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where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.


I recently celebrated my 10-year anniversary at pMD. 10 years at the same company is becoming a rarity in the software industry. Yet my dad, Dan Kenney, worked for 40 years for the same architecture firm. 40 years! It sounds like an old-timey tale, a story about the Company Man. I began to wonder what about his company could have possibly held his attention for so long - it must have been quite an amazing institution.

But many others at his company came and went over the years, so maybe it was him rather than the company itself. Did he lack imagination? He’d been very successful and could have retired earlier, yet he kept chugging away and taking on greater responsibilities. I think he was genuinely happy there, and he didn’t feel a need or desire to move.

I began to wonder if the anomaly is not him or his company, but rather the software industry. It began to seem strange that Amazon has a 1-year median tenure and Google has a 1.1-year median tenure, both in the bottom 5 of the Fortune 500 according to PayScale for this measurement. If these companies are admired and successful, why aren’t their employees sticking around?

There are many good reasons to leave a company. The top reason given is greater opportunity for career advancement elsewhere. In other words, there is a lack of mentorship and growth at the old company. Now, the same companies that failed to offer in-place growth opportunities are adapting to their job-hopping employees:

"Hiring managers worry they’ll become the next victims of these applicants' hit-and-run job holding. For companies, losing an employee after a year means wasting precious time and resources on training & development, only to lose the employee before that investment pays off.” - Jeanne Meister, Forbes

But by reducing training and mentorship, wouldn’t they further decrease the opportunity for in-place career growth? They aren't expecting employees to stay around for a long time, so they’re not investing in their people, instead focusing on making their jobs more specific and interchangeable - like a “code factory” where a new assembly line worker can easily be slotted into a vacant position.

I don’t know whether companies or employees started this vicious cycle, and perhaps it makes sense in an increasingly commoditized industry that is dominated by a few huge near-monopolies. And I’ve met my share of counter-examples even at these companies, “lifers” who have stuck around for a long time and have no intention to leave. So there’s a ray of hope: if the fit is right, and the position has room to grow, then career bliss can still occur - even in today’s bleak landscape. So then, how to find the right long-term fit for you?

While researching this question, I found many different answers. A romantic advice blog said it best:

“When you know what you want, everything else becomes trivial. The better you understand yourself, the more experience you have and the clearer the life you want becomes. When we learn more and more about ourselves throughout our lifetimes, we come to a point of clarity. We come to a point at which we know what we want, and we know what we have to do to get it.”

I think self-knowledge was the key to my dad’s 40-year happy place. He knew what he wanted to achieve in his career and what kind of culture he needed to be successful, and he worked ceaselessly towards both. He didn’t bail when times got tough because he knew what he wanted, and he knew that his company was the right place where he could forge that vision into reality regardless of any setbacks along the way.

Dan Kenney

Self-knowledge sounds great. If only they sold it on Amazon! Some people seem to be “old souls,” born with more of it. Unfortunately for the rest of us, it’s generally hard-won. Most people gain self-knowledge by making mistakes and learning from those mistakes. Indeed, embracing failure is the approach most commonly recommended in tech. This is a very effective way to learn, but not a very efficient way because there are so many possible mistakes. Even if you learn from each mistake that you make, there are countless other varieties just around the next corner lying in wait for you. You’ll never live long enough to make all the mistakes.

Fortunately, you can also gain self-knowledge in other ways. You can ask experienced and successful people for advice, or read books written by wise people, and benefit from their mistakes without having to make the same mistakes yourself. You can pursue meditation or counseling to gain greater awareness of your own biases, blind spots, and true desires.

For example, would you enjoy the rollercoaster ride of a high-risk company such as an early-stage startup, or would you prefer the sanity and routine of a company that’s been around for a while? Would you appreciate the well-defined, relatively narrow expectations of a career at a large company, or would you prefer the freedom, flexibility, and variety of a small company? Is it most important to you to feel protected and cared for by a high-comfort company, or are you happiest when making sacrifices for the good of others at a high-service company such as a nonprofit?

In the end, it’s all about what you want and what makes you happy and satisfied. If you know what your sweet spot would look like and you put all your energy into finding or creating it, then all the other decisions along the way become trivial and you’re on your way to the mythical 40-year, same-company career. I hope to see you there!

Interested in joining the pMD team? Check out pMD's careers page for more information! To find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.
It takes a team of amazing people to develop and support pMD’s charge capture and secure messaging software. Here’s a chance to learn more about one of our team members, Siavosh Bahrami. Siavosh is a Lead Software Design Engineer and the mastermind behind our system that allows pMD employees to efficiently provide unparalleled service to all of our customers.

How long have you worked at pMD?
We were just talking about this. I’m a super senior.

What does that mean?
Over five years. Wow. That’s a long time.

How do you explain your job to someone you meet at a dinner party?
Well, since I live in San Francisco, I don’t usually need to do much explaining. Outside of San Francisco... I’d say that I write software, and I make websites and mobile apps for medical folks.

What sort of languages do you use on a regular basis?
The main language we use for the backend server at pMD is Java. The database is MySQL. On the front end we do a lot of JavaScript, HTML, and CSS. We use different libraries. We have frameworks we use: Backbone, jQuery. And then there’s iOS development and the language is Objective-C.

Do you do any sort of software development outside of work?
I’ve always liked programming, and I think programming outside your regular job is helpful if you have the time. I don’t always have as much time as I like. But yeah, I do programming outside of work. Actually, one of my side projects is something I talked about in my pMD interview at the time.

Side projects always introduce you to new things. And it's actually a really good feedback loop. A lot of times I’ve learned stuff in my side project that I brought back to work, too.

What’s the side project?
My hobby is woodworking. I was frustrated by having to follow a lot of blogs manually. I would have to open up like 50 different tabs just to see if a site had posted anything new. For whatever reason I never got into RSS feeds. I never could find the software, figure it out… I guess it was over my head. And there would be blogs that didn't have RSS feeds and I couldn’t really keep track of them very easily. So essentially I wrote a web crawler that goes out and checks all these blogs for me and posts if they have new blog posts. These are amateur woodworkers who blog about stuff they’re building. It saves me a lot of time. A few other people use it too, so that’s kind of fun. At this point, it probably checks 300 blogs a few times a day. It posts the links and the pictures. You should check it out! It’s called

What health care trends are you following most closely?
As a company, we’re paying very close attention to the community aspects of health care. ACOs are very interesting. I think that would be a dramatic shift in how the country does health care. I think it's very important for software companies like us to try to support that.

It fits in line with our philosophy. Our philosophy is to make the doctors happy. Doctors are obviously happy if they can focus on treating the patient. Regardless of what the reimbursement model is, that’s going to be a constant. If your software company can keep the doctor happy and effective, and the patients as healthy as possible, it will succeed no matter what.

What's been your biggest achievement as a developer at pMD?
One project that was really fun just last year was when we introduced the web chat client. We ran into interesting scaling issues after we had gone live. What I still remember is that we convinced the team, the whole company, to give us 5 days to re-write the message panel after we had learned a whole bunch of stuff.

As a software developer you don't often get the chance to go back and re-do something. This was a very special opportunity. It was a very important opportunity. It was a lot of fun working very closely with the rest of the devs architecting it, implementing it (all within 4 or 5 days), and releasing it successfully. I still remember that week as being super fun - and intense. Looking back, I’m very proud of what we, as a team, accomplished.

What are you most excited to develop in the next year?
I would love it if pMD does a virtual reality app. (laughing) I’ve been reading a lot about VR and think it's so super fascinating. VR and augmented reality have been talked about in the medical world for a long time so it’s not totally far fetched.

But realistically… I think it would be fun to build an app for the Apple Watch for the physicians. That would be fun. Writing a brand new iOS app for the Apple Watch would be a great chance to use Swift, the year-old language that Apple introduced that replaces Objective-C. It would be a lot of fun to build something from the ground up.

What’s your superpower?
It’s definitely not running or anything athletic! Well, I tend to be pretty curious, which has led me to learn a little bit about a lot of different things. I wouldn’t say it's a superpower, but it’s something I’ve learned about myself. I find most things pretty interesting.

Best soundtrack for an afternoon Code Bash?
For a morning code bash I usually listen to electronic music. Trance or something. That usually gets me going with coffee in my hand. In the afternoons I tend to mellow out a little bit, so in the office we sometimes play some Miles Davis. It depends on my mood. I’m a moody guy! I listen to everything in between those two.

ICD-9 or ICD-10?
I’m old school; I like ICD-9. But you know, supposedly, ICD-10 is going to help the world keep track of things.

Giants or 49ers?
You’re asking the wrong guy.

New York or San Francisco?
Tough one! There’s no city like New York. Everyone should try to live in New York for at least a little while. San Francisco is a pretty cool place… aside from the weather.

Favorite pMD customer memory?
We have a customer who I’d spoken to a lot over the years. When I finally traveled there, it was wonderful. We felt like we knew each other. She hugged me on first sight. It’s nice putting a face to somebody you’ve worked with for a long time. Having the face-to-face interaction helps to build the communication and the trust.

Favorite pMD team memory?
When we first came out to San Francisco, a lot of us didn’t know anyone here so we used to hang out a lot. When one of our colleagues Ryan first came out (it may have been for his interview or during his training) we went out to the Mission and had a great night. We had dinner and it was an all-night sort of thing. It was a good time.

Tell me a joke.
Um…. I have no jokes. I’ll have to get back to you on that one.

We’ve been anxiously awaiting the inclement weather in the Bay Area this week like children waiting for Christmas. In Northern California, rain can mean drought relief, snow in Lake Tahoe, and the chance to test how prepared you are for a natural disaster.

I got a call early this morning from my colleague Lindsay Cornwell who lives nearby. The storm had fulfilled its promise of disaster. Her power was out, she didn’t see any buses, and Uber was at 4x. That’s when I realized that my power and phone data were out too and that power was likely out in our San Francisco office.

One of our favorite quotes at pMD is from Louis Pasteur, the founder of pasteurization and hero to cautious milk drinkers. He said that “Chance favors only the prepared mind.” The best way to weather any storm is with a good plan. Here are some of the best things that we’ve done:

1. Have a phone tree and emergency response plan

We keep each other’s contact information in our phones, and I also keep a paper list in my work bag. Many of us carpool to work or live in the same neighborhoods, so we check in with our nearest colleagues first. Lindsay called me, and we then called our other colleagues in town. We keep a team calendar with our travel schedules so that we know where everyone is at any given time, and most smartphone calendar apps have some offline functionality so that our schedules are visible.

2. Maintain multiple and redundant servers

Our customers are doctors, hospitals, and medical practices who rely on our mobile charge capture and secure text messaging software to manage their patients, communication, and billing workflow. We co-locate our servers and back-up data regularly to minimize the chances that our customers are ever impacted by a natural disaster or power outage. Our servers are located in different parts of the country to protect us against different natural disasters, and our developers can quickly reconfigure our system to always give the best performance. Our app also works offline so that doctors can continue using it even if they are impacted in their immediate areas.

3. Disperse your team

Our team thrives on collaboration and good humor, but as much as we like being together, it also helps us to be apart. Because some of our team is across the country visiting customers at any given time, they were already managing our 24/7 customer support. Those of us in the Bay Area were able to focus on problems with flooding, traffic, and power outages this morning.

4. Keep a charge on all of your electronics

You never know when you may lose power, so keep a full charge on your phone and your computer whenever possible. We were able to contact each other, and even people without power have been able to get some offline work done on projects today. I use an iPhone 6, which can give up to 14 hours of talk time, and a MacBook Air, which has 12 hours of battery life. There are other great device options, and wireless chargers and external batteries can also extend your productivity.

5. Safety First

Although a lot of us planned to be in the pMD San Francisco office today, it’s always best to do what is safe. Some of our colleagues who live outside of the city and would have had to cross bridges or flood zones to get here made the decision yesterday and early this morning that they should just stay home. I’m working from another area of town today, but I will also head home early ahead of the traffic. People are our biggest asset, and they should always feel empowered to put safety first.