of shortcomings, but don’t doubt that those cons are accompanied by a long list of pros; the benefits of computer medical charting are real.

Conclusion. Medical Informatics is mostly just out of beta, but we’re making slow progress, and our 2.0 version will arrive some day. But, in the meantime, if you request your kid’s medical records, and happen to read that he or she has no head, before you call 911 or run into the street screaming in panic, I’d go down to their bedroom and verify the presence of a noggin. More than likely, all is fine.

Just saw Gran Torino. I loved its depiction of a surly old man having his defenses relentlessly attacked then breached. I loved its honest depiction of races living together. I loved its depiction of a goofy teenager finding the oddest of all possible role models. As Roger Ebert puts it:

“Gran Torino” is about two things, I believe. It’s about the belated flowering of a man’s better nature. And it’s about Americans of different races growing more open to one another in the new century. This doesn’t involve some kind of grand transformation. It involves starting to see the “gooks” next door as people you love. And it helps if you live in the kind of neighborhood where they are next door.

But perhaps most of all, I was freaking thrilled to see a genuine Catholic priest on the screen who looked like a real live human being trying his best to serve God in the middle of this mixed up world. When asked by Walt if he’d like a beer, you could almost see Father Janovich relax as he admitted, “I’d love one.”

Barbara Nicolosi:

There is also a very cool and respectful religion sub-plot, in which a priest is actually portrayed as a compassionate, thoughtful and three-dimensional human being.

You don’t see that onscreen every day.

Sweet news today. Terrell Owens is gone.

Opinions are mixed today, but I don’t know why. The Dallas Cowboys are better today than they were yesterday. Tony Romo will play better, the offense will be more consistent, and, obviously, the flesh-eating psyche destruction will be less.

Owens said he wanted to retire and go into the Hall of Fame as a Cowboy. Hmmm. That’s taking a lot for granted. Time will tell for Owens, but for all good Cowboys fans, the clock has struck REJOICE.

Observations, Complaints, Quibbles, and Suggestions Regarding the Safari 4 Beta

What he said.