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Patient Testimonials Are Unethical And Should Be Banned

Patient Testimonials Are Unethical And Should Be Banned

Still, he says, a doctor seeking any gift must always consider: “Is the patient really in a vulnerable position where they don’t feel comfortable saying no? Or do they have the impression, whether warranted or not, that their care is going to be affected?”

Even if health providers refrain from directly asking patients for blurbs, as long as they are permitted to advertise themselves by curating a selection of individual patient outcomes, they risk misleading prospective patients with a disingenuous picture of results—what Wynia calls “bluffing, puffing, and spinning.”

Some providers crib reviews from sites like Zocdoc and tout them in marketing material, sometimes with identifying details attached. Zocdoc, a New York firm founded in 2007, is focused on vetting the authenticity of its reviewers and on preventing instances of fraud directly on its platform. Once they’re online, though, doctors can funnel the reviews, filtered by star rating so the most glowing ones are highlighted, directly to practice websites.

And then there’s the issue of incentives. In one of its training videos, an employee at RealSelf, the cosmetic procedure platform, notes that FTC rules discourage practitioners from incentivizing their own patients to write reviews, but steers them to a workaround: “It is not against the rules for RealSelf to offer incentives to your patients to write a review, and you can leverage our incentives,” like entrance in a monthly $500 sweepstakes, “in place of your own.” Josh King, the company’s general counsel, adds: “It’s not that doctors absolutely can’t incentivize reviews. It’s just that your typical plastic surgery practice doesn’t have the know-how, tools, or consumer volume to offer incentives in a compliant way, and may well get themselves in trouble if they try.”

Doctors and other practitioners shouldn’t be bluffing, puffing, or spinning—or anticipating the perfect moment to ask a recovering patient for a favor so as to reel in the next one. Nor should they be authorizing review companies to dangle prizes to their patients. Rather than a patchwork system of standards and statutes, or engaging in guesswork about the timing of gifts, a blanket ban on patient testimonials and using patient statements in marketing would protect current and future patients while allowing practitioners to focus on care.

There are other ways to advertise medical services. “The public has a right and a vested interest in knowing if a hospital, clinic, or medical practice is offering a type of service,” such as gastric-bypass surgery, says Albert Einstein’s Herron.“You can talk broadly about ‘this is something we’re providing, and if you’re interested, please contact us.’ Because it’s more about the institution, not about an individual.”

Or there’s the strategy that Paul Hughes, a UK psychotherapist with offices in Reading, Oxford, and London, uses. He has a page on his practice website titled “Why no testimonials? A page on ethics.” (Websites smattered with testimonial videos are common among UK therapists.) Testimonials represent a breach of confidentiality, put the patient in a difficult position, and represent only a snapshot in time, he writes. He includes some excerpts from his Google review page and a link to his full listing. “We are there to serve the client’s interests,” he tells me. “They’re not there to serve ours.”


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Activision Blizzard Employees Are Done With CEO Bobby Kotick

Activision Blizzard Employees Are Done With CEO Bobby Kotick

Several top Activision Blizzard employees resigned or were let go by the company in the wake of the DFEH complaint and follow-up investigations. Some were directly implicated in allegations, including former chief technology officer Ben Kilgore and former lead developers for Diablo 4 and World of Warcraft. Company president J. Allen Brack, who the DFEH alleges knew about complaints of harassment, also resigned.

“In the past, we haven’t asked for anyone to resign,” says one Blizzard employee involved in the walkout. “We believed in the ability to fix this and have people learn and grow.” But after The Journal‘s bombshell report published on Tuesday, the employee says when it comes to Kotick, “there’s the belief that the integrity isn’t there to allow learning and growing.”

The report alleges Kotick misrepresented his knowledge of the depth and breadth of misconduct allegations to both Activision Blizzard executives and board members. The board was reportedly blindsided by California DFEH’s complaint this summer, despite the department’s investigation stretching back two years. “Some departing employees who were accused of misconduct were praised on the way out, while their coworkers were asked to remain silent about the matters,”  The Journal reports.

The report also recounts multiple accusations involving the CEO himself. Kotick allegedly harassed an assistant in 2006, including saying in a voicemail that he’d have her killed. A spokesperson for Kotick says he apologized at the time and regrets his tone. In 2007, a flight attendant on a private jet he co-owned sued Kotick after she was fired for complaining about the pilot’s alleged sexual harassment. Kotick settled with the attendant and paid her $200,000, according to The Journal. A spokesperson for Kotick denied there was retaliation.

In a statement, Activision Blizzard denied the WSJ report and said it presented “a misleading view of Activision Blizzard and our CEO … The WSJ ignores important changes underway to make this the industry’s most welcoming and inclusive workplace, and it fails to account for the efforts of thousands of employees who work hard every day to live up to their—and our—values.”

Kotick himself also sent a video message to employees on Tuesday in which he said the report “paints an inaccurate and misleading view of our company, of me personally, and my leadership.” He added, “Anyone who doubts my conviction to be the most welcoming, inclusive workplace doesn’t really appreciate how important this is to me.” Kotick added that the company is moving forward with “a new zero-tolerance policy for inappropriate behavior—and zero means zero. Any reprehensible conduct is simply unacceptable.” An Activision Blizzard spokesperson told WIRED that the company had no further comment.

“I don’t know that anyone I know at the company actually thinks Bobby Kotick and his Trump-era goons have employees’ best interests at heart,” says one current Blizzard employee who asked to remain anonymous for fear of repercussions. (Chief compliance officer Frances Townsend worked as president George W. Bush’s homeland security adviser, and chief administration officer Brian Bulatao has worked with the Trump administration.)

How Apps Commandeered the Age-Old Idea of Takeout

How Apps Commandeered the Age-Old Idea of Takeout

At the turn of this century, when Seamless was launched, mostly as a tool for offices to place large orders from restaurants and caterers, it didn’t register as a threat. Nor did Just Eat in Denmark (2001) or Grubhub (2004) or a host of others, which all began swallowing one another in a series of mergers and acquisitions that read like a tech version of biblical birth announcements: “And Just Eat acquired Hungryhouse from Delivery Hero, and Seamless merged with Grubhub, and Greylock Partners and Redpoint Ventures did invest in Just Eat, which begat SkipTheDishes.”

As with humans, the family of companies grew wider and more diverse. Here is a partial list of major competitors and also-ran companies in this sphere: Talabat, Snapfinger, Hungryhouse, Menulog, Eat24Hours, Ele.me, EatStreet, Eat Club, Munchery, Postmates, OrderAhead, DoorDash, ChowNow, Caviar, Foodpanda, Menu Group, SkipTheDishes, SpoonRocket, Deliveroo, Gopuff, Hello Curry, Foodora, Dunzo, Swiggy, Uber Eats, Wolt, TinyOwl, InnerChef, Maple, Tapingo, Rappi, Spring, Chowbus, and Glovo. As they proliferated and merged, these companies collected more detailed, more accurate customer data, the information aggregating into a tool that could anticipate and meet customer demands far more efficiently than even the most veteran restaurateur.

The arrival of the iPhone in 2007, followed by the 2008 recession and a whole generation of young engineers mobilized to create apps in a get-rich-quick land rush to be the next Facebook, was an indefensible assault on restaurants. A host with a reservation book and a landline was under-equipped to compete with order-placing technology that was suddenly in every diner’s pocket, feeding data into Silicon Valley app companies. Within a few years, these companies knew more about a restaurant’s customers—what we wanted, when we wanted it, how much we were willing to pay—than a small business ever could.

In 2016 a number of these companies made news by stopping their so-far-unobstructed growth. Before shutting down, Bento conceded that there was more money to be made in catering than on-demand delivery, SpoonRocket sold its technology to Brazilian food chain iFood, and Square tried to sell Caviar to Uber or Grubhub.

As word got out that third-party delivery was unprofitable, despite much-heralded sales, the conversation shifted. The problem wasn’t that the emperor had no clothes, that these companies—valued in the billions, with more investment cash pouring in every day—had hustled restaurants and investors. It was that of course delivering food wasn’t profitable. Not with human labor. When restaurant meals could arrive at our door via drones, robots, and self-driving cars, however, that’s when the sector would go from red to black. “If we don’t get the [autonomous car] software thing nailed, we’re not going to be around much longer,” Uber CEO Travis Kalanick told USA Today in 2016.

All of these enterprises prefer to be known as tech companies, as opposed to taxi or restaurant businesses. That’s true. They don’t deliver food. Many of them farm out the physical schlepping to other agencies, like Relay, Homer Logistics (acquired by Waitr), and Habitat Logistics. Bike and car couriers are never employees but “independent contractors,” granting the company the maximum exemptions from labor and employment laws regarding scheduling, overtime, sick pay, and wages.

Committed to the legal fiction that their product is something other than delivery, and that couriers are not employees, these companies skirt around the particulars of what service they actually provide, reminding you that you get food brought to you because of them, in some hard-to-quantify way. “Grubhub helps you find and order food from wherever you are.” “Uber Eats is the easy way to get the food you love delivered.” “Whatever you want, we get it. Order delivery for yourself or with friends and watch in real time as your Postmate brings you all the things you love.” It’s an impressive feat of copywriting, implying that they deliver food without stating it and therefore avoiding the liability of identifying themselves as delivery companies.

Oura’s Gen3 Launch is Marred by an Unhealthy Business Model

Oura’s Gen3 Launch is Marred by an Unhealthy Business Model

I never would’ve guessed that the rollout of Oura’s third-generation ring would go poorly. The Finnish health-tracking ring debuted in 2015 to high praise (some of which I gave). It’s simple, accurate, stylish, and the near-universal choice for businesses and organizations to spot early warning signs of Covid. Everyone (well, everyone who cares about these things) eagerly awaited the arrival of Gen3.

But early reports have been disappointing. It’s not because the company has significantly changed how the ring looks or works, but because Oura has transitioned to a new subscription model. Instead of accessing all the features when you purchase the ring, you now pay $6 per month for personalized insights and guided videos. Worse yet, many of the new features you’re paying for, like blood oxygen measurements, don’t even show up until early 2022.

Oura hedged its bets somewhat. The first six months of the subscription are free, and if you’re upgrading from a Gen2 to a Gen3, you get a free lifetime subscription (but only if you buy before November 29!). In the end, you’re still paying money to upgrade, and then paying more money for features you can’t use yet. Oh, and Oura reduced the warranty from two years to one.

A subscription model isn’t crazy in and of itself—other fitness trackers like Whoop and Fitbit require subscriptions. Those wearables are significantly cheaper than the Oura, though. That said, there just isn’t anything out there quite like the Oura. It has a ton of sensors that are mostly very accurate, plus it’s small and very easy to wear. If you want an Oura ring, the Gen3 still works fine. But I understand why people are feeling frustrated.

Ready to Go

URA Ring
Photograph: ŌURA

The ring looks basically the same as the Gen2. You measure your index or middle finger with Oura’s sizing kit to get a ring that fits you precisely. An astonishing array of sensors fit into this little package—Gen3 now has green and red LEDs, in addition to infrared and a new temperature sensing system—to track everything from your heart rate (24 hours a day) and minute changes in your body temperature to when you fall asleep and wake up.

These metrics get boiled into three separate categories—your body stress, sleep, and activity. Based on your performance in each of these categories, you get a Readiness Score every morning that assesses how able you are to tackle each day’s activities. If you have a score of 85 or over, you’re ready to take on any physical challenge. Under 70? You should probably back off for the day.

I’ve been wearing the Oura and double-checking it with a Whoop band and the Apple Watch Series 7. I’m a restless sleeper, and when it comes to sleep tracking, both the Whoop and the Oura are noticeably more sensitive and accurate than the Series 7, which regularly says I sleep an extra half-hour or hour. The Oura measures sleep latency in particular, or how long it takes to fall asleep each night—a useful metric that corresponds to whether I drank alcohol or worked out later in the day.

India’s New Rules for Map Data Betray Its Small Farmers

India’s New Rules for Map Data Betray Its Small Farmers

The geospatial data regulations are part of a bigger picture. They’re the latest in a series of reforms—land reforms, proposed farm laws, amendments to the Forest Act, new drone regulations and land digitalization schemes—that are all positioned as being beneficial to individuals, but which make it easier for private corporations to enter these sectors.

 In the past decade or so, successive governments have promised prosperity via “digital governance” in order to coerce more and more Indians into giving up their data—personal and otherwise—ostensibly for their own good. Schemes like Aadhaar, a unique biometric-based ID; AgriStack, a collection of technologies and digital databases about farmers and farming; the Health ID; and others have resulted in massive, digital databases. Though specialized for different things, when these databases are interlinked, they form a powerful digital superstructure—with unchecked scope creep, no data protection laws, and sketchy regulations on the use and access to that data. With geospatial data now up for grabs, there is no clarity on how this might be integrated or correlated with the other existing databases.

So while these companies can extract land data and use it to make money, the marginalized folks who live in these areas and earn their living from the land are pushed further to the peripheries. The further the private sector advances into indigenous lands and into the lands of small farmers, the more the former’s control over the land and its resources grow. This is happening, for example, in the southern state of Andhra Pradesh, where the government’s plan to lease out inland waterways to private companies risks the livelihoods of local fishers.

Another example of how this plays out, explains Srikanth L. of the consumer collective Cashless Consumer in a tweet thread, comes from the Survey of Villages and Mapping with Improvised Technology in Village Areas (Svamitva), which aims to chart land parcels in rural, inhabited areas using drones.

Svamitva grants whomever is currently living in a particular rural area an official title to their property, which would serve, Singh writes, as collateral for loans. (Landownership in India can be complicated because of systems created during colonial rule, along with legal gaps and poor administrative record-keeping.) Srikanth, however, is skeptical. “That’s not to say that this can’t happen,” says Srikanth. “It will happen, but not for everybody—maybe for the early adopters.” This is because rural borrowers tend to be outside the formal banking system, sometimes even unaware of waivers and credit schemes they might be eligible for, and depend largely on informal credit.

Yet while the promised collateral system will likely not work out, Svamitva could become the umbrella under which the infrastructure for drone surveillance is brought in. The Indian government is set to fund a network of continuously operating reference stations (CORS)—a kind of “highway” for drones to fly autonomously and do their surveying—to support Svamitva. Srikanth believes that the Svamitva scheme uses the “low-hanging fruit” of surveying residential rural land to venture into drone technology. Surveying residential land is “slightly less political than to, say, go after agricultural land,” he says, and when technologies like drone-based deliveries, imaging, and photography become possible, CORS ends up being a key infrastructure that the state has invested in. 

That these geospatial data regulations come alongside recent corporatization and privatization in mining, defense manufacturing, civil aviation, space exploration, and more is probably not a coincidence. Private companies will be lining up to provide the back-end technologies. For geospatial data collection, too, somebody will have to provide the back-end technology—operate the drones, map the data, issue property cards, and so on.

The Best Desktop Gaming PCs We’ve Played With

The Best Desktop Gaming PCs We’ve Played With

Consoles like the Nintendo Switch or PlayStation 5 may be great for gaming, but they’re hard to come by. Fortunately, a good old fashioned gaming PC is always an option. If you want to get access to the massive library of games on stores like Steam and Epic, we’ve got some of the best gaming PCs collected here.

Since gaming desktops can be upgraded more frequently than consoles, they can deliver high-fidelity visuals unrivaled by most other systems. Paired with the right peripherals—a quick and responsive mouse, a mechanical keyboard, and a good headset—a gaming PC can quickly become the place you spend most of your free time.

Choosing a gaming desktop can be incredibly complex, though. There are several specs and factors to consider, including specs, what kinds of games you’re going to play, and how many thousand RGB lights you want on it. Building your own PC is also a great option if you want to make it yourself and upgrade it over time, but for everyone else, these are the best gaming desktops we’ve tested at WIRED.

Updated November 2021: We’ve removed the HP Omen and Dell G5 desktops because those models have been discontinued. We also added the NZXT BLD custom build system.

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