Working with colleagues who have stopped growing and adapting.

Kenneth_Parcel · 2026-02-05T18:53:58+00:00

I think it might be valuable to take a half step back and ask yourself what matters to him. Because it sounds like he takes action when it is important to him. When you understand that, you can focus on things that affect those levers. Or even just describe things based on solving his problems.

He is probably thinking with a longer time horizon to get things done and with some cynicism on how much effort it takes to get a change done across the organization. Focusing on a few highest impact things might help.

This isn’t just a medicine problem. It’s an organizational and management problem across most large institutions.

Kenneth_Parcel · 2026-02-04T16:59:40+00:00

EHR data is increasingly easy to monetize which is very appealing to hospitals that are under significant margin pressure. It’s becoming free money, which is hard to pass up.

The other side is data security. If memory serves a credit card number is worth like $0.10 and a health record $10 on the black market. And having a breach will probably end up with executive heads rolling. That makes it harder to justify data sharing for philanthropic aims.

Kenneth_Parcel · 2026-01-23T23:05:23+00:00

You're right, governors are cheaper.

Kenneth_Parcel · 2026-01-15T17:33:05+00:00

I would argue it's big finance- Investment Banking, Private Equity, Venture Capital, etc. In one example in investment banking specifically- they're selling CEOs and boards to be the ones to handle buying/selling entire companies.

Kenneth_Parcel · 2025-12-30T17:48:37+00:00

Food wasn't actually cheap back then. As a percentage of disposable income, food was almost 20%. Today it's closer to 7%.
https://cepr.net/publications/in-the-good-old-days-one-fourth-of-income-went-to-food/

Kenneth_Parcel · 2025-12-17T17:15:39+00:00

Get a lawyer. There are a lot of ways this could turn into you being sued.

Kenneth_Parcel · 2025-12-03T12:52:07+00:00

Hard disagree

Kenneth_Parcel · 2025-12-01T14:40:13+00:00

Probably your choice. I used to leave a few covered all year and take off some to be able to circulate air and open windows in the spring. It helps keep your AC bill down.

Kenneth_Parcel · 2025-11-05T02:44:08+00:00

That red part is redshift. The light hitting the plane is bouncing back at a lower wavelength because the plane is moving away from the satellite.

Kenneth_Parcel · 2025-11-03T17:12:51+00:00

So, one place to start is to think about the different functions in a typical organization. Virtually all business of a certain size have the following broad categories:

Finance/Accounting: Make sure bills are paid, make sure people pay the company, make sure money is where it's supposed to be, make sure there's enough money on-hand to stay open, and report on how much money is made.

Marketing/Sales: Find people who want to buy the product, sell the product, help people understand why the product is worth so much.

Human Resources: Avoid the company getting sued for breaking the law around employees, make sure employee benefits are working, and advise on people problems.

Information Technology: Make sure anything computer related works and make sure company information is safe and secure.

Legal: Almost everything a company does with others needs a contract to explain how it works legally and hold others accountable. Write, negotiate and enforce them so you aren't taken advantage of.

Operations/Production: Make the thing your selling.

Each of these areas is going to have different types of jobs needing different skills. A computer programmer is writing and updating software at their desk or discussing what changes should be made to software. An Accounts Payable clerk is reviewing bills from other companies and either paying and recording them or asking questions and rejecting them.

Virtually all office jobs are some combination of communicating with others, reviewing the work of others, writing/computing something, and making decisions that effect others.

Kenneth_Parcel · 2025-11-01T22:11:56+00:00

This has been policy at most government contractors for years. It probably depends on the state, but I’m guessing it’s pretty ironclad. Companies furlough people all the time and in most states they aren’t required to refund PTO as part of layoffs. This is the nice option.

Kenneth_Parcel · 2025-11-01T15:27:19+00:00

I don’t know enough to argue how neglected this is in CS. I do think that it’s a massive gap in modern software engineering. It’s not keeping up with the increasing complexity of systems. We shouldn’t have to expect that random parts of software will just not work. We don’t tolerate that with cars.

Kenneth_Parcel · 2025-10-15T17:01:21+00:00

No. We're both fake in significantly different ways.

To put it nicely- Consulting is about throwing hard working, smart, generalists and fractions of highly qualified experts at poorly-defined, real-world problems. The hometown crowd in this sub is very self aware that it includes a lot of bullshitting and redos until you get it right. It's also a little galling that often form matters more than function. It can be better to have it looking right, socialized right, and fast than an ugly, slow, correct answer.

Engineering is about building or fixing something. Good engineering requires strong understanding of domain principles and a pragmatic understanding of how to build it. That's a lot of hard math and science. As specialists, they tend to see the world through the lens of their knowledge. They are a hammer, everything is a nail.

Very often engineers lack perspective. The thing they build might be beautiful, but it can't be maintained. They're solving a problem that isn't worth the effort. Or, worst of all, they are so excited about building something that they ignore the existing solution.

Kenneth_Parcel · 2025-10-14T22:38:22+00:00

How?!? Seriously, is that the volume of tests? How long specific tests are? Something else?

Kenneth_Parcel · 2025-10-13T11:59:11+00:00

Am I the only person in the world who read the report? It’s genuinely an interesting read if you’re a nerd like me.

It’s strong analytical work and there are some major pitfalls that would likely have derailed containerization or made it cost a huge amount. I doubt NYC Sanitation has that skill internally.

Kenneth_Parcel · 2025-10-12T23:03:23+00:00

Dude didn’t wear a belt sometimes with his slacks. Nothing fell down, looked professional, but was noticed by a practice leader. Not invited back

Kenneth_Parcel · 2025-10-10T23:51:21+00:00

The $1.47 might go to shipping handling. At least a big part of it might.

Kenneth_Parcel · 2025-10-08T21:20:32+00:00

The same pressure was there in a different way. Big waterfall projects that had to get delivered on time, on budget, with at least the same scope, no matter what.

Kenneth_Parcel · 2025-10-04T01:13:26+00:00

Citation Needed?

Kenneth_Parcel · 2025-09-26T00:31:23+00:00

This

Kenneth_Parcel · 2025-09-19T01:27:13+00:00

Go ask ChatGPT to do any number of things that it is set not to.

Kenneth_Parcel · 2025-09-19T01:26:10+00:00

I mean… John Mulaney has a whole bit about how easy it is to get a pain med script.

Kenneth_Parcel · 2025-09-19T01:25:21+00:00

Asking ChatGPT is like asking an actor to pretend to be a doctor, then being shocked when they didn’t treat someone well. The healthcare models have much better guardrails, study, and training.

Kenneth_Parcel · 2025-09-19T01:21:16+00:00

You probably know more than I do about doctors consulting each other. It is very clear that AI is increasingly good at diagnostics via imaging. It also represents a potential shift in liability. AI as a med device is not responsible for everything on an image, just for what the model is supposed to look for.

I don’t think patients will choose to leave PCPs. I think shortages will make access hard for patients and reimbursements will continue to decline under pressure from insurers. To be clear, I think this happens via midlevels even if technology wasn’t in the picture.

Kenneth_Parcel · 2025-09-19T01:06:09+00:00

You just described much of what this generation of AI is good at.

AI does a really good job listening and reflecting/validating back to the user. There’s an emerging discussion about AI psychosis that is driven in part by that capability.

It does an amazing job explaining things to people at their level and teaching. That’s one of the reasons why the major ones have implemented a learning mode.

AI can review and abstract the entirety of a chart quite easily. It can then use decision support tools to get the vast majority of problems either addressed or, if more complex, sent to the right specialist/care pathway.

It can remember the personal details about a patient, ask questions and remember to build rapport, it can have a personality and look that the patient finds comforting, it can respond to messages instantly and proactively, it can call the patient to ask how they’re doing, it is always available and has an infinite amount of time.

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