skyhatch1

We took similar actions at my recently failed startup, which headed on a slow, downward path. I identified an apparent pain in our target market based on past conversations with friends working in that space. My team and I felt we validated the pain because we kept hearing about it in our face-to-face interviews with potential users & buyers. One interviewee even went into mild theatrics half way through his interview, "Stop! This keeps us up at night because we ..." That was just the beginning of his 10 minute proclamation that the problem was worth solving, and that they'd pay a decent amount for the solution. Exactly how he said it.

We developed what we thought and what our potential customers claimed was a solution to an unmitigated problem in a very sensitive financial process. We followed startup advice and made it clear that we would charge for the solution. Fast forward a few months: usage dropped from supercharged to minimal then to nothing. Most of the customers we worked so hard to acquire went back to their old ways. When we did followup calls, their newer recruits were none the wiser that we even built something specifically for them. Clearly, the problem wasn't that important in the grand scheme of things.

Semi-related story: Slack lost us a partnership deal

Last year, I met with the EVP of a division at a Fortune 500 company in New York, to discuss a partnership opportunity for our software company.

His direct reports had talked us up to him because we had a highly differentiated offering for a crowded space; one which his company was competing in.

It all went south as soon as the EVP recalled his experience with Slack. "You guys sound like this Slack we tried last month." While our product didn't handle group chat whatsoever, I couldn't convince him otherwise.

According to him, Slack increased the noise in their communications because they "worked on a long-term case/problem basis" and they and "always refer back to conversations", which was difficult to do with constant chatter.

Unfortunately, you cannot cite clinical trials as the sole means to determine individual patient relapse potential.

Many doctors, especially psychiatrists, use clinically-proven if-then-else type criteria tools created by professional psychiatrist bodies.

As your therapy progresses, depending on how you score with the criteria, the doctor will opt to:

- Taper down and cease medication

- Reduce medication dose and supplement with behavioral therapy

- Stay on the current dose

- Increase dose if your symptoms worsen

In the early days, most drug discovery (while amazing for its time) covered comparatively simpler diseases with arguably less complex physiological and pharmacological models i.e. low hanging fruit. Many of these diseases (e.g. Type 2 Diabetes) are still improperly addressed to this day. But they are not as lucrative for today's pharmaceutical company as they used to be in simpler times.

Governments and insurers are too astute to pay excessively for incremental improvements in mass or lifestyle disease categories. It makes more business sense for Big Pharma to target complex, hard-to-cure diseases that affect a small population set. While the success rate for such molecules is much lower, it's also much harder for payers to apply their usual mass-oriented drug economics to them.

One of the better examples of this is the recent introduction of Hep C "curing" drugs. Sponsors are going uncontested in pricing their molecules up to $84,000 per patient year[1,2].

With 3 million patients in the US alone, that's a TAM of $252 billion per year. For one drug category.

References:

[1] http://hepatitiscresearchandnewsupdates.blogspot.com/2014/03...

[2] http://www.grassley.senate.gov/news/news-releases/senators-s...

We were taught both sides of the story in our "drug diversion impact on public health" classes. Decriminalisation opens opportunities up to reduce harm to the public through reduced drug-related crimes, safer injecting (of the hard stuff) and less blood-borne viruses spreading. Australia has its own version of decriminalization known as the "harm minimisation policy". While all drug-related activities are illegal there, the judicial and healthcare systems are not so black and white about enforcing the laws.

Nonetheless, the other hand always wants its share. In the case of Australia, harm minimisation has reduced drug-related crimes, but the prevalence of drug use in the general population continues to rise, especially with regard to pills and amphetamines. Blood borne viruses are also on the rise, despite the ubiquity of safe injecting rooms in every major city and availability of "sharps kits" in every retail pharmacy.

Interestingly, the conservative party temporarily swayed from this stance and implemented a "tough on drugs" policy for part of the 90s[1]. It was dubbed to the wider public as a "harm prevention" measure i.e. protecting those yet to experiment with drugs and the wider community that didn't use illicit drugs regularly. There was a significant reduction in every measure: drug use, drug crime and spread of blood-borne viruses. This policy did not cut safe injecting and drug use services, but increased police activity and ephemeral "say no to drugs" cut-through education programs. The policy was reversed in the early 2000s.

[1] https://www.unodc.org/documents/ungass2016/Contributions/Civ...

"My coworkers, for example, bonded at lunch over their dating lives and the quest to find the perfect yoga pants. They couldn’t really relate to worrying about the cost of daycare. I didn’t think the fact that we had little in common in our lives outside the office was a problem. To me, it had no bearing on our ability to collaborate on projects."

There's a lot of talk about culture - especially in startups. This article challenges the notion of culture, and could force many to think about and clarify their position. I have experienced what the author has - being the odd one out in a homogeneous workgroup, having to force myself to fit in socially just to get some work done!

A fair enough statement: "The broader availability of [over-the-counter] insulin allows patients with diabetes to obtain it "quickly in urgent situations, without delays," the FDA says, and is intended to increase patient safety."

However, it seems like there are no visible protocols in place to control use in non-emergency situations like with the patient mentioned in the NYTimes article. That's certainly risky for poorer diabetics who don't necessarily know better, or are desperate enough financially to risk the long-term consequences.

Type I diabetes is a complex condition where restricting carbohydrates may not necessarily reduce hyperglycemia (high blood glucose) events. There is a dangerous downside counterbalancing the negligible benefits. The dieter significantly increases their risk of hypoglycemia (low blood glucose). Serious symptoms of hypoglycemia include heart palpitations, dizziness and coma.

I'm guessing a no carb diet could also imply high protein, to replace the carbohydrate calories. Too much protein (>20% of calories) is bad for Type I diabetics leading to a state known as microalbuminuria. In layman's terms: increased stress on your kidneys. More on this at: http://journal.diabetes.org/diabetesspectrum/00v13n3/pg132.h...

In summary, almost every (if not every) diabetes publication & specialist advises heavily against low/no carb diets, instead recommending a balanced diet.

I'll concede to the fact that this has stirred a debate the public cares for. Also, I am genuinely sympathetic to the plight of workers being exploited by their employers.

However, the post risks polarizing readers, most of whom could start to see or confirm that managers don't care about the plight of their lowest rung. At my work, our lowest level employees get paid ~$23/hour, but even at that level, a few still complain about their wages being too low to live on. Managers are perhaps myopic in thinking about living wages, but they don't have much choice.

Companies like Yelp are coming of age, and that means they need to turn profits, not just grow. Most such businesses have strict wage budgets, usually a % of revenue, to control operating costs. In this case, if Yelp's CEO capitulates and increases wages, his team will have to hire less people than before.

Perhaps once again, a lose-lose situation. The business loses servicing power and less people get the opportunity to work towards their dream of working in media.

The author has failed the open letter litmus test, where the positive result is reserved for thoughtful discourses of potential public interest or concern. This Medium post read more like something you tell your friends after a few drinks - and even then, they would be silently thinking, "We're all in the same boat but I haven't sunk yet so quit complaining!"

At the end of the day, the author - like anybody living in the free world - has the choice to pack and move to a more accommodating work/home situation.

Imagine someone comes along and convinces you that you need insurance. Years later, you finally need to make a claim. You call the insurance company only to learn your situation was underinsured or not insured correctly at all. In that situation, they have no legal obligation to pay you.

This would not have happened if the person selling you the insurance was under a legal (read: license) obligation to provide you the most appropriate insurance.

Cannot say that I've seen family act in ways I didn't expect on Facebook, but certainly have seen it with looser social relationships. I've unfollowed a lot of people because they shared their very strong, retrogressive views on everything from homosexual rights to certain religions. When you see these same people in real life, none of that really reflects in the conversations you have with them. As the other guys said, it's often best to be selectively ignorant.

I couldn't easily jump off Facebook, mainly because of a large contingent of overseas family. Also, a lot of private social events are purely shared on Facebook. Easiest thing to do was unsubscribe to literally everybody except said overseas family and 'Like+Follow' work-related fan pages (or whatever they're called these days.

My first memory of real cinema. We learnt at school about how 18th century aristocrats lived, but to see it in vision via Barry Lyndon made the whole franchise seem as exuberant as our history teacher had said. Strangely, one of the slowest moving films I've seen, but it grips your attention with a vice. Worth watching.

Hopefully they don't draw polarize the two personas by bringing up paid DOTA2 gamers playing 15 hours/day vs the soccer mom who loves her 15 minute daily dose of Angry Birds

Totally clicked thinking this was going to be some of weird but interesting Taylor Swift shrine, but yeah, this is cool too. Useful for my buddies who work with iOS devices.

Certainly great customer service, but also a very good business decision by the airline. With an average cost of $100k per diversion, 54 diversions cost Lufthansa ~$5.4m annually.

With a conservative 40% of urgent cases being treatable under the Doctors on Board program, that's a $2.16m saving.

Cost of such a program is next to negligible - airlines spend hundreds of $ per flyer per year marketing in various ways to frequent flyers. A €50 discount voucher per flyer certainly won't break the bank.

Sidenote: Eichler homes look very modern. Definitely better looking than your standard SV brick-and-wood-paneling matchboxes.

I remember a popular unicorn founder (can we just call it that) once referred to himself as "opportunistically lazy". That certainly fits with the technical persona since something within makes us averse to repetitive work.

But now it seems that we've automated pretty much everything we could, so where to now for the technically minded lazy opportunist?

Reminds me of when I used to live in SF. moved into a building that was built in 2005; thought they'd factor in the 120+ dB measured on streets. I was wrong. Didn't really sleep for the first 2 months. Choppers grunting past, hobos fighting with chains. Fun.

Pricing comparison charts for 8 drugs in 14 countries: http://www.bloomberg.com/graphics/2015-drug-prices/

US tops the list every time - even with discounts negotiated by insurers. The flipside to these exorbitant costs is the accessibility they bring.

It's easy to ignore the fact that US pricing arrangements motivate pharmaceutical companies to market more of these drugs. Keyword: market.

As sad as it feels to say this, a more socialist agenda wouldn't nurture as much drug commercialization - development perhaps, but not marketable products.

Australia's social healthcare, Medicare, is driving down the price of common "molecules" to negligible amounts.

These days, you can really sense apathy on the pharmas' part. Stock outages are frequent because there simply isn't a $ factor to make them care.

On top of being a geek, I'm a pharmacist business manager - knowing how drug pricing economics works is part of my job.