I think James has shown over time that he is appreciative of hard working physicians but is aware that some physicians do not have their priorities straight.
That is how I viewed his original response and all his subsequent ones.
Can he be somewhat abrasive, sure, but aren't we all. Most of the time it is either tongue in cheek or possibly being tired.
Remember, his advice here has been free and would be the equivalent us being actively involved in a consumer medical site but trying to answer questions and be helpful without the risk of being sued.
I'm sure we all know docs who would be just as he painted them, penny pinching for the practice but must have the bling. Nothing wrong with having bling, but I prize quality equipment. Penny wise and pound foolish. Then when there is a problem, it would be his fault for providing the POS machine he was told to buy. Most docs are not this way, just as most patients don't scream and curse at the front desk. But they do exist!
I think this tangent has dragged on.
