The Takeaways: Week 2 of 2022


John Cutler, The Beautiful Mess. TBM 2/52: Leaps of Product Faith (January 13, 2022)

This is why I tell product leaders that they are in the narrative business AND the make-regular-progress business.

Part of your role is creating a coherent narrative—both qualitatively and by structuring (and periodically updating) a quantitative model—that tells the story of how efforts today will contribute to success in the future. And then selling it. You may be able to get some help from an analyst to “back up” your point, but if you’re going to lay the groundwork for the future, some leap of faith is required.


Danilo Campos, Redeem Tomorrow. Wordle: A factional skirmish for the soul of technology (January 12, 2022)

What this beef can show us is a fault line in the culture of those who participate in technology. Some for fun, others for profit. This is a long-brewing conflict, and you can find the seeds of it going back generations.

Lorin Hochstein, Surfing Complexity. The ambiguity of real work (December 28, 2021)

Over and over, I’ve seen the theme of ambiguity and uncertainty appear in ethnographic research that looks at professional work in action. In Designing Engineers, the aerospace engineering professor Louis Bucciarelli did an ethnographic study of engineers in a design firm, and discovered that the engineers all had partial understanding of the problem and solution space, and that their understandings also overlapped only partially. As a consequence, a lot of the engineering work that was done actually involved engineers resolving their incomplete understanding through various forms of communication, often informal. Remarkably, the engineers were not themselves aware of this process of negotiating understandings of the problems and solutions.

Hrishi Olickel. Losing our product to button syndrome (January 10, 2022)

Intent cannot be well-defined before usage, and usage cannot happen before functionality. You can predict some with theory, but the only way to see if something can hold water is to fill it. This way, we put functionality in front of the user, like we buy things we're not sure we'll use and place them in our homes. We forget to clean them up later.

The second and final part of this problem is the human mind, and the shared-tenancy nature of software. If you live alone, you can recognize every year at spring when you have something you no longer use. You can then get rid of it or move it elsewhere. For a platform like Facebook Ads Manager, you merely share this house with millions. You can be sure that every single piece that impedes you in your life is essential to someone else, given enough users.

The only solution forward, then is to spend more time understanding intent before you change things. There is an innovation quota - even in software - of how much "new" your users are willing to tolerate. You'll know when you've hit it.

Mohana Ravindranath, STAT. Telehealth companies are testing the waters with taking on more risk (January 13, 2022)

These companies are negotiating new contracts that give them a bigger financial stake in patients’ care. They can shoulder that risk in a number of ways, such as by covering the full cost of patients’ care up front and pocketing the savings, or by betting that their offerings can drive down costs and splitting the savings later. These types of contracts are a departure from fee-for-service, a system that reimburses providers a set fee for doctor’s appointments or procedures and has long been a mainstay of both brick-and-mortar medicine and telehealth. The riskier approach also reflects the need to find novel ways to get paid for a bevy of telehealth offerings that don’t fit traditional billing models, like in-app messaging and automated reminders to check vital signs.

Casey Ross, STAT. In a battle over the future of U.S. health care, a question emerges: Is primary care scalable? (January 13, 2022)

The competition is producing a dizzying array of business models and service lines that are searching for the perfect balance between low-overhead virtual care and the stability and certainty of bricks-and-mortar clinics. It is also raising an even more fundamental question for patients, physicians, and investors alike: Is primary care, like fast-food or cellular service, a scalable business with products and services that can be delivered via a repeatable corporate formula?