He found a better way to get girls - become the world's richest man exploiting a monopoly. I think I just created an infinite loop of irony.

Certainly some of the claims in the patent are what are known as "context management", and would have significant prior art. The specific linking of them to the exact framework they describe (web-based context switching and data tracking within contexts) may or may not have prior art, it's kind of hard to tell w/o spending more time than I care to reading the material. I certainly think that I used tools that could do much of that prior to 2003 though.

We have a couple of programmers like this, and I can tell you, they pretty much all wind up like Josh if they're bad enough. The problem is that their antisocial behavior results in huge sections of code, even within a "group" project, that only they understand. Over time, that means they become more "valuable" only because they're the only ones who know the code, and as such they tend to develop seniority, which makes them even more dangerous as they implement their craziness elsewhere. They also drive away other more reasonable and often just as competent developers, who themselves can't tolerate how mgmt tolerates the crazy in their midst, and elevates them despite them not doing the right thing. It's a vicious cycle.

In other words, both the developer and their manager are at fault. If that dev, at the age of 22 fresh out of college, had been told within a month of their first job that they could change their behavior or be unemployed, most would have changed. The ones who wouldn't or couldn't would be (and should be) unemployed, and living in their parents' basement working on some open source project. Not doing so is the classic short-term gain at a long-term cost, and managers need to look at it in that sense in order to make the proper business decision. Sometimes that makes sense, but most times it doesn't.

Telemedicine is really only useful for these sorts of interventions. Basically consultations where you can rely on somebody else to gather the necessary info (in this case history and physical by an ER physician), or where you need no physical contact whatsoever (like telepsychiatry). I personally wouldn't want to be treated by an NP or PA in some foreign country, it's bad enough when they can actually examine me. Nor will that happen anytime soon, as insurers would not pay for it, and patients refuse to pay out-of-pocket for their care.