Health reform to worsen doctor shortage by 50% in 2015

Unfortunately, says a new report from the the Association of American Medical Colleges, the U.S. health insurance legislation will worsen a shortage of physicians as millions of newly insured patients seek care, Reuters reports.

The group's "Center for Workforce Studies" released new estimates that showed shortages would be 50 percent worse in 2015 than forecast.

'While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025,' the group says.

'The United States already was struggling with a critical physician shortage and the problem will only be exacerbated as 32 million Americans acquire health care coverage, and an additional 36 million people enter Medicare, the report says.

Other groups, such as the nonprofit Rand Corporation and the Institute of Medicine, have also projected various physician shortages.

Once might infer something else, as well. Since medical care is subject to laws of supply and demand, just as any other commodity would be, the effect of increasing demand without increasing supply will cause costs to go up. You might remember this very basic relationship from high school or college economics. 

It isn't exactly an "unintended consequence." Observers, not limited to medical practitioners, had been warning of just that problem before the health insurance reform was made law.

Health reform to worsen doctor shortage: group | Reuters

T-Mobile Says 4G Can Wait

It isn't clear whether the latest statements from T-Mobile USA about fourth-generation networks, its preference for air interface or its timetable for 4G migration necessarily add much new insight about what T-Mobile USA might do in the future about its own 4G choices.

Some will speculate that the firm's clear preference for LTE mean it would not invest in Clearwire under any circumstances.

That is among the inferences one could draw, but not by any means the only conclusion. It is correct that T-Mobile USA has some time to make a firm 4G decision, given its recent HSPA+ upgrade that will support bandwidth highly comparable to LTE.

As far as its ultimate migration to 4G, it remains unclear whether there is any path for gaining the needed 4G spectrum other than leasing it from a partner, or possibly investing in Clearwire or some other firm that does have spectrum assets.

Some will point to T-Mobile USA's preference for LTE, not WiMAX, as evidence an investment in Clearwire, or buying wholesale capacity from Clearwire, is not a likely option. But that assumes Clearwire will run WiMAX as its own protocol, and will not, in fact, light an LTE network that runs alongside its current WiMAX network.

Both Clearwire and Sprint Nextel executives (Sprint is the majority owner of Clearwire) have said there is no technological barrier to running LTE alongside WiMAX, or ultimately even in some mode that essentially replaces WiMAX.

“We’ll look towards LTE at the right point in time for us,” Neville Ray, T-Mobile USA’s chief network officer, told Bloomberg.

“That ecosystem is going to be much richer than the competing one from WiMax, which is really a niche play,” Ray said. Most observers now would agree with the general outlines of that position.

Fourth-generation LTE networks promise average download speeds of about 10 megabits per second, compared with 1.7 megabits per second for 3G. But HSPA+ boasts speeds comparable to the LTE speeds AT&T and Verizon Wireless have been saying would be available commercially.

T-Mobile Says 4G Can Wait, Clearwire WiMax Is ‘Niche’

Social Media Someday Will be as Foundational a Tool as Email

One day, the tools we call "social media" will be like the fax machine or email. We’ll wonder how business got done without them.

We aren't there yet, but it's coming. Social media will as routine as customer service and technical support groups, a routine part of the sales and marketing mix.

Mission Unaccomplished | jatiN mahindrA doT coM

Google on Display Ad Future

Looking forward, Google believes that what we today know as “display” advertising will just be “advertising,” a single platform that can coordinate an advertiser’s campaign across streaming audio ads in car stereos, interactive mobile experiences on smartphones, and high-definition video ads on set-top boxes, for example.

Of course, Google expects it will be well positioned to be the manager of campaigns using such diverse channels. Google expects it will provide a single platform to optimize such campaigns, automatically delivering the best-performing ads, best returns and best mix, across all those platforms.

Display advertising is about much more than ads in web browsers, Google now believes.

People are watching video, reading newspapers, magazines, books and listening to digital music at an ever-increasing rate, on a wider range of devices.

So Google intends to give publishers a single base that can deliver ads into this expanding world, including streaming video and mobile ad delivery.

Official Google Blog: Online publishers: growing the display advertising pie

The Value of a "Liker"

Newspapers and other content organizations can use social mechanisms, such as the Facebook "Like" mechanism, to drive traffic, engagement and clickthrough rates, Facebook argues. Do get those results, content publishers should use social plugins, beginning with the Like button.

When a person clicks "Like," it publishes  a story to their friends with a link back to a site, adds the article to the reader’s profile, and makes the article discoverable through search on Facebook.

Publishers also should optimize their "Like" buttons, perhaps  showing friends’ faces and placing the button near engaging content, but avoiding visual clutter with plenty of white space. That can increase clickthrough rates by three to five times.

Publishing engaging stories or status updates (things that are emotional, provocative, related to sporting events or even simple questions) increase on-page engagement by 1.3 to three times, Facebook says.

Highlighting the most-popular content on a site leads people to view more articles. Those who click on the "Activity Feed" plugin in particular generate four times as many page views as the average media site viewer. Place it above the fold on a home page and at the bottom of each article for maximum engagement.

Publishers should use the "Live Stream" to engage users during live events, as well. The live stream box can serve as a way to reach an  audience, facilitate sharing of content, and get them involved in what is streaming, be it an interview, conference, or other type of event.
People who click the Facebook "Like" button are more engaged, active and connected than the average Facebook user, Facebook says. The average “liker” has 2.4 times the amount of friends than that of a typical Facebook user. They are also more interested in exploring content they discover on Facebook. They click on 5.3 times more links to external sites than the typical Facebook user.

Many publishers are reporting increases in traffic since adding social plugins, including ABC News (+190 percent), Gawker (+200 percent),  TypePad (+200 percent), Sporting News (+500 percent), and  NBA.com (number-two referral source). Publishers have also told Facebook that people on their sites are more engaged and stay longer when their real identity and real friends are driving the experience through social plugins. For example, on NHL.com, visitors are reading 92 percent more articles, spending 85 percent more time on-site, viewing 86 percent more videos, and generating 36 percent more visits.

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Globe to offer two websites: one free, one pay

Experimentation is the watchword throughout most of the media. So the Boston Globe next year will split its digital news brands into two distinct websites, keeping Boston.com free while establishing a subscription-only pay site, BostonGlobe.com, which will feature all the content produced by the newspaper's journalists.

That will set up a clear test of end user preference for online local news.

The change, scheduled to take place during the second half of 2011, is aimed at building an audience of paid subscribers online, a strategy that newspapers across the country increasingly are moving towards. With this approach, the company also aims to maintain high traffic to Boston.com, one of the nation’s largest regional news sites and a site that generates revenue from advertising.

In the video arena, attention is focused on experiments with on-demand and online-delivered entertainment video. But one change already has occurred: cable networks are vastly more profitable than the old broadcast TV networks.

Bravo, for instance, is valued at $3.2 billion, according to research firm SNL Kagan. In contrast, Wunderlich Securities says the NBC network is worth a negative $600 million.

ABC Family is worth $3.3 billion, while ABC's value is just $1.2 billion, according to Kagan and Wunderlich estimates.

Just about everything happens faster when the Internet is involved, it is worth noting, but the vast growth of cable programming value, and the decline of broadcast networks, took decades. Few of us would suggest it will take decades for online video to have significant impact on the multichannel video entertainment business. But it wouldn't take much insight to predict a decade as a reasonable expectation for online channels to have displaced a significant percentage of today's "cable-delivered" programming.

Globe to offer two websites: one free, one pay

YouTube Leads, But Facebook 2nd-Largest Video Site

Google Sites, driven primarily by video viewing at YouTube.com, ranked as the top online video content property with 146.3 million unique viewers in September 2010.

But Facebook.com jumped one position to capture the number-two spot with 58.6 million viewers, for a total of 243 million viewing sessions. Yahoo! Sites ranked third with 53.9 million viewers, followed by VEVO with45.4 million.

Google Sites had the highest number of overall viewing sessions with 1.9 billion and average time spent per viewer at 270 minutes, or 4.5 hours.

The duration of the average online content video was 4.8 minutes, while the average online video ad was 0.4 minutes.

comScore Releases August 2010 U.S. Online Video Rankings

20% of AMericans Have Reduced Spending on Cable?

In a short piece on how Americans are economizing during the recession, sponsored by the Harris Poll, brief mention was made of the fact that 20 percent of Americans have cut back someplace on their "cable" spending. If so, that would presumably include cutting back on HBO subscriptions, disconnecting an outlet and therefore saving a monthly cable decoder rental, or other actions that keep the basic cable subscription in place.

If true, though, such data would show the important role the economy, housing crisis and joblessness are having on fixed-line service providers. Significant percentages of people also claim they cut off a mobile phone subscription or fixed-line voice subscription as well.

What Americans say they gave up in 2009

Google Android OS Has Momentum

Among consumers planning to buy a smartphone in the next 90 days, 37 percent say they prefer to have the Android OS on their new phone. That is a seven percentage point jump since the previous survey and a new all-time high for the Google operating system.

Over a year, preference for Android has grown about 600 percent.

While the Apple iOS remains the number one OS preference for future buyers, it dropped as expected in the aftermath of the huge spike we saw during June’s iPhone 4 release.

ChangeWave Consumer Smartphone Survey - Google Android OS Momentum

Sprint Board Members Depart Clearwire

Sprint Nextel Corp. executives serving on the Clearwire Corp. board of directors have left the board, the Wall Street Journal reports.

Sprint Chief Executive Dan Hesse and fellow executives Keith Cowan and Steven Elfman have resigned from the Clearwire board. A spokeswoman for Sprint said the company plans to appoint independent successor directors in the next few months. In the meantime, Sprint has named its general counsel, Charles Wunsch, as an independent observer to the Clearwire board.

Clearwire said that the resignations were prompted by recent changes in antitrust laws, but the move could also could provide Clearwire added flexibility to pursue a deal of some sort that might bring T-Mobile USA into Clearwire as an equity owner, for example.

On the other hand, some speculate that Sprint might also have an opportunity to increase its stake, as other shareholders such as Comcast Corp. have signaled they are unwilling to provide additional funding Clearwire requires. A move of that sort might not require a greater arms length relationship with Clearwire, though.

Clearwire said the move came "out of an abundance of caution to address questions raised by Clearwire

Clearwire's board structure allows for 13 members, seven of which Sprint has the right to appoint. The remaining four independent Sprint appointees to the Clearwire board remain.

Since Clearwire and Sprint compete at the retail level, the current board membership has proven awkward, observers note.

In some ways, it is hard to see any long-term solution that does not have Sprint acquiring a larger stake in Clearwire. Whether a firm the size of Sprint can live, long term, with buying its crucial 4G services from a firm it also competes with is open to question.

Sprint Nextel also faces the complexity of operating several different air interface networks (iDEN, CDMA and WiMAX). Those problems are not directly related to the size or control of the Clearwire network, but could become even more complicated if Sprint adds Long Term Evolution services at some point.

Weak Economy, Not Cord-Cutting, Drives US Pay-TV Subscriber Decline by 167,000 in the Second Quarter

The number of U.S. households buying multichannel video entertainment services fell in the second quarter for the first time (down 167,000 subscribers across all platforms). What remains unclear is whether the unusual decline is just an anomoly, or the beginning of a pattern. And even if some sort of pattern develops, does it portend some change in demand for the product, or simply financial stress which is causing consumers to temporarily suspend their purchases?

Though nobody can be sure, analysts at In-Stat argue that the decline is caused by the poor economy.

"There are several reasons behind the quarterly subscriber loss," says Mike Paxton, Principal Analyst. "While growing availability of over-the-top Internet video is spurring talk of mass 'cord-cutting,' this decline is not about cancelling pay TV in favor of Internet video."

"The main driver of these subscriber declines is the struggling U.S. economy and high unemployment," Paxton argues. If that is the case, some forecasters might ultimately project a return to growth. If high unemployment is causing the defections, a return to normal levels of employment should bring customers back.

There are a couple of issues, though. If forecasts of a return to "normal" employment (defined as pre-2008 levels) are correct, we might not see a full restoration of underlying job conditions until 2012 or later. That will mean a period of some years until anybody can really assess what is happening.

The other issue is that the attractiveness of alternatives will increase over time, though most observers probably do not believe alternate channels will make sense for another three to five years.

The point is that we might be in for a few, or several years where subscriber growth in the multichannel video business will be quite constrained, then face a period where demand might well be shaped by adoption of alternatives.

Either way, it now appears that multichannel video entertainment is at the point fixed-voice services reached in 2000 or 2001, depending on which data source one wishes to use: namely a historic high-water mark. After 2001, all data suggests, the number of fixed-line voice subscribers has steadily fallen.

Whether we have reached such a clear turning point for video is not yet clear, and will be difficult to assess because overall economic conditions will keep pressure on the business for a few to several years. The other unknown is the suitability of alternate consumption modes.

Weak Economy, Not Cord-Cutting, Drives US Pay-TV Subscriber Decline by 167,000 in the Second Quarter of 2010, Says In-Stat:

Apple, as Usual, Provides the Exception to the "Openness" Rule

There is little question but that the "Internet" is not as "open" as it used to be, with countries putting up the equivalent of firewalls, with the growth of opt-in communities and use of mobile and other apps that are not actually "open" in the old sense of the term.

Whether the end user value obtained from the variety of different Web experiences is better or worse is a matter of interpretation. Apple has been a salient exception to the "open" trend. But Apple's achievements also illustrate the fact that "closed" approaches to user experience sometimes are embraced by end users.

Power Users Prefer "Customization," Others Prefer "Personalization" of News

There is a difference between "power users" and "typical" users when it comes to the ability to tailor news to their own interests. Power users want the ability to active shape and control delivered news items, while typical users want the software to do that for them, without requiring effort on the user's part.


There is a major push toward customization in the marketplace because designers assume that more customization is better, but our research shows that only some users prefer customization," said S. Shyam Sundar, distinguished professor of communications, whose research with Sampada S. Marathe of the Media Effects Laboratory in the University's College of Communications appears in the July issue of "Human Communication Research."

For purposes of the study, researchers defined "customization" as a more proactive, highly user-driven practice, and "personalization" as having the system tailor content for users without active user input.

In the first study, the researchers discovered that power users -- those having higher levels of comfort with technology and interest in controlling their experiences -- found their visits to an online news site more enjoyable when they could customize the search process by defining search parameters or making changes to a website's settings themselves.

Conversely, "non-power users" -- those less comfortable with technology -- enjoyed personalized experiences the most. Under those parameters, the site shaped the news it provided without any overt control by the users themselves. It offered news based on user behaviors while browsing and searching during a previous visit.

"Power users like to control their information universe," Sundar said. "So they like news when they customize it themselves. But regular or ordinary users of the Internet like it better when the system configures the news for them.

The follow-up study indicated that power users might prefer customization out of a concern for their privacy. As part of that second study, users were notified that the news site they visited either "may use" or "will not use" their browsing information to provide services they requested. This subtle difference in notification resulted in dramatic changes in user behaviors.

Specifically, in the high privacy environment, power users were more willing to cede control and have information tailored for them because they trusted the site and appreciated the convenience. In a lower privacy setting, those same users wanted more control.

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Most Users Don't Like Ads, but iPad Owners are More Receptive

A new study by Nielsen suggests iPad users, who tend to skew younger and male, are the most receptive to advertising, compared to other smartphone users. Keep in mind the findings are relative. By inference, 65 percent of iPad owners do not enjoy ads on their iPads. Some 82 percent of iPhone users do not enjoy ads, while 83 percent of all connected device owners do not like ads.

10 'Innovation Principles' for success in a disrupted telco marketplace

Taking care of a firm's biggest-spending, most-profitable customers is a rational strategy for virtually any company in any industry, and the telecom business is no exception.

But there's a downside to success. When a business model works well, there is resistance to change, and sometimes change is needed.

Analysts at Telco 2.0 point out that one way to jumpstart innovation is to focus on "unattractive" customers. By that they mean a focus on why some customers or segments have proven difficult to serve at reasonable margins, or which have not so far generated enough gross revenue.

That will not be an instinctive reaction, as competitors typically will have incentives to launch attacks at a firm's best customers, leading an incumbent to focus even more attention on the "best" customers.

On the other hand, attackers also have incentives to attack those customer segments that are not well served by incumbents. Short-haul or discount airlines have proven troublesome for incumbent airlines, for example.

The point, say analysts at Telco 2.0, is to seriously examine why a particular customer segment cannot be served at a reasonable profit, and retool the delivery system so a reasonable profit can be made.

10 'Innovation Principles' for success in a disrupted (Telco) marketplace