This article is about truck drivers in the US, where getting a license requires a big investment. The article states that there is now a shortage of truck drivers and argues that this may be a result of the ‘inevitable’ rise of automated drivers.

Many young people are reluctant to pay $5,000-$10,000 to learn to drive an 18-wheeler at a time when experts are predicting that it is a dead end career.

This is akin to what I wrote about before. When people know that a line of work is ‘unlikely’ to continue, they are prone not to want to invest in it. It is not too fanciful to see this happening in medicine. Start with imaging specialties first; and then look at the use of paramedical staff in restricted clinical domains.

Restaurants have also lagged behind retailers in offering “experiences”, as the trade jargon has it, rather than the usual broccoli. This is how the more innovative retailers now try to differentiate themselves in a crowded market. It also lets them do something with their underused floor space.  ….John Lewis, for instance, opened its 49th store in October with 20% of the space dedicated to eye tests, children’s car-seat fittings and free styling services for men. Selfridges, another big department store, marked the 400th anniversary of Shakespeare’s death in 2016 by performing “Much Ado about Nothing” in store, and last year it staged concerts. Waitrose hosts yoga classes, and Marks & Spencer mental-health drop-ins called Frazzled Cafés.

People say we spend too much on health, but business does not view it this way. As things approach the margin, there is even more to sell.

Economist

Universities are certainly putting their courses online. The question is “why?” I talked last week with a University President whom I have known for many years and asked him why he was building online courses. His answer, unsurprisingly, was “fear.”

Roger Schank

This is an old quote, but still redolent.

Most, if not all, of us, if asked to be cared for by a television doctor if we had a serious medical problem, would select Dr. Gregory House of the TV series House. He would fail most of the core competencies except for knowledge and skill.

Sidney Herman Weissman in Academic Medicine.

There is a parallel argument used in business: about rounding out the edges leading to less hard thinking. I might agree.

There are periodic evaluations, but a poor result means losing only a fraction of your funding, says Schuman, who previously held one of the plum positions in U.S. science: as an investigator funded by the Howard Hughes Medical Institute on a 5-year contract. “I did not realize how the renewal clock of 5 years dissuaded me from going for risky ideas until I became a Max Planck director,” she says.

Cue, David Bowie:

 

Well, just as I approached utter despair, it seems the authors of this Editorial in the Annals of Internal Medicine, say no. Whew! Gee, they will soon wonder if texting patients appointment times might occasionally be a good idea.

Nice article in the FT. It is about the increasing use of capital markets by UK universities, and the deal by Portsmouth is highlighted. It joins some dots:

Because the Portsmouth deal is private, so are a lot of the details about it – the borrowing cost, the contractual stipulations. But one aspect in the public domain is the emphasis placed on university rankings in the deal’s press release. ]Text below] From that release:

According to The Economist’s own ranking of UK universities, the University does more to boost its graduates’ earnings that any other university in the UK. The University was ranked 37th in the 2018 Guardian University Guide (having risen for the third successive year from 43rd in last year’s guide and 49th in 2016) and for the third consecutive year, it ranked in the top 100 young universities in the world, in the Times Higher Education ranking of universities which are less than 50 years old.

Even if it is not an explicit part of a lender’s investment process, university rankings are a critical part of the emerging financial infrastructure for universities. They mediate both the demand of student-consumers (in line with the guidance of their parents and schools) and the overall marketing process of debt issuance (lenders, we assume, will be reassured by high or rising rankings).

“It’s hard to keep a straight face and conduct professional conversations about finite element modelling or soil strength profiles when I’m in a site office surrounded by pictures of naked women.”

From a review of: Built: The Hidden Stories Behind Our Structures, Roma Agrawal Bloomsbury, 2018. 308 pp.

Reviewed in Science

So, where it this from?

At the peak of the crisis, the hospital had the equivalent of eight full-time pharmacy employees battling the shortage. Technicians worked through the night to mix saline by hand, while nurses injected the solution of salt in water into patients using syringes — a task normally done by the metal stands and plastic bags used for intravenous drips. “Sometimes we’ve had over 20 nurses at a time doing that,” ..

Yes, in the US, at the Cleveland Clinic. FT