As an investor in healthcare AI companies, I actually completely agree that there's a lot of bad implementations of AI in healthcare settings, and what practitioners call "alarm fatigue" as well as the feeling of loss of agency is a huge thing. I see a lot of healthcare orgs right now roll out some "AI" "solution" in isolation that raises one metric of interest, but fails to measure a bunch of other systemic measures.
Two thoughts:
1: I think the industry could take cues from aerospace and the human factors research that's drastically improved safety there -- autopilot and autoland systems in commercial airliners are treated as one part of a holistic system with the pilot and first officer and flight attendants in keeping the plane running smoothly. Too few healthcare AI systems are evaluated holistically.
2: Similarly, if you're going to roll out a system, either there's staff buy-in, or the equilibrium level of some kind of quality/outcomes/compliance measure should increase that justifies staff angst and loss of agency. Not all AI systems are bad. One "AI" company we invested in, Navina, is actually loved by physicians using them, but the team also spent a LOT of time doing UX research and feedback with actual users and the support team is always super responsive.
Agreed, what was obviously missing from this person's experience was an opportunity to guide deployment in ways that work well for their understanding of the workflow. I think companies often fail to explore what actually happens on the ground of their organizations and make assumptions that are not accurate. AI could be a huge help to nurses but it takes conversations and direct insight during development to get it right.
Pediatric allergy and atopic diseases in general is a mess an only slowly getting better. There's strong correlation between early eczema and food allergies, and now mild but convincing evidence it could even be causal. That eczema (and atopic disease in general) is strongly linked with microbiome and exposure to beneficial bacteria, especially in the first few days and weeks of life. This is also associated with malnutrition, diabetes, obesity, colic, and other symptoms we generally only treat symptomatically and in a silo. Yet for structural reasons, most pediatricians will at best tell you that early probiotics is a placebo. Top pediatricians in the know though will enthusiastically support targeted probiotics. Hell, the whole country of Bangledesh has a successful probiotic program -- https://www.science.org/doi/10.1126/scitranslmed.abk1107. It's amazing how much of common pediatric wisdom in the 80s/90s (clean newborn after birth, eat mushy prepared foods, enriched formula feeding, clean environments, avoid allergens, etc) are now seen as really harmful.
As a healthcare tech investor, I do see a lot of startups selling potentially dangerous AI systems into the healthcare system. That said, there are also a good number of companies that are implementing systems thoughtfully to address a number of issues that are very real in healthcare like staff burnout, continuing education, adherence to standard of care, managing complex value-based payment contracts and coordination of care, etc. The trouble I see is that clinician/hospital buyers of these systems can't always tell the difference. A basic initial filter that can be used is simply (a) does the team have an experienced medical professional with power on its executive team, and (b) does the team credibly know how to measure clinical quality impact of what they're building and do they have a plan to honestly measure it.
Metagenomic sequencing: The field exploded after technologies and techniques were developed for using next-gen sequencing to characterize entire populations/communities of living things, first with 16S rRNA sequences, then with full genomes. The cost to do this has also gone down many, many, many orders of magnitude in the last decade or two (just search "sequencing cost graph" on google).
The unfortunate thing is that large stretches of California desert (and much of the Central Valley to the north) used to be lake bottoms and have incredibly rich and fertile soils. Between that and a long growing season that's nearly cloudless, you get ideal growing conditions -- rich soil, lots of sun, low moisture (i.e. low disease load), and H2A labor -- provided you can control the irrigation. Ah the problems caused by mispriced externalities...
Most of the water that goes to farms in the Central Valley does not come from the Colorado river. It comes the Sierra and Owens Valley. The farm lands that would be impacted by this are in Imperial County.
Whatever trickle of water left over as it passed through imperial valley ends up in the armpit of Baja California where there is a lot of agriculture (which probably ends up in the US). I wonder how is Baja California going to react to this much needed plan for the Colorado river’s supply
> I wonder how is Baja California going to react to this much needed plan for the Colorado river’s supply
This doesn't affect what the US is obligated to deliver to Mexico, so so (other than perhaps feeling slightly more confident that they will get their water) probably not much at all
Yep, you're right. Only meant to associate them in terms of why they're valued land, but yes, they're in separate riparian zones. Central valley is Sacramento/San Joaquin river delta.
We're talking money in the range of $100 million and upwards that these politicians make within a few years in office. The anti corruption has to be the primary focus because the incentive to make money even with $1M salary is huge.
Had a similar experience with GCP -- wanted to run an experiment in AWS, Azure, and GCP side-by-side. AWS and Azure were set up within a day. GCP required hitting up support to "turn on the feature," then a salesperson called to tried to upsell over a few calls before they'd turn it on. There was then confusing payment UI flow that meant my payment wasn't set up correctly. Overall took 3 weeks of back and forth to even start. This was 4 years ago, so maybe it's changed a bit now, but it's hard imagining depending on them as a business unless you're the scale of Snap and have leverage.
I'm reading this comment and this thread, thinking of the excellent service we get from AWS (which we pay for) and that stuff just works, and wondering why on earth anyone would risk their business on a Google service.
AWS has its own serious liabilities - particularly the issue with a lack of billing caps, and the resulting surprise bills. It's discussed here pretty regularly. That may not be unique to AWS, but my point is it's hard to avoid serious liabilities as a small account on any of these clouds.
I'm finding with the teams I'm working with that the junior employees are the ones most impacted by not working from an office, but they often don't realize what they're missing -- the less formal forms of mentorship, stronger community, interacting with more people that's not on their team and in their role, overhearing context, the ability to have a 3-min quick chat with a senior person without a scheduled meeting, and developing that stronger sense of "what good looks like." I'm really concerned that we're going to have a two-tiered system where a bunch of people early in their careers are going to feel stuck in a few years and not even realize why.
As a junior employee (1 year experience, entirely remote), you've pretty much hit the nail on the head. I've been having a miserable time working remote for all the reasons you've mentioned. It doesn't help that my team seems to really lean into independent work. The biggest thing that I wish I had was more opportunities to learn from senior devs.
Now that I feel like I have enough experience to find a new job, I will be looking for a workplace with a strong emphasis on in-person work & collaboration.
Most programming I have seen is independent work. You go off for a day or two and come back to share your results. For a junior dev, they need to be spending some time screen sharing to a senior and explaining what they have to get some feed back regularly.
Don’t give up because of the comments here or because of your experiences. There are still companies out there that believe in hiring juniors and believe in the merits of face to face work - they are harder to find these days, but I think it’s a competitive advantage. If you’re in Chicago, London, or Brisbane, reach out.
In my hybrid office, the juniors are also mostly the ones going into the office, so maybe they've appreciated your point.
I also observe that they are also the ones hanging out outside the office, so I would guess this is part of it too. Seniors tend to compartmentalize "work friends" vs friend-friends.
This seems like it would be taken care of fine by formalizing some remote training, mentorship, and pair programming activities. Something that better work environments already think about, remote or not. Not sure why this would be some sort of unsolvable problem.
Edit: also a remote culture of hopping onto a one-on-one voice, vid, and/or screenshare helps too.
This is true, so much so we just don’t hire juniors because we haven’t figured out how we’d manage, we’re fully remote. If We did hire juniors I’d probably want them co-located near me somehow.
Ultimately I think people will work more in offices again for this reason and for the reason that even the company I work for, which has always been remote first has a large group of people who live in the same city, they meet in person more often and seem to call much more of the shots and receive promotions more than others.
IMO, This is the biggest problem with WFH. I personally have avoided all internship/development programs since COVID started at my company because I know it will just make my life harder and be frustrating on both sides.
We're already starting to feel the effects of the reduced talent pipeline especially as we get deeper into the Great Resignation.
The career-related reasons why early-career employees want to go in to office are valid. But that is not the whole story.
For many early-career engineers living away from families in cities like SF, Seattle etc have better office spaces than personal living spaces - better buildings, better air conditioning, better TV, better restrooms, better kitchens, better stocked fridges etc. This factor does not apply as much to later-career employees who live in the suburbs.
It's just about applying the existing communication technology and having policies that support mentorship or these other things that are supposedly impossible to do without being in person.
I believe that most of these supposedly intractable problems can be solved with a Discord/Matrix/IRC whatever and just enforcing policies about communication. Have a bi-weekly required five minute voice chat and at least one hour of time per day where people need to have the chat open. If juniors are not asking questions or seniors are not replying within X hours or whatever follow-up sessions from the five minute intro discussions is appropriate, then they get warned, and if the lack of communication effort continues, fired. And you make that policy clear.
You can also look into various types of 'multiplayer' virtual presence. Several different browser based or 2d or 3d (even VR) options for this.
I feel like people just stop trying to communicate more than a weekly meeting or something a lot of times when they are remote. That in no way proves that different types of communication or mentorship or whatever require face-to-face. People just need to show up online to communicate.
It can't be fixed industry wide. I guess it could be partially fixed at individual companies. But those are just band aids. It's just how it is. If you're not face to face, the relationships will be at arms length.
In addition to the mentorship issue, think about promotions. Especially to more senior levels. The people in the office or with pre-existing relationships will be the ones getting promoted and will be the power brokers. If you are someone who doesn't think that will be true, then (IMO) you are confusing how you wish the world to be for how the world is.
Two thoughts: 1: I think the industry could take cues from aerospace and the human factors research that's drastically improved safety there -- autopilot and autoland systems in commercial airliners are treated as one part of a holistic system with the pilot and first officer and flight attendants in keeping the plane running smoothly. Too few healthcare AI systems are evaluated holistically.
2: Similarly, if you're going to roll out a system, either there's staff buy-in, or the equilibrium level of some kind of quality/outcomes/compliance measure should increase that justifies staff angst and loss of agency. Not all AI systems are bad. One "AI" company we invested in, Navina, is actually loved by physicians using them, but the team also spent a LOT of time doing UX research and feedback with actual users and the support team is always super responsive.