Meta thing: how the slight is not the kind of thing most managers or executives, or even knowledge workers generally, would care about. (As evidenced by the software people here questioning if a birthday wish is a big deal.)
Lesson: your employees think differently than you. Get curious.
I think this is actually where the study is interesting. Because the “no duh!” Comments actually have merit on their face. But the argument is that these are tiny slights—not harassment, not pervasive toxicity. By definition it’s the kind of thing management doesn’t notice. So I think the argument is that employers consider those employees to be some default percentage of the workforce, and the argument is that you can move the entire performance bar up by hiring/training managers to be thoughtful and consistent.
Ok actually you sound kind of awesome. The article is about how thoughtless, petty slights demotivate employees. You are talking about the opposite of thoughtlessness: doing something that takes effort for you, going out of your way to stretch out of your default for their benefit. They see you making the effort. And on a team that size, you’re not fooling anybody—they know it’s effort. I imagine they appreciate that quite a lot.
People like dazzling conversation from their manager for like two weeks. Manager who will flex against their own instincts out of respect for my needs? I’ll line up behind that person every time, even if they’re a little awkward here and there.
I want to complain a little about the journalism (not) being done here. Because I read this article, and I read the (better, but still lacking) Bloomberg Law article it links/rewrites, and I still have no idea what's happening.
The law firm says the surgeon made false claims. (Which claims? Were they false?)
The surgeon reacted with some twitter grandstanding saying she was on the side of the women she cares for who are battling cancer. (Noble, but irrelevant. She can tell the truth for a good cause or lie for a good cause. Which did she do?)
UHC's spokesperson makes a big show of saying there are "no insurance-related circumstances that would ever require a physician to step out of surgery" and they would "never ask or expect that." Happens all the time actually, in part because if you don't work on the insurance company's schedule and answer their calls, you may not be able to talk to them for weeks, and your patient is denied in the meantime. But is that what was happening here? Apparently nobody thought to ask or include that information.
The implication of this news item is that UHC has hired a shakedown operation to chill criticism on social media. Big if true. But it seems to really matter whether the people on either side are telling the truth. Somebody should report that out. Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
> The law firm says the surgeon made false claims. (Which claims? Were they false?)
The letter seems clear to me, and unfortunately for the doctor they have receipts (phone call recordings and the paperwork)
The biggest problem for the doctor is that they have a record of the doctor conceding that the wrong paperwork was submitted by her office (hence the call) and that the UHC rep asked for her to call back when convenient (not in the middle of surgery).
I think the UHC doctor got carried away, assumed all mistakes were on UHC’s end rather than her own admin staff, and then went to TikTok to tell a viral story with an exaggerated (at best) version of events.
> Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
This mentality that we must pick a side, where one side is good and the other side is bad, is a huge problem with social media ragebait.
We can admit that the surgeon was wrong to make a viral TikTok with information that was somewhere between very misleading and an outright lie. Admitting this doesn’t make UHC the good guy or the hero.
You don’t have to pick a side. You shouldn’t automatically assume viral TikToks are true because they are targeted at companies you dislike.
> the UHC rep asked for her to call back when convenient (not in the middle of surgery)
I'll echo the above poster - when an insurance rep calls us we drop everything on the floor and rush to answer it because otherwise they will continue to deny our claim and not get back for weeks. Then they reject our claim because it's now outside their 3 month window.
> the claim should have been denied because it was filed incorrectly
Spoken like someone who has never spent hours online with an insurance company. They have told me that they can't see uploaded forms due to a 'glitch'. They have told me fields were missing when I am looking at the same forms and telling them where the field is and what it contains. They have been carefully instructed to tell lie after lie after lie hoping that the consumer finally gives up.
That seems a bit incredible because it suggests that they would be denying 100% of their claims. If they're going to start lying about a form being filled out correctly in one instance, why ever stop? They can just keep lying forever on all claims.
I've had weird experiences online arguing (about shoplifting, as it happened) with people (I assume teenagers) on Discord who seemed to have a genuine belief that buying insurance was a magic positive-sum process for dealing with damages. They hadn't/didn't make the link that the insurer pays out approximately what they take in from premiums. That experience applied to medical insurance leaves me with a strong suspicion that UHC gets a lot of hate because they are the cheap option and people haven't cottoned on to the sad reality that if they want their claims paid out they can't go with the provider that is cheap because it denies a lot of claims. UHC's margins are there but don't seem to be that impressive. It wouldn't be surprising if they have to push back fairly hard or become insufficiently profitable.
These companies - every company - know how to maximize profit. They know how many claims they can deny, they know what kind of claims they can deny, they know who is or isn't likely to fight back.
Hint - the people with the fewest resource are the least able to fight back.
UHC shouldn't have margins. Healthcare and profit are a deadly combination.
Knowing the general madness of US healthcare, I want to stress this isn't rhetorical.
So why are people going with UHC?
EDIT I want to reply to 2 replies with the same comment, so I'll put it here - if the companies are paying & buying known-dodgy insurance, then why aren't they going with a cheap option?
You have very little choice in healthcare in the US. While you have the “option” of trying to get healthcare on your own, if you have an income it’s usually prohibitively expensive as most companies are able to both a: negotiate a better rate as a bulk deal for bringing all of their employees to the plan at once, and b: subsidize the plan for employees.
What this means is that the most choice Americans face is whether to take the high or low deductible option their plan offers and whether they take the single or family plan.
If your company picks UHC and you don’t have a spouse whose job has something better, then you’re getting UHC or nothing
Most get it through work, and most areas have only a handful that count local docs as in-network. If you're lucky, work might offer a choice between two insurers.
Because in the madness of our economy we've decided that people need to pay for their healthcare either out of pocket or through their employer. They have limited choices and often need to take the cheapest because its all they can afford.
Fortunately for health insurance companies, people who need to take the cheapest healthcare could rarely fight back.
No, but my newborn had to go to the ER once and it kicked off 18 months of billing disputes with the hospital. And the thing I learned was the depths of incompetence, malice, and laziness that a hospital billing department was capable of.
One of the key lessons - if a doctor submits an incorrect billing code, insurance can't do anything to change it. If a doctor doesn't want to work with insurance to fix the codes, you as a patient have so few options to do anything.
I'm very sorry to hear that, I've been through any number of ER visits with my child. I have not personally had any issues with hospital billing departments, so perhaps I have been lucky. It is only the insurance I've had problems from.
But it's not the only billing problem I have had. A hospital billed us double for an emergency c-section (once for the mother, and again for the child) and hit us with $300k in claims. A dermatologist once faked a surgery and sent it to my insurance. And don't even get me started on the exploitative agreements hospitals sign with ambulance companies.
We're not even people who spend a lot of time in hospitals - but we are pretty close to a 100% hit rate for billing issues with hospitals. Even during times in my life when I didn't have insurance.
I get that people kind of ascribe all sorts of medical billing problems to insurance companies. But I think a lot of it is kind of ignorance comes from inept hospital management shifting blame. And often doctors and practitioners themselves are very removed and unaware of the awful billing at their own practices.
I've seen the same damned thing. Even when the state has previously gotten involved on behalf of a patient, I've seen insurance try to deny a surgery less than an hour before it was scheduled. Patient's husband called up the state and they said to not worry about it, they'd handle it. But even still, insurance companies do not stop trying it. The penalties they get are a joke to them. Executives need to face criminal penalties and be locked up in federal prison. Fuck it put em in Gitmo, those people are terrorizing us all.
The goal is to wear you out and it's the context missing from the discussion. An external observer could look at any of my contested insurance claims and say 'They asked for more information, you gave it to them, the claim was approved, so what is the problem?"
What's missing is all the days I had to get up, check on my claim, and call them because the claim was still denied and they sure weren't going to call me.
What's missing is the hours I spent on the phone with them taking them step-by-step through the same issue each time.
Most independent doctors billing OON may also need to speak with 3rd party claims processor, in all likelyhood. Same is true for some WC/NF/Lien claims
It also matters whether they are actually reachable at your convenience. A lot of business are virtually impossible to actually talk to unless you answer their call. They say to call back at your convenience, but you will only get their voicemail or an infinite waiting queue.
Why? They presumably have recordings so it's unlikely to going to devolve to a "he said she said" situation, and I'm not sure how else you would rephrase "at your convenience" so the doctor wouldn't scrub out. Does every interaction need a 1 paragraph disclaimer to guard against a social media shitstorm?
The fact that a Doctor has to be worried about this shit at all is damning. The fact that a patient doesn't even pick their insurance (mostly tied to employer HR) is damning. The fact that a group can own the whole vertical is damning. The whole mechanism is a knot and anything less than untying it is going to have scary consequences I think.
You have pesky PHI in the middle. Funny how of all things, PHI hasn't done a thing to prevent data leaks in healthcare, but it has done fairly well in hindering all async communications with payors.
That’s not an excuse. There are messaging systems inside electronic medical record software they can use. If my healthcare provider can communicate to me via a website and show me all my labs and results and even synchronize with the Apple health app on my phone, surely, a doctor should be able to message an employee of the managed care organization.
Right. Specifically all modern EHR applications now support DirectTrust Direct Secure Messaging. This is basically just regular email with standardized encryption and other added security features necessary to make it HIPAA compliant.
I think the false claims were on the Tiktok, but the crux that i detect is the issue "UHC called doctor out of OR" is likely true even if UHC didn't intend it that way.
>>The letter seems clear to me
Where is the letter?
>> doctor conceding that the wrong paperwork was submitted by her office (hence the call)
That is a strong assumption to make. The tack you are taking is that one of the 2 parties noticed a wrong PA was requested (and approved) and tried to do something about it, preop. That's the assumption. IF the PA was fine, and that's 100% shenanigans by UHC. Less likely, but still very possible.
Thank you for such a well articulated response, I agree with you.
I am not a surgeon but I have experience standing right next to them during surgeries. In my opinion, they already know that there is never a need to take a phone call from an insurance company during a case. Other reasons for a call may exist, sure, that part is not out of the ordinary... but insurance approval would have already happened before the case had ever started. Plus the overnight stay is not part of the billing for the surgery itself anyways.
If anything, the doctor is admitting to a potential crime! Medical providers aren't supposed to deny procedures based on insurance coverage. Even if UHC called during surgery to say the claim was denied, it's the doctor's choice to do the surgery of not.
> Medical providers aren't supposed to deny procedures based on insurance coverage.
This is false. There's EMTALA, which requires that emergency services will be provided until a patient can be transferred. But doctors absolutely refuse to provide services based on ability to pay all the time.
Good point. But as the original story made the rounds on social media, it got exaggerated to make it sound like this was a life-threatening surgery. Knowing that it was a routine call and it was a plastic surgery procedure definitely deflates the scandal of the whole thing.
Well that would depend on the facts of a particular case. If a patient presents at the ER with a brain tumor which is causing severe symptoms such as unstable vital signs then under EMTALA the hospital might be legally required to remove the tumor regardless of the patient's ability to pay.
No; the tumor itself would be non-emergent. The symptoms it causes - pain, for example - would be treated, then the patient would be discharged with a suggestion of a follow up with oncology.
Are you certain about that? I think it would really depend on the severity of symptoms. Cases like Munoz v. Watsonville Community Hospital et al indicate that courts have interpreted the legal requirement to stabilize the patient rather more broadly. Just discharging the patient with painkillers and a referral isn't necessarily sufficient to avoid liability.
Yes; that case involves a clearly emergent post-surgical complication.
https://casetext.com/case/diaz-v-division-of-soc-servs-1, as an example, involved a case where chemo was warranted for emergency treatment, but not on an ongoing basis. The court found they could treat enough to stabilize, then discharge, even if that guaranteed an emergent return later on.
I always find it kinda funny in a morbid way when somebody finds out for the first time that the US healthcare system lets people die all the time because they have the wrong insurance or not enough money. Hell they let people die all the time who have the correct insurance and enough money, health insurers just deny and delay long enough to save some money.
There's a good reason Luigi killed the CEO of United Healthcare.
As far as I'm concerned, I still appreciate the propaganda value of a story even if it's full of half-truths like this one, because it's time for a reckoning for these companies. There's a tiny, like 1% chance, that someday we'll have the opportunity to institute single payer and kill these businesses full of sickening, greedy ghouls overnight, and anything that helps convince people of their sins so that they won't doubt that it's worth doing, I'm okay with. They've earned it with their many, many, 100% factual bad deeds. And they've never been above lying.
I admit that taking this attitude toward falsehoods isn't 100% ethical, judged by itself, but if it helps to end a system that has killed many thousands and will continue to do until it is abolished, this is a rare case where I'm ok with the ends justifying the means.
>As far as I'm concerned, I still appreciate the propaganda value of a story even if it's full of half-truths like this one, because it's time for a reckoning for these companies.
Just like "2 weeks to flatten the curve" and "masks don't work"? There's no way that "the ends justifies the means, a little lie to advance our cause" would backfire, right?
Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.
Because the fact is true that even though they probably didn't demand to speak to the surgeon immediately, there's a reason the staff deemed it worth pulling her from surgery, and it's because if she didn't get to talk to the caller right now when they were on the phone, it could be any number of days before the matter could be resolved, and the hospital may not be willing to proceed if the insurance company is going to deny the claim, since that could saddle the patient with an unexpected $10,000 bill. In this way, our shitty system, designed on purpose by companies like UHC, forced most of this to happen.
>Indeed, I didn't like the dishonesty there. There's probably many situations where you're absolutely right. It's just that my hatred for this industry is too strong to grant them any quarter even when they're technically in the right.
You know what's arguably worse than insurance companies? Racists. So when there's a mysterious flu coming out of China and racists are latching onto it as a way to hate on Chinese people (eg. "China flu"), we better downplay it[1] so we don't give them any rhetorical ammo.
>there's a reason the staff deemed it worth pulling her from surgery [...]
Sounds like you're giving infinite charity to the doctor/staff and not allowing for any possibility that any sort of mistake on their end. Is this based off of any facts, or your "hatred for this industry is too strong to grant them any quarter even when they're technically in the right"?
You linked an article titled “No Clear Evidence Wuhan Coronavirus Can Spread Before People Show Symptoms” from _January 27 2020_.
The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.
> On the call with reporters, Messonnier also seemed to allay concerns that the virus could be transmitted via packages sent from China. Coronaviruses like SARS and MERS tend to have poor survivability, and there’s “very low, if any risk” that a product shipped at ambient temperatures over a period of days or weeks could spread such a virus.
> “We don’t know for sure if this virus will behave exactly the same way,” Messonnier said, but there’s no evidence to support transmission of the virus via imported goods.
Why are you trying to paint that as doctors lying?
>Why are you trying to paint that as doctors lying?
the exact wording I use was "downplay", not "lying".
>The headline is accurate, at that point in time nothing about the virus was clear. The only portion of this article that even tries to downplay anything about China is this portion which as far as I know is still accurate.
Even though the headline is technically accurate, the "downplay" part comes from the CDC trying to imply that the risk was low.
"Messonnier repeated her message that the immediate risk to the US public is low at this point."
I'm sure there was a technical mistake on the doc's end! But it's because UHC wants absolutely everyone to make 'mistakes' constantly, because every mistake delays or avoids a payment. Even a delayed payment moves an expense forward, maybe even into a new period, while the revenues are always captured promptly when your employer pays your premium. So, UHC's processes are purposely designed to add as much uncertainty and to be as easy as possible to derail.
The system insurance companies designed works something like this:
Provider: Enters patient ID, procedure code, date, etc. into the insurance billing system.
Insurance company: Applies an automated check to find reasons why this claim might be denied. For example: "Our records show that you amputated her right arm yesterday, so we can't pay for wrist surgery with a date of today" or "automatically deny all claims for XXXXXX as 'not medically necessary' and wait for them to appeal by following a separate process". If it finds any reasons, claim is denied. Some limited info is sent to the provider or patient, usually with a lot of latency.
Doctor or Patient: Must play a game with the insurance company to figure out (1) why insurance company thinks [insert wrong belief] (2) how to satisfactorily prove to them otherwise and (3) why despite after solving 1 and 2, the claim is still showing as denied. Providers are overwhelmed with hundreds of instances of this at all times, so they can't always handle doing this for you, and patients often lack the documentation, medical knowledge, and legal definitions in the policy, to be able to advocate for themselves.
If it were designed by anyone other than a bunch of ghouls looking to profit off killing people, there would be good ways to asynchronously but promptly enumerate and solve the problems that prevent claims from being paid. This would be tricky to build, but not impossible if the parties involved wanted to cure disease and save lives more than they wanted to be rich.
>Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work, we don't need to be curious about who the hero(ine) and the villain are.
spoken like someone who doesn't have a chronic illness requiring an expensive medication to be delivered every month for the rest of their life, who every year has to fight with the insurance company about the fact that multiple sclerosis does not go away and that the medication is still needed, and yet STILL has lapses in receiving the pre-approved and approved and re-approved treatment which causes new symptoms to occur and old ones to relapse while the bureaucrat at the insurance company who is incentivized to give you the runaround plays delay deny delay deny delay over the medication that has been effective for YEARS and will be needed indefinitely.
No, we really do not need to be curious about who the villain is. If UHC is worried about their image, maybe they should DO THE THING THEIR CUSTOMERS FUCKING PAY THEM TO DO
> maybe they should DO THE THING THEIR CUSTOMERS FUCKING PAY THEM TO DO
Health insurance in America is broadly profitable. But note that UHC just paying out claims puts them in the same place as California home insurers. Part of the job of a health insurer is to deny unnecessary claims, to be a check on providers, both in procedures and their pricing.
> Health insurance in America is broadly profitable
Health insurance is actually a lot less profitable than most big businesses. Something like half as profitable as the S&P 500 average.
But ignoring that, there are also big non-profit insurers. They aren't appreciably different.
There's a big misconception that if we could just remove profit from our healthcare system every problem would be solved. However, if you look at where healthcare dollars go, profit and administrative overhead (insurance, hospital admin, etc.) are a single digit percentage of overall spending. If you could wave your magic wand and make it go away tomorrow, things would barely change.
Note that even countries with socialized medicine have administrative overhead in the single digit percentage range, so it's not actually possible to drive it to zero.
We severely overestimate how much of our healthcare dollars go to profits and executive compensation. I think because those are the only safe targets to be mad at. Nobody wants to engage in conversations about getting surgeons to take lower compensation or limiting certain types of care (which is very much a thing in any medicine system). American healthcare is expensive, but we Americans also consume (and demand) much more healthcare than elsewhere in the world.
We have a lot of unnecessary gatekeeping. Prescriptions come to mind.
Unless it’s addictive or subject to group effects (e.g. antibiotics), it should be OTC. If someone kills themselves self administering another YouTube cure, that’s on the influencer and the patient.
The nice thing about having grown up in and around the underground cash economy that drives the USA is that I never forget that it’s usually cheaper and easier to just call your guy than to go wait in line like a schnook.
My first box of Paxlovid was bought for cash.
When Germany offered me only NSAIDs the 9th day after using a bone saw on me, the black market was there for me too.
Seems cat food would be an easy one. Want me to ask my guys, or are you sorted now?
The cat is dead now, but not before I was squeezed for a few grand by excessive regulation. At the time, I was wishing there was an underground option for blood testing. You don't need a 300k degree to stick a needle in a cat or read a PDF to me.
Kinda like how a barber in my state need a 20k license and 1000 hours of training, but on steroids. At least at home haircuts aren't illegal (yet).
I'm not really sure I understand the rebuttal. Are you implying that pharmacy companies play no role in healthcare generally? If you make that claim I assume you've never had to fill a prescription, ever. Because pharmacies and drug prices play a GIANT role in the cost of healthcare. I mean, even the US government feels this way
> Faced with competition, some pharmaceutical companies are cutting deals with insurance companies to favor their brand-name products over cheaper generics. Insurers pay less, but sometimes consumers pay more.
All of the job of for-profit health insurance companies is to make money for their investors. Everything else they do works towards that goal.
Now all of the job of any for-profit company is to make money for their investors, that in and of itself is not a problem. The problem is that specifically, for health insurance companies, they make money by denying people health care. They have no incentive to pay claims beyond the minimum necessary.
We have public health care too and it isn't perfect but they don't lie to our faces when telling us why they won't cover something.
> Part of the job of a health insurer is to deny unnecessary claims, to be a check on providers, both in procedures and their pricing.
How can this occur with the given incentives? You have parent corp UHG who owns the whole vertical and you've got dumb fucking congress (deduced from Hanlon's razor) saying only a single part of that vertical is capped.
Even Kaiser is bumping up against resource constraints (at least in Washington). I know quite a few Kaiser employed doctors and insureds, and they all report declining quality.
Edit: I scrolled down and saw someone else say the same:
> glad the company that pays for my treatments can be "a check on providers" for me
Outside large hospitals, there is an alternative: pay yourself. You can usually draw down against an FSA or HSA, or just eat the cost. Only works if you’re wealthy, of course. But most small providers have a cash rate they’ll tell you verbally but never in writing that is below their official negotiated rate.
I don't know much about Fortune magazine, but Wikipedia says: "The magazine competes with Forbes and Bloomberg Businessweek in the national business magazine category and distinguishes itself with long, in-depth feature articles"
Which seems incredibly ironic given that this article is 3 paragraphs.
And when people assume bad faith, they needlessly produce unkind responses, which is what happened here.
EDIT: Nope, I checked his comments, every single one is "you clearly know nothing about <blank>" and the next one is "you clearly know nothing about <something else>". Total Hacker News Redditization happening before our eyes.
> Alas, I guess "big company vs plucky surgeon in social media spat" is a simple script that requires no work
> UHC's spokesperson makes a big show of saying there are "no insurance-related circumstances that would ever require a physician to step out of surgery" and they would "never ask or expect that." Happens all the time actually
You make a good point. UHC has said something that, according to your direct knowledge, is patently untrue, and yet this article contains nothing accusatory against the surgeon that said something contradictory to the statement that you assert is completely wrong.
If one party says something wrong and another party contradicts them, reporting that is a failure of journalism becau
Well as mitchelist points out we don’t even know what claims were made. The third paragraph of this article reads
> On Jan. 7, a plastic surgeon named Elisabeth Potter posted a video of herself on Instagram claiming that UnitedHealthcare called her mid-surgery and asked her to justify an in-patient stay for a woman who has breast cancer and needed a surgical procedure to treat it. Potter then claimed that the insurer denied the patient an overnight stay and threatened her with legal action for her posts.
Are these claims? What does “surgical procedure” mean? In what way is she using the word “denied”? It says UHC threatened her with legal action for her posts but, as mitchelist has surmised, we don’t know what she said or if she said anything at all.
While the article articulates exactly what the surgeon said about UHC and links directly to her video of her saying it [1]… does it? Who knows what’s going on? I’d write more here but I am using speech to text because my dominant hand is stuck inside a jar of honey and my wife’s cries of “stop making a fist” (whatever that means) are getting picked up by my microphone.
I agree, but somehow when a lot of people fall on the “summary execution is warranted and encouraged” side of this debate, the specifics of any single given case end up far below the noise floor.
> The law firm says the surgeon made false claims. (Which claims? Were they false?)
This is in the Fortune story. UHC provided a direct quote, right after some text you quoted, and the post continues on with the claims the lawyers make.
>The implication of this news item is that UHC has hired a shakedown operation to chill criticism on social media. Big if true. But it seems to really matter whether the people on either side are telling the truth.
Implication? UHC uses the services of a high profile law firm that openly advertises itself as specializing in "defamation matters and representing clients facing high-profile reputational attacks" and, sent a surgeon treating a UHC patient, a C&D letter, over a social media post.
The firm worked for Dominion - and if anyone cares to look back, their record, like nearly every other electronic voting company, isn't very good.
There's really nothing in the story that is unbelievable, and by your own admission we can see how they very carefully phrased it as 'never asked or expected'. This means she'd have to prove that missed calls resulted in delayed care for UHC patients - likely possible, but cumbersome...
Frankly it seems like you didn't read the article fully, or you're being disingenuous.
I've been the SD in circumstances like this. And I'll say this is good advice, but there's the potential for a subtle trap in it. Sounds like you're in a fairly political org. Not my favorite environment tbh, but if it's the game you're playing, don't go forth blindly.
(Note: I don't know genders of anybody here. I'm going to call OP "he" and the SD "she," because lots of they's and titles get confusing.)
The SD probably thinks this conversation is over. From her perspective: I told OP what to do (what was in his "best interest") and he did it. End of talk. I'm in an ultra-fast growing pressure cooker with 30 things on my plate to get right, and I work for people who don't hesitate to fire leaders. Now he wants to put time on my calendar to talk about it. This can go one of two ways.
Option A: OP doesn't like the way things went because he wants to spend time in the other domain. (which is what this is about.) On net, to the SD, this is just causing friction. Maybe she helps you out and puts you back in the old domain, at least after a while, and you owe her a favor. Maybe your performance is good, but not irreplaceable-good, and she gracefully handles the conversation, but she is annoyed. When your new director gets on, she tells them to look out for that one, he's high-maintenance. New director, you can decide whether or not he's worth the effort to keep happy, but please don't let him jump onto my calendar again without vetting what he's talking about. K thanks. (And yes, this is a real conversation that happens.)
i.e., it might get you what you want, but it also might backfire.
Option B: As a mid-to-senior manager in an org like that, your SD is always on the lookout for engineers who get "the way the world works."[1] You can go in framing the ask for advice differently: "I was on team A, I had to leave because of what happened on team A, now I'm on team B. Team B is fine but I don't see the headroom given the other players there. I'm happy to keep performing here, but what advice do you have for making a real difference in this circumstance, and are there upcoming challenges I should volunteer for?"
This may seem like a subtle distinction, but the framing is really important. In one of them, you come and say, "what's important to me is working on this domain, and that was taken away from me. Solve my problem for me." (To which the SD says, _damn, this guy can't wait 2 weeks for the new director to start_ ?) In the other, you send a different series of signals:
"I had a sweet gig where I loved the domain and was making progress as an expert/leader..." Ok, he's passionate. He cares.
"Nobody loves team disruption, but what happened happened and made sense. I'm not saying I necessarily want to go back." Grudges are for amateurs, this guy is future-focused. I can work with that.
"I took your advice, and thanks for taking the time to give it." He will engage hierarchy respectfully even if he doesn't love where it has landed him at the moment.
"But in the domain where I'm working now, you already have two leaders well-developed who are definitely the right people to lead it forward." He's a team player, not trying to knife anyone in the back. But he's also hungry and ambitious. Plus he's giving me a private and unsolicited (therefore probably honest) endorsement of other in-place players, which is a gift of high-value information.
"So with a lot of changes going on, new director onboarding, etc., I wanted to set a goal to make the biggest difference I can for our shared success. But you have better visibility than I do about how to actually stack tactics against that goal. What would you advise I volunteer for / do over the next 6 months? What should I tell this new director that I want?" He gets it. His goals are my goals. There's a clear reason he came to me rather than the new director, this is not a waste of my time. He's pragmatic and ambitious and technically excellent. I might not have anything shovel-ready for him this second, but I'll keep him in mind next time I need something knocked out of the park. And I think my 3 pm meeting tomorrow is about something like that.
[1] "The way the world works" in circumstances like this is more precisely, "the way to operate in this particular organization and leadership climate that will ruffle the fewest feathers while pleasing the right people."
I don’t know that there’s a single answer, but the replies here are in the neighborhood. Fees of some kind are the only revenue model, so you pick the ones that work for your use case.
Two other thoughts, one speculative/general and one where I know of what I speak:
If you make most of your income off a small group of your customers, then it’s wise the charge some nominal fee on the other customers to get them to breakeven unit economics. (That holds in most any industry, not just finance. Consider the endless think pieces on the problems caused by a high proportion of free users at zoom and Dropbox.) No, you’re not “making big profits” from them, but the point is to make sure your customers aren’t adversely selected. That can mean, “let’s still make something off the people who pay their credit card bill every month.” It can also mean, “overdrafts create manual work in our back office; let’s make sure they pay for themselves and aren’t correlated to our profit margin on the real business, which is lending.”
Area I know more about: for credit cards in particular, don’t underestimate what the annual fee does for the issuer. The psychology of it for the consumer is huge. People will cancel accounts they’re not using, sure. That helps, because forcing unused accounts closed can draw regulatory headaches. But consumers also consider the card more valuable and may be more loyal to it if it costs as much as their Netflix subscription each year. The issuer is making money on other sources—interest, interchange, travel portals, etc. The fee is, for the right type of customer, a kind of marketing device.
If you know what you are doing, the credits that you get for doing things you already do should offset the annual fee even if you don’t use the card. Wander over to r/creditcards.
We have five Delta cards between my wife and myself that we only make one charge a year on for the hotel credits. Just by having the card, we get a buy one get one free plane ticket good for anywhere in the US, Mexico, Central America or the Caribbean. That more than pays the annual fee.
We have over a dozen trips planned this year and we took over a dozen each year since mid 2021. It’s a hint of ours.
But it illustrates one of my deeply held beliefs pretty well: there are things that are virtuous at small scale that are disastrous at large scale, and vise versa.
In society "othering" out-groups leads to many wrongs. But it's hard to argue there's much evil in cultivating a sense of family pride. The vice turns to virtue at very small scale.
I believe in giving more help to those who need it. But does that mean I should skip Christmas presents for my kids because there are people starving in [insert poor country or war zone]? The virtue becomes vice at small scale.
A unified theory of moral behavior is actually hard to come by.
3 thoughts, ordered from most concrete and practical to most speculative.
Concretely, how do I do this? My kids go to a Waldorf school. (waldorfeducation.org) Is it expensive? Yeah. But, among many other benefits, you're automatically joining a conspiracy of parents dead set against tech-ified childhood. (A HUGE number of whom, you know, _work in technology,_ which tells you something.)
Second, and more reflective: I find that as a general matter, I spend more time thinking about how to call my kids toward things rather than away from things. Yes, social media and TV and video games will fill attention voids. But only if there are voids. The stereotype is that a parent will try to keep kids from doing 12 million things, but really you spend your best parenting effort trying to get them to love or value about 4 things. If you succeed, avoiding destructive habits and behaviors is much easier.
Third, and most speculative but most optimistic: I think we have hit peak social media for teens. It feels a lot like that point with cigarettes where everyone was still addicted to nicotine but nobody was pretending it was cool or sexy anymore. If you don't have kids yet, then society has 10-15 years to get its act together on this stuff before your kid is in the really dangerous age range for bad mental health outcomes from being drowned in tech. Could it remain this bad? Sure. But it's (literally) a generation from now in every respect: culturally, technically, politically, and socially. There is momentum for reform at many levels: legislative, private, school-level, and social. You have time for several of those reforms to fail and iterate. Someone will have figured it out by then. You may have to move—or join a cult—but I promise your kid will be worth enough to you to go find those people and live among them.
I was similar to you out of school—ended up the lone techie in a small oilfield services company.
How do you grow as an engineer? Go get a job at a company that does that. It won't be hard. Based on the problem-solving experience you're getting now, you'll impress hiring managers much more than similar-aged / similar-comped candidates, because all they have done is focused on code, and your mindframe is probably somewhat permanently bent toward larger-picture thinking. This is an asset.
It might be the wrong question, though. The question is: are you sure you want to be an engineer? You have a seat at the table in a small business and a mentor who is a strong and experienced operator in the space. Don't under-value that setup for making a career. If you measure yourself against the yardstick of being a good technologist, then yeah, this is not the best setup to grow. But if tech is a skill, not an identity, then you have other goals: building a strong career, producing value in the market and capturing some for yourself as wealth. Lean into playing that game. Ponder how irrelevant it is that some 26-year-old vegan in Silicon Valley would sneer at your code quality. Make it your goal to have an ownership stake in your company or a similar one in the space—maybe one you start or acquire with leverage from your mentor—by the time you're 35. If you get this right, you will earn dramatically more money in your career than most engineers. You will face much better odds of business success than most startup founders. And frankly, the small business operator space is starved for high-end young talent. (It's not comparatively lucrative for the first 5-10 years, and people find the frequent nepotism annoying.) There are a ton of boomers with profitable businesses and no good succession plans. The infrastructure they built—or at least their customer bases—has to go somewhere.
My story: I left the small business I started in and went to a tech company, but I did it because my first firm was terribly unhealthy. (It folded soon after.) Never lost the vision for building and owning something, though.
The headlines are "court sides with NRA!" which fits the ongoing "illegitimate court" narrative for progressives because the NRA is unpopular. (Partly owing to "ew! guns!" and partly owing to other, unrelated legal trouble growing out of NRA leaders embezzling + offering an illegal insurance product.) But... this was about whether a government official could threaten arbitrary regulatory action against a firm's customers/vendors/partners because of that firm's constitutionally-protected advocacy. (And whether that had in fact happened in this case. 9-0 it did.)
And if you're the kind of person who is set off by that and can't abide NRA having a win, I'd ask if you want your favorite progressive advocacy organization to be able to have a bank account and an insurance policy in Texas and Florida.
This was not a close call or earth-shattering case.
How small the slight is.
How big the effect is.
Meta thing: how the slight is not the kind of thing most managers or executives, or even knowledge workers generally, would care about. (As evidenced by the software people here questioning if a birthday wish is a big deal.)
Lesson: your employees think differently than you. Get curious.