No. 103: Doctor Deserts

I'm sorry to say, it says deserts, not desserts. You'll have to find another newsletter if you want to know what they keep in the hospital vending machines.

In a past issue, I noted a major medical school donation that would make tuition free for students. This is actually becoming a trend, and that has opened up a discussion about how philanthropy can best support the medical profession. Doctors aren't always easy to find – more on that below.

I've stacked this week's list of job opportunities with small and emerging companies, including one at a women-owned software consultancy in Los Angeles that sounds pretty awesome. If you have your project management druthers about you, be sure to check it out.

~ Greg

What we're reading

A wave of high-profile donations has reduced the cost of a medical education for hundreds of students and inspired a discussion on how philanthropy can best improve American healthcare. (Vox)

• Doctors are paid especially well, but their tuition costs are astronomical: $236,000 on average.
• A number of philanthropists have donated to medical schools with hopes of easing that burden. For many students, their tuition becomes free. One goal is to increase the talent pipeline to fill much-needed roles as baby boomers retire from the profession.
• It turns out that it's not so much the number of doctors but the types of doctors and where they are located that are the bigger issues, and experts say that these donations don't address the root causes.
  • As you'd imagine, rural areas are less likely to have stable healthcare services. The number of doctors per capita is higher in cities. Primary care is a specific concern.
  • I was surprised to find that most physicians practice in areas similar to where they grew up. Effectively, you need to build a pipeline of people in rural areas going to medical school and returning to similar cities.
  • Easier said than done: most residencies occur in major cities, and that's where doctors tend to stay when their residencies are over. So why not set up more residencies in rural areas? Medicare funds most residencies but not the costs of standing up a graduate residency program, meaning larger hospital systems are better equipped to support it.
• All of this creates something of a flywheel where cities benefit most. If you wanted to make a difference in rural areas, you'd need to build similar inertia somehow. I don't have the answer, but I do think it's worth considering in the broader portrait of America – are opportunities becoming concentrated in cities, and how does that contribute to the appearance of decline, if not decline itself, in other areas around the country? Can our unrest be explained in part by loss?

For years, companies have touted sustainability goals like getting to net-zero emissions by the end of this decade. These companies can't meet the goals on their own, however, and utility companies are struggling to meet the market in some cases. (Grist)

• I love this story because it's a good reminder that social impact efforts are a lot more complex than we sometimes give them credit for.
• For example, Hyundai has a new electric vehicle plant in Georgia that they want to power entirely with renewable energy sources when they start production later this year. The associated utility company, Georgia Power, isn't close to that target, so Hyundai is leaning on solar energy from Texas.
  • Would that we all had this opportunity to simply plug into a renewable energy source from whomever can provide it, but I digress.
• In other cases, local governments and major employers are urging the state government – Georgia's Public Service Commission, for example – to set different energy sources. It's probably not as challenging as getting Congress to act, but it's up there.
• In short, we need these sustainability targets to focus our efforts, but we can't go it alone. This particular market is adapting, but not necessarily at a rate where companies will reach those targets independently.

Job of the week

You know I love a good small business job, and this one from Compiler in Los Angeles brought a smile to my eye this week.

Compiler is a woman-owned consultancy that builds software for government agencies so they can provide equitable services to the general population. This is their first ever Project Manager role, and the format is unique: full-time work is 30 hours a week, not 40, and it still pays a six-figure salary. You can work onsite in Los Angeles or remotely. Personally, this sounds like an awesome way to make a difference and find more work-life balance if you have been a Project Manager for a few years.

Community roundup

• Canada is tying zoning law updates to government infrastructure funding. Five billion Canadian dollars were set aside as conditional infrastructure funds, and cities can take advantage of them as long as they rezone single-family housing to support fourplexes. (Grist)
  • This is a relatively new policy with few equivalents in the U.S., so it will be interesting to see if cities adopt it. I've written about a bunch of affordable housing approaches in the past – love to see more experiments in the space to see what sticks.
• Rising sea levels in Florida have caused the Key Largo tree cactus to become extinct, the first species to go extinct under these circumstances in the U.S. Scientists have preserved seeds in hopes of starting a grove in a better location in the future, and the species can also be found on a few Caribbean islands. (ABC News)
• OpenResearch has published three papers on a years-long universal basic income study in Illinois and Texas, the largest study of its kind. One of the takeaways: UBI offers flexibility for targeting a variety of underlying outcomes but is imprecise if you want to target a specific outcome. (Bloomberg)
• Havas, a major creative agency, had its B Corp certification revoked after a lobbying campaign by other B Corps in the space. Havas had been criticized for taking on Shell as a client since environmental impact is one of the cornerstones of B Corp certification. (ADWEEK)
• The Department of Education canceled another $1.2 billion in student debt, this time for public service workers. (Axios)
  • I haven't been keeping a tally, but Axios knew I would be curious: that marks $168.5 billion of student debt relief to date.
• Spain is using software to predict whether women are at risk of gender violence, but it has historically misclassified risk in 22 percent of cases – sometimes with fatal consequences. (NYT)
  • I've actually come across this type of software challenge in the past, particularly in healthcare. Models are tuned for the type of problem they need to solve, and you can purposefully bias the model to hedge against risk.
  • In this case, you would rather have false positives than false negatives: labeling someone at risk who isn't actually at risk in order to ensure that the software never labels someone who is at risk as not being at risk.
  • This isn't just a tuning problem. There's something to be said for people reviewing the data with a human eye as well, and the high percentage of mistakes here are cause for concern.

Hot job opportunities

• Account Executive – Kalderos – Remote
• Director of EHS – ZincFive – Tualatin, OR
• Associate Sales Development Representative – Beanstack – Remote
• Corporate Controller – New England Biolabs – Ipswich, MA
• High Volume Recruiter – Amplify – Remote
• Operations Manager - Rocky Mountain National Park – Xanterra – Estes Park, CO
  • Even if you don't apply to this job, you should look up Estes Park. I've been there once, and it's absolutely beautiful.
• Client Program Manager – WeaveGrid – San Francisco, CA
• Director, U.S. AI Governance – The Future Society – Washington, DC
• Staff Program Manager, Learning and Development – Zoox – Foster City, CA
• Director, Employee Relations – Crusoe – San Francisco, CA
  • They have a bunch of other roles as well I'd recommend checking out. First I've heard of them this week, but they are well-positioned for today's market.

Resource of the week

I was pretty excited when I came across the Stanford Social Innovation Review this week, because it's the kind of writing I love to read and I'm sure it'll be up your alley as well – change agent that you are.

Articles in the review are written by and for social change leaders in a wide variety of areas: education, health, energy, social services, cities, arts & culture, and a lot more. Chances are, people there are writing about your personal mission.

What stands out to me though is the type of writing: people are discussing ideas, more than reporting on the news. It's the kind of work that gives you a broader perspective on social impact and the path we've chosen.

Test your knowledge

Conscious consumer that you are, I'm sure you're trying to purchase products that are built to last. Heck, a few months ago I talked about the idea of recommerce, where major companies are setting up marketplaces for used clothing.

Last week's trivia question looked at the other end of the spectrum: planned obsolescence. Fast fashion is a great example of this – clothing designed to be worn for a season then discarded as the next trend hits. If you have found companies with long-lasting merchandise, I'd love to hear your recommendations (and I'll put a spotlight on them in an upcoming issue).

Social impact has its fair share of well-known figures, but few are recognizable just by their first names. See if you can spot this one:

Who is the youngest Nobel Prize laureate ever, recognized for her work advancing female education?

Email me your guess, and I'll send one lucky winner a couple of One Work stickers!

I have been teasing this for months, but my house officially goes on the market this week. Fingers crossed it'll be a quick sale, and I'll be off to the PNW in short order. You can find me on LinkedIn and Threads.