XX hybridization - are males doomed?

It seems to me that cloning just reproduces the genome, whereas sexual hybridization with haploid gametes results in diploid cells with a combinant genome...the biological mechanism that ensures diverity, variation and sucess in adapting to environmental changes.

Bacteria (and viruses) swim in an ether of pieces of nucleic acid and fragments of protein, and are able to pick up these fragments and incorporate them into their own genome - these plasmids are like the spread of memes using twitter in the twether.

So outside of the usual haploid fusion through biological whole organism mating, we humans have introduced ICS, in vivo fertilization....and in fact, we can scrub sperm of surface proteins, and even extract its genetic material and introduce that into an egg, to achieve fertilization which can then be completed through surrogate wombs.

What we have not yet done, is to take the genetic material from a diploid ovum, introduce that into another ovum and produce a diploid XX zygote. Of course, if the sperm contains the haploid X chromosome, the resulting gamete will be XX, but why not the genetic material from another ovum?

Curiously, I have not been able to find anything about this ovum-ovum hybridization idea on the Internet....my conspiracy theory friends say that first, if I can think of it, it's being done somewhere (meme theory), and secondly, that it would be done by the backing of billions of dollars guaranteeing total security (like Manhattan Project)...

Others more technical say its something about telomeres....and it will come. If and when it comes, we can see three kinds of zygotes - XY from female and male haploid cells, XX from female and male haploid cells, and XX from female and female haploid cells. Clearly, since an ovum is always X, no YY zyogtes are possible.

Will this then be the demise of the human male? The fundamental tenet of evolutionary adaptability will have been met with hybridization from two genomes - through ovum-ovum fertilization.....and any Ys of interest can be kept in the freezer for use with the same technique.

Merely a biotechnology question on my part, but there may be some social consequences if the technology is feasible.

Patient as expert

The context for "patient" is a person who feels ill, and needs others to arrive at an improvement. The steps in scientific medicine are: urgent care-diagnosis-treatment, over time. The need for others varies with time and with the nature of the tools needed for improvement. If a "cure" has only cognitive elements, then surgeons, interventional radiologists would not be needed, and DIY stents would be available over-the-counter. There may always be a need for others with more knowledge, skills, or experience at various points along the journey.
Providers have studied to acquire this set of knowledge, skills and experience over numerous subjects. Most patients call on a subset of this information space with a need for one or two entities, diagnoses, paradigms, syndromes. The more specific the illness state, the more readily a patient can become an expert on it, to a depth exceeding the harassed GP who needs to have several hundred diagnostic entities and care patterns at hand and in mind.

The partnership between patient and provider is highly contingent on social relationships of respect, trust and acceptance of the other's knowledge. A provider who respects and trusts the patient's knowledge can defer all choices and decisions to the other, often seen when one doctors treats another, with no perceived need for recommendations.

The limiting factor of patient as expert is that true expertise is not just knowledge of a subject, but also knowledge of the subject's connections to all related subjects. What might be called wisdom increases as the boundaries of what one does not know comes more sharply into focus.

For the healing process to work well between the person who is ill, and all his or her assistants (providers), trust, respect, and acceptance of what the others know need to be mutually acknowledged.

Health2.0 could crunch physicians

Well, I am a physician in general practice, and I saw 58 people today in seven hours in the clinic. Now I ask myself, with every one of these visits, whether it was a necessary visit, and from the patient's point of view, I would have to say yes. So I spent seven and a half minutes per patient, which includes listening and talking, examination, writing notes, writing prescriptions, writing lab and imaging orders, writing referrals, calling the emergency, calling the pharmacy. Not all these apply to each patient, but at least three or four of them do.

Some of the patients waited for an hour, some more....that's because it's a first come first serve no appointment clinic. We don't turn people away. So from the patient's point of view, there's a lot of wasted time sitting around. Even if one got into the queue, left and came back an hour or two later, there would still be a sense of makeshift time. And all this for an average of less than six minutes with the physician.

So if a patient could save two hours of travel and wait time, and instead spend fifteen minutes on an eHealth medium with the physician, and get all the things that you want, and HelloHealth promises, that would incur a demand of fifteen minutes of time from the physician. Where would this extra seven and a half minutes come from? Would I have to work fifteen hours a day to see the same 58 people each with fifteen minutes of electronic interaction? Or is there some sense that with eHealth tools, some of the 58 visits would not be needed? It's more likely that with increased communications capability and information, comes more questions and demand for answers. If no visits in a time-slice today are unnecessary, then all 58 visits will continue to be made, either face to face or electronically.

The problem here is that the total time spent waiting among the patient population could be considerably diminished, but if none of the visits were unnecessary, the physician still needs to interact with the same 58 people. While the benefits of eHealth could increase the time per interaction and decrease waiting times for the patient, where would it generate extra time for the physicians in a workday?

With HelloHealth, if each physician were paid for an hour of eVisit with one patient, would first of all this hour mean that six others would not be seen, and secondly, a small but not insignificant point, would the hour's visit cost seven times more than a visit with a physician in a clinic?

These are challenges that need to be faced squarely before we can implement on a population wide basis methods which are asymmetrical - reduce patient waiting time, increase patient interaction times, but without reducing demand on the same pool of physicians who are already struggling to meet the meeds of a population that feel underserviced with insufficient time and care.

Bottom line here - no matter how inefficient the office and wait times seem to be to the patient, the physician works very hard at producing a great clinical encounter in the seven minutes spent with a patient. Sometimes it doesn't work, usually it is satisfactory. It seems unlikely that eHealth, while making things quite a bit better for the patient, could improve the efficiency of the physician to permit more overall service time that would be incurred by the additional demands created by eHealth tools....huis clos