Digital Exhaust | November 12, 2022

The biggest company in the world | Thinking about thought leaders

Thank you for following me here. It means alot. I’m sorry I was quiet for so long, but I’ll share what I’ve been up to in the next week or two.

If you’re new here, this weekly letter captures some of the interesting things I found over the week. My intention is for you to skim it over and find a thing or two that gives you some insight. At the end is ‘digital exhaust’, which are short shares, some of them funny or weird. I call this end-of-week email Digital Exhaust because I really like the name. I hope you enjoy.

I’m just learning the Substack formatting, so bear with me as I experiment with fonts and things.

As always, I would love your input. For now, email me at fox42@me.com if you have an idea or just want to say hi.

The biggest company in the world?

Andreeseen is predicting that the biggest company in the world will be a consumer tech company. They see two pathways to this full stack care behemoth: 1) a vertically integrated path of building a “payvidor” (combined payor and provider) that owns most care, and 2) a horizontal path of building a consumer marketplace or infrastructure layer that enables other care delivery companies.

Twitter’s slow slide

This week the blue bird fell into mild chaos with Elon’s ill-fated verification experiment. Lilly erased 15 billion in market cap when a verified fake account declared that ‘insulin is free.’

I say ‘slow slide’ because Twitter’s been on the outs for a few years. In fact, I thought it was circling the drain in 2018. But the new management isn’t helping matters.

I’m concerned that humans can’t behave in large groups. Case in point is the medical profession’s gross display of out-group demonization and tribalistic behavior during COVID. What began as a public commons centered in the common human experience of medicine has evolved as a space for causes and vindication. Information, messaging, and conversation that live outside of these narratives get little interest or carry. So that’s why I don’t spend much time there anymore.

I think there may be a brighter future in smaller, more controlled social networks. Joanne McNeil offered prescient view of Twitter in April. We don’t need corporate social media. What we need are options that empower users: community-scale tools rather than mass $44 billion dollar hellsites. McNeil, is the author of Lurking. One of my fav books of 2020. Highly recommended.

And Mastodon is a sign, not a solution.

If you’re a virtual prepper, here’s how you can download all of your Twitter information.

Long live the thought leader

Steven B. Johnson is one of this generation’s great thinkers. I’ve read all of his books (My fav: Where Good Ideas Come From — the most important book for me over the past decade). This week he wrote an interesting essay on the unsung heroes of medicine — the evangelists who popularize major medical breakthroughs.

The key point here is that when we talk about the history of innovation, we often over-index on the inventors and underplay the critical role of popularizers, the people who are unusually gifted at making the case for adopting a new innovation, or who have a platform that gives them an unusual amount of influence.

While I’ve always found the term cringy, this piece had me thinking that thought leaders in medicine may be undervalued. Unlike media docs who have a chameleon-like ability to read and repeat broad swaths of information, true thought leaders are niche experts who can translate and conceptualize ideas.

What I’m thinking about

Lots of things. But I’ve been writing about the evolution of Epic as a platform. I’ll post to the 33 charts site or share it here. I’m still working out the balance between the site and this letter list.

Digital Exhaust

• Not the Onion: Emergency room gets busy and calls 911 on itself.

• For the woman who has everything this Christmas, an earwax candle kit.

• Attention VCs: High design pooping palace positioned to disrupt the portapotty industry.

• Facebook Meta is shuttering Portal.

• How to disable fertility tracking on iOS.

Thanks again for joining me in the transition. If you could find someone in your network who might like this it would really help. You can just press the share button below.

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