How many tech companies have been consistently crushing it in their fields for nearly 50 years? …

>- Instead, product was built the old-fashioned way - by talking to customers; quite often, customers would reach out to us! "Please build time-saving feature x", "support new medical procedure y", "help us publish more research by analyzing z". Think that might be a plus. PM/PO has ruined the industry. This way at least one has a direction to the customers, which is something I can't say about large companies.

My wife is a doctor and has a lot of negative things to say about Epic. I think they have succeeded due to vendor capture and lock-in in spite of their shoddy software that doesn't actually meet the needs of the users. Every doctor I've met through my wife would ditch it in a heartbeat if they could.

There’s also a strong culture of ownership of quality for individual developers. Design documents are expected for even minor changes, and each change goes through at least 2 rounds of well-documented testing by 2 other developers on your team. Compared to other companies where automated testing is the norm, it’s startling how few bugs they manage to ship. Another thing I thought was interesting given modern dev practices is that you don’t even touch production code until after about 6 months of training, including exams and testing on the actual functionality of the product, even bits you’ll never interact with personally. They’re serious about making sure you know what you’re doing before you get within a mile of something that could affect patients. They also have a pretty strong accountability culture. I shipped two fairly embarrassing bugs my first year and had a very serious conver…