Letters to the Editor

Will MP3.com make you a rock star? Plus: If pilots can boost safety, your doctor ought to be able to; looking for literature's "real men."


Letters to the Editor
December 9, 1999 10:00PM (UTC)


Singing the MP3 blues


BY EMILY VANDER VEER

(12/02/99)

Why any musician would think that simply putting his or her music online would give them "exposure," I cannot imagine. Anyone who has been on the Internet for
more than 10 minutes knows that there are millions upon millions of
things to see or do or listen to for every minute of possible viewing
time. With thousands of musicians with identical-sounding music and
equally ironic/random names, how is anyone supposed to choose?

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-- Mark Solomon

Not all musicians measure success by
CD sales to perfect strangers on a national or international scale
anymore. Not every recording artist is young, single and
struggling to "make it" in music. In fact, with the advent of home digital
recording, many 40-something musicians can now record the album
of their dreams without giving up their computer consulting businesses or
their IRAs or their children's schools (or even their grandchildren's).

Many of these career musicians set up expensive home studios and produce quality music for the ultimate reason: self-satisfaction. Therein lies the true
genius of MP3.com: They'll host your music with bio and links and a credit
card transaction service in a site that's guaranteed both to not cost you
a penny and to get you heard by somebody, even if it's nobody important. You might even sell
a copy, even if it's only to your mother, without costing you zip. And if you happen to have a band that plays gigs, you put your MP3.com site on your publicity and you no longer have
to mail out demo tapes.

I sold about a dozen of my piano albums
with very little effort and no cost in my first few months at MP3.com, and reaped a good number of gigs by having an easy site for my private-party clients to find and listen to my music. And I have a friend who sold an average of 100 CDs a month this past summer by targeting
specific country-music newsgroups with ads for his country-blues MP3.com
site. I don't think we're exceptional. And BMI wasn't searching for a
place to mail either of us our royalty checks before MP3.com either.

-- Jim Eshleman

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When an artist signs up at MP3.com, the contract states that the artist will be paid at the end of each business quarter -- unless the total amount due at the end of a quarter has not
exceeded $50, in which case the payment will be held until the first quarter that the artist's due payment has reached $50. What this means: Since
MP3.com shares revenue 50/50 with the artist, an artist must sell at
least $101 before they "earn" 50 bucks. So, a band could sell 97
songs at a buck each, and never get paid. Who keeps the cash? Mp3.com,
of course!

-- Abbey Smith

One of the principal problems with actually buying CDs from MP3.com is
that they are still too expensive. MP3.com has several artists whose work I would like to collect, but their CDs still cost about $10; call that $15 Canadian. After I get past the initial cost, plus any shipping cost, plus Canadian federal sales tax (7 percent) plus an extortionate $5 (Canadian) "handling fee" from Canada Customs, I am looking at a final bill of well over $20 Canadian -- quite a bit more than the cost of a store-bought CD (usually $16 to $18 Canadian). That's a problem.

The key is to sell the CDs cheap and stay away from middlemen. Get the
price down -- below the cost of at-the-store CDs -- and online artists will
sell plenty more than one CD per month.

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-- David T. Anderson

Emily Vander Veer's article contains a slight inaccuracy about the
music business when she states, "In exchange for the high percentage they
make off CD sales, record companies fork out big bucks. They pay for a CD
to be recorded, mixed, mastered and pressed and they pay to develop the
artwork and promote the finished recording."

Those costs are initially paid by the record labels, but most (especially
recording costs) are considered recoupable, and paid as an advance against
future royalties payable to the artist. If the artist doesn't sell enough
CDs to cover these costs out of their cut, they receive no money from the
label, though they don't owe the difference to the label, either.

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-- Rebecca Luxford


The culture of secrecy

BY DR. JEFF DRAYER

(12/02/99)

and


Who's watching the docs?

BY JAMES B. STEWART

(12/02/99)

Substitute the words "airline pilot" (or "copilot" or "mechanic") every time the word
"doctor," "resident," "intern" or "attending" appears in this story. Would it then be so easy to wonder how health care professionals can overcome the imperatives of a "culture of secrecy" (and worse, shame and anxiety) in order to save the lives of more people? How did the airline industry do it? If all those pilots and engineers and mechanics could manage safety, why can't health
care professionals manage the same kind of thing?

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I have a passionate personal interest in this matter. My husband was killed
by medical negligence at the medical center associated with the university
whose English department he chaired. I wrote a book about his death and
about the lawsuit my children and I brought in order to find out what
caused that death, but to this day no one at his (and my) institution has
violated the "culture of secrecy" to explain to us exactly what happened
to my husband -- their colleague.

-- Sandra M. Gilbert

Author, "Wrongful Death: A Memoir" (W.W. Norton, 1997)

Paris

U.S. hospitals must maintain accreditation
from the federal government. The accreditation requirements include
extensive programs for monitoring and improving quality. Mistakes that are
fatal or contribute to a poor outcome are discussed at morbidity and
mortality conferences, departmental meetings, nursing staff meetings,
pharmacy committees, risk management committees, review boards,
credentialing committees, state medical review boards, etc. This is a code
of silence?

Only a handful of bad medical outcomes result from truly
incompetent health care professionals whose lack of skills were not
reported by colleagues. The majority of mistakes in medicine are made by
good, caring professionals who erred due to a wide variety of factors:
stress, fatigue, distraction, ignorance, confusion, etc. Hang around an
emergency room, intensive care unit or surgical recovery suite and try to
imagine yourself functioning in that environment for eight to 12
hours a day, day after day, week after week. Could you perform at 100 percent efficiency all the time? Could anyone?

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Medical professionals are not surprised that fatal mistakes occur during
hospitalizations. Frail patients may not tolerate even relatively minor,
short-term mistakes (like one incorrect drug dosage). Many of the patients
who died from medical mistakes may not have survived the hospitalization
even with perfect care. The errors and deaths are still tragic, but their
impact may not be as bad as claimed in the media.

Health care professionals welcome changes that would decrease the chances
of making serious mistakes. How much are payors willing to pay for such
changes? Some nurses have been replaced by "patient care technicians."
Some medical technologists have been replaced by laboratory assistants.
Some doctors have been replaced by physician assistants or nurse
practitioners. These changes raised the likelihood of error. They were
implemented to save money. As with all endeavors, there is a tradeoff
between cost and quality. Recently, the pendulum has swung toward saving
money. If we Americans change our priorities, then greater efforts can be
exerted to improve health care and decrease the likelihood of serious
mistakes.

-- Gregory Tetrault, M.D.

As an R.N. with 25 years experience, I wish it were that easy. Medical
errors do occur, both by nurses and physicians, but the medical
community covers for rather than censures those physicians whose mistakes
are egregious, while hospitals continue to allow them to practice in spite
of recurring errors. Nursing has no such luxury -- serious mistakes are
generally quickly and harshly dealt with.

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Until the medical community takes responsibility for itself, deals with
incompetent physicians, provides quality assurance and polices its own
practices, there will continue to be more mistakes than necessary

-- Rex Walters, R.N.

Savannah, Ga.

Jeff Drayer's article carefully dodges another very touchy issue: a
physician's bloated ego. As a professional medical transcriptionist, I have encountered too many mistakes made by careless and/or exhausted physicians which could have easily endangered
patient care. I'll never forget the orthopedic surgeon who dictated:
"What am I trying to say? I don't know what I'm trying to say. You know
what I'm trying to say. Why don't you just put it in, OK?"

One definite improvement would be an impartial board to which medical
transcriptionists could report those doctors whose dictation is
inaccurate, incompetent or downright dangerous to patients.
Peer review by the Medical Records Committee never works because doctors
don't like to rat on each other.

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-- George Heymont

The prime movers behind the legislation giving patients the right to sue
are the trial lawyers. Unfortunately, most of the Congressmen are attorneys
themselves and most have received major campaign contributions from both the legal establishment and those in the medical community who'd love to go back to the good old days of fee-for-service and minimal cost controls.

-- Arnold Koch

Sexual pedagogy
BY DAVID ALFORD

(12/03/99)

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David Alford would have us believe that the only women that exist in his
world are his Lolita-esque students; therefore, what's a man to do?
As a former graduate student I have come to accept that male professors
have always and will forever continue to sleep with
their female students. What David Alford doesn't address is why he doesn't
have an equal interest in non-students? That's the part I always find more
striking than the predatory nature of men's libidinal appetites.

-- Nicole Horvath

Spare us the intellectual bullshit and crying over poetry and just
call this what it is: a man in mid-life crisis taking advantage of
relatively unsophisticated and weaker prey.

-- Mark S. Kowal

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A good man is hard to write
BY JONATHAN MILES


(12/02/99)

Why does Miles choose books that can be deemed "literature" in only the
vaguest sense? People will not look back on "The Beach" or even "High
Fidelity" (enjoyable as it is) as the defining cultural landmarks
of our time. Why not turn one's attention to books such as David Gates'
brilliant novels, "Jernigan" and "Preston Falls"? Such books as these (as well as the writing of Annie Proulx and Rick Bass) engage the questions of masculinity in a far deeper way
than Hemingway ever did. Perhaps after Hemingway's childishness has once
again faded from the "vogue," the true great works of contemporary
literature will be left standing and will leave little room for griping.

-- Nathan Oates

Geoffrey Marcy, master of the universe
BY WILLIAM SPEED WEED
(12/02/99)

I think Weed made a slight mistake: The star and the planet
must orbit around their common center of gravity, meaning that the star
leans away from the planet. It's like two people spinning while holding
hands (although one is much more massive than the other); they must lean
away from each other, or they fall.

-- Tyler Ward


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