The Takeaways: Week 28 of 2022

A periodic review of articles, newsletters, and podcasts that I found interesting, inspiring, or otherwise worth remembering.

Closed Tab of the Week

Holly Barker, Discover Magazine. How Do Dolphins Choose Their Name? (July 5, 2022)

Unlike most animals, dolphins cannot use voices as their identifying feature because it becomes distorted at different depths. They instead invent a melody – a pattern of sound frequencies held for specific lengths of time – that they use to identify themselves for the rest of their lives. Bottlenose dolphins (Tursiops truncatus) can even imitate the whistles of their friends, calling out their names if they are lost. Additional information, such as reproductive status, can be conveyed by changing the volume of different parts of the whistle, not unlike how people emphasize certain words to add nuance.

But how do they choose? Studies show different possible factors: social (similarity or difference from peers), familial (similarity or difference from mother or siblings), or environmental (sonic modifications based on the main habitat's ability to propagate sound).

Like the human equivalent, signature whistles are more than just a name. They can reveal family ties, alliances and possibly a dolphin's overall environmental landscape. Scientists believe there is still more to unlock, including whether dolphins use their impressionist skills to deceive and whether they talk about their friends behind their back. Uncovering the complexity of how these animals use signature whistles may reveal just how imaginative their inner world really is.


Alexis Haebin Kim and Adrienne Alyzee, Product Managers at Work. How to ramp up on a new industry 10x faster (June 27, 2022)

One of the biggest blockers to having a strong opinion is feeling like there is some singular right answer you are trying to find. This makes it hard to navigate a space because you feel like the answer is out there, and you just have to find it.

Your role is to invent a reality and connect data points.

Ellen Chisa, Ellen's Newsletter. First Few PMs (DevTools) (March 7, 2022)

In addition to building personal knowledge and providing some starting empathy with users, doing this tends to create an immediate team bond. It provides an artifact that the PM and existing team can talk together about, and a tangible set of examples the PM can draw from. It opens up conversations about intent and usability. To be able to hit the ground running with this work, an early devtools PM should come in with the basics of being able to build software. It's nearly impossible to be learning a new tool while also learning about an editor, what REST is, and how to use Github from the CLI or the app.

In rare cases, teams will think “we don’t need them to use the product, we have plenty of engineers.” This is usually a signal that the team is thinking about hiring a project management, not someone who deeply empathizes with the users. I’d be suspect of a team that doesn’t expect the proof of work.

More common is the opposite, which veers into Shreyas’ ideas around proof of worth. The early devtools PM is not an extra engineer. They do not necessarily need to contribute to the core codebase, or know the deeper nuances of the tools outside of the one the company makes. Beyond the ability to use the tool, asking for continual proof of technical credibility becomes too much.


Ryan Badger, Medium. “Magic links” can end up in Bing search results — rendering them useless. (Jun3 27, 2022)

Bing has been indexing my email verification links. Bingbot was then automatically visiting these links, and automatically logging into the new user accounts.

Fortunately, they didn’t do anything after the login event, except click around a bit, and all of these were brand new accounts, so didn’t actually hold any sensitive data yet.

Stephen Downes, Stephen's Web. Commentary on Chris Aldrich, Call for Model Examples of Zettelkasten Output Processes (July 13, 2022)

I have compiled, at latest reckoning, 35,669 posts - my version of a Zettelkasten. But how to use them when writing a paper? It's not straightforward - and I find myself typically looking outside my own notes to do searches on Google and elsewhere. So how is my own Zettel useful? For me, the magic happens in the creation, not in the subsequent use. They become grist for pattern recognition. I don't find value in classifying them or categorizing them (except for historical purposes, to create a chronology of some concept over time), but by linking them intuitively to form overarching themes or concepts not actually contained in the resources themselves. But this my brain does, not my software. Then I write a paper (or an outline) based on those themes (usually at the prompt of an interview, speaking or paper invitation) and then I flesh out the paper by doing a much wider search, and not just my limited collection of resources.

Jim Groom, Bavatuesdays. The Blogsphere is Hot….with Edtech Angst (July 9, 2022)

The bit that stuck in my craw a bit from Martin’s post was the idea that “a lot of new ed tech people are driven by values, such as social justice, rather than an interest in the tech itself.” I don’t discount this, and speaking just as anecdotally I can see it in the next generation of folks working at Reclaim Hosting. That said, this idea that understanding the tech and remaining interested it what it affords is somehow different than being a critical participant paints a myopic picture that the previous generation of edtechs were simply navel gazing around the latest tools... Now I may be reading too deeply into this, or even carting my own baggage here, but I feel like my job as an edtech is to understand the larger shifts technically and culturally so that we can work with faculty and students to provide options that enable empowerment... Good ed tech is like good reading, you have to engage the technical and pedagogical work, try and understand it deeply, and then critique as part of the larger landscape while being honest about its affordances at the same time.

Sheon Han, The Verge. The Hidden History of Screenreaders (July 14, 2022)

I am sighted and a product manager. Although my device of choice is a MacBook Pro, I keep a PC emulator provisioned on my work laptop with NVDA installed in the environment.

In its early years, users considered NVDA good enough for home use but unsuited for professional tasks. The fact that it was free gave people the impression that its quality wasn’t on par with commercial screen readers. But that began to change as the project grew. The number of contributors ballooned, and NVDA expanded to more than 60 languages. Accessibility teams at Google, Microsoft, and Mozilla wanted to work together to make NVDA integrate well with their platforms and browsers.

Accessibility screw-ups, technological or not, are massively scalable. Take for example, how US dollar bills are identically sized for every denomination. Before smartphones, blind Americans would have had to carry around a separate — and costly — device just for identifying the bills, or otherwise place trust in every cashier they met. (Many other currencies use differently sized bills for exactly this reason). When systems don’t build in accessibility, the burden passes to individuals with disabilities to make up for it on their own, often by buying expensive technologies. Makeshift solutions are only necessary because of the thoughtlessness of the people who designed the system.

M.K., Simply MK. The sadness of finishing anime (April 7, 2019)

This has happened so many times, again and again. And yet there is something about it that makes you want to do it again.

If you get these feelings for anime, it means it has done its purpose really well. You got attached to the characters.

You’ve spent a certain amount of time with them, be it on a sad day or a happy day, you were with them in their own world.

But then reality said hi and separated you.

But it doesn’t have to end that way.

Allison McMillan, DayDreams in Ruby. Staring at a blank page (June 4, 2022)

No matter how frequently I tried, I was just stuck... But here’s the truth of it. I was getting things done, but what I needed to get done was different. What I did (and still) get done revolves around numbers, exposure, vaccination rates, and risk/benefit calculations. Making sure that I and my family need to be happy and healthy.

And also, I miss it. I miss putting out posts that are hopefully helpful to others. I miss speaking at conferences (or even just attending conferences and catching up with people I used to see regularly!!!). So I’m trying again. I might not succeed. I might not be able to stick with it. But i’ve reserved 1 hour every saturday morning to sit outside at a coffee truck and write.

Or stare at a blank page for an hour but remind myself that it is ok because i’m building the habit again, and i’m making the time and space for good stuff to happen. Which is the most important part.

Rebecca Pifer, Healthcare Dive. CMS finds ‘troubling’ implicit bias in 3 payment models (July 8, 2022)

The use of certain risk assessment and screening tools, provider processes and payment design algorithms caused some beneficiaries to be unintentionally excluded from the Kidney Care Choices Model, Comprehensive Care for Joint Replacement Model and Million Hearts Cardiovascular Risk Reduction Model, according to a new article published in Health Affairs from Center for Medicare and Medicaid Innovation researchers.

“These findings are troubling” due to limiting access to model participation and stymied efforts to evaluate the models, researchers wrote. CMMI has taken initial steps to address existing bias, and has begun developing a guide to screen and mitigate bias in existing and future models prior to launch, according to the article.

Christopher Rowland, The Washington Post. Beat cancer? Your Medicare Advantage plan might still be billing for it. (June 5, 2022)

The government said its investigation confirmed that Palo Alto Medical and Sutter systematically added false diagnoses to patient records. In a sample of hundreds of cases [whistleblower Kathy] Ormsby audited, the government’s lawsuit said, she discovered 90 percent of diagnoses for cancer were invalid, as were 96 percent for stroke and 66 percent for fractures.

The aggressive billing tactics stem from incentives built into Medicare Advantage. Under the program, companies are paid a flat fee per month to provide whatever care is required for a patient based on age, gender, geography and health risk factors. To compensate plans and providers for potential costs of care for individual patients with conditions such as diabetes, heart disease or cancer, Medicare boosts the monthly payment to Medicare Advantage plans under a “risk adjustment” for each additional condition. The system differs from the traditional “fee for service” payment, in which Medicare pays hospitals and doctors directly each time they provide a service.

Heart attack, stroke, cancer, vascular disease, depression, obesity and malnutrition were among diagnoses most often cited by the government in its false-claims lawsuits. In an example cited in the Sutter case, thyroid cancer was added as a current condition in a patient record even after the thyroid gland had been removed five years earlier and the patient had been free of cancer for years. None of the allegations has been fully tested in court, because they were settled by the companies without an admission of liability or, in the case against Kaiser Permanente, remain pending.

Some critics contend that a byproduct of these practices is that patients’ medical records, padded with false diagnoses, are inaccurate. That could unnecessarily stigmatize patients who were improperly deemed obese, or malnourished, or mentally ill. It introduces potential phantom influences on treatment decisions, critics say.

Natalia Weisz and Roberto Vassolo, Harvard Business Review. What You Lose with Your New Strategy (July 13, 2022)

[F]rom our research and work with companies large and small all over the world, we have come to a straightforward conclusion: unpredictability is overrated. On the contrary, we have found that organizations more typically fail at anticipating and then navigating changes that are fairly predictable, having to do with enduring, repeated challenges. Furthermore, there is one key factor that strategic decision-makers often neglect in formulating and implementing their strategies: the crucial role and impact of loss.

Corporations trying to implement strategic initiatives typically trumpet the benefits and ignore these losses, treating implementation as a straightforward technical challenge. Doing so is a comfortable default. It gives strategic change the illusion of  a win-win: no one gets hurt, and nothing gets left behind.

It’s a risky, even dangerous illusion. At its best, strategic planning involves informed conversations about the organization’s future, resulting in a plan reflecting new priorities or reordering of old ones. For any strategy to be successful, executives need to identify, understand, and allocate time, attention, energy, and money for the losses the organization will face in pursuit of its new priorities.