Eh, I think experimental physicists and medical imaging also lean towards newer tech.

Eh.. you'd be surprised. Medical Imaging isn't as radical as you may think it is (I spent 7 years doing projects for the exploitation of medical images).

I’ve had the pleasure of annual echo cardiograms my whole life, and moved around a lot, and at least my experience has been visible hardware/software/imagine improvements almost annually.

In any event I wasn’t saying all medical imaging is state of the art, I was saying it is another field where people prefer newer tech.

Absolutely fair. The vendors have gotten much much better tech "in the room" as it were - CT's are lightning fast anymore, US is clearer and can do more on-the-fly analysis than ever before (e.g. highlighting bloodflow dynamically and capturing tons of data in microseconds), etc. Every modality has grown tremendously so my comment wasn't nearly fair enough in acknowledging that.

Downstream is getting better with items such as AI advancements and more sophisticated mechanisms to transfer data between systems both on-prem and cloud-based, however utilization of all of this tend to be stifled a ton by the standard issue of tech moving faster than policy. My frustration/disgruntlement is due to this issue more than anything.

Thanks for the insight and the reminder that my bubble of experience isn't the world - seriously.

Anecdotal, but a co-worker’s parent works at NHIS and I’ve heard they’ve adopted Kubernetes.

No area of health work tends towards new tech. It's disallowed by regulation.

JS frameworks are also battle tested. "old school" is not necessarily a bonus because the common paradigms have shifted.

Using Django with React is not as easy as a full-stack framework like Next.js. Modern tech stacks are now generally moving towards either full-stack JS frameworks like Next.js, Remix, Astro, etc and/or serverless with things like railway.app, fly.io, Cloudflare Workers, Deno Deploy, Supabase, neon.tech, etc.

Many features of "old school" frameworks are becoming redundant or are being replaced by options with better DX.

I do not want to start a flamewar, but most of the things you mentioned Next.js, Remix, Astro, fly.io etc are not even 6 years old. Django is running production ready code since about 2006 and has more shelf life. I was not downvoting JS but in terms of longevity and robustness, Django has that going for it.