Sunk Costs and Mid-Career Dips

In September 2019, when Chris and I started talking about the ideas that led to Traversity, we felt like we had identified a problem so obvious that we were frankly a bit surprised it wasn’t getting much attention elsewhere. I mean, if tools that enable online synchronous and asynchronous communication can be useful for people working in corporations who choose to work remotely, why wouldn’t you use them in healthcare where teams are distributed by default?

We felt like were either onto something, or we were completely wrong. Nothing in between. But it sounded like a fun and interesting side project to work on together. And knowing how slowly technology-enabled workflows are adopted in healthcare and understanding the regulatory and legal restrictions in healthcare we thought it suited a long-term bootstrapping approach.

Then of course, came a huge covid-shaped spotlight to illuminate all these types of problems in the healthcare industry. The world shifted almost overnight.

We’ve now got health tech companies beating down the door of any clinician they can get in contact with trying to convince them their telehealth platform is special. My inbox is flooded with offers of webinars and advertisements for virtual conferences regularly contaminate my newsfeeds. Health departments and organisations have suddenly realised they have Teams as part of their Microsoft licence and are (finally) thinking about how to embrace remote working to make better use of their workforce. There have even been shifts in regulations and legislation to enable more uptake of technology-enabled workflows. We’re living amidst a game-changing inflection point that is enabling rapid innovation.

This is great for progress. We need it. It just kind of screwed up our plans, that’s all.

In their recent digital event, Microsoft outlined the plans they have for virtual health and collaboration with Microsoft Teams in healthcare and they pretty much described all of the things we’d been talking about over the past year and working on building. (It’s a bit boring to watch but the innovations it will enable are pretty cool). The good news is we weren’t wrong. Validation is nice, we were onto something. But, I mean, Microsoft. Yeah. Some of our plans are now a bit dead in the water.

Another aspect we were looking at was secure message delivery (SMD), and how to make that more integrated. Call us crazy and idealistic, but we believe ICT infrastructure used to allow healthcare professionals to communicate with one another about patients should not be built on closed networks. Turns out, the technology is there to allow this interoperability to happen, what is blocking it is the service providers. Their business models are built on locking people into their networks and they’re not about to give that up for the greater good. What’s annoying about this is the Government have basically handed the market to them.

So what do we make of our time and efforts spent over this past year? Do we put it all down as a sunk cost and forget about it? Or is this just a dip that we have to push through to forge a way forward? How can you tell the difference?

I listened to a good podcast on this today from Seth Godin, who I’ve talked about many times because he just seems to make sense to me. You can listen to the Akimbo podcast episode here - it’s not very long, around 20 minutes.

One of the examples Godin uses in the podcast is a lawyer who is growing tired of lawyering. But they’ve put so much time, effort, and money into becoming a lawyer that they feel obliged to keep going. What should they do? Should they accept the status quo of an unfulfilling professional life and just keep on keeping on? I’m pretty sure this example will ring true for many healthcare professionals out there. It certainly did for me.

To help think it through, I think it pays to consider the two key concepts - sunk costs and the dip.

Sunk costs is the idea that the money and effort you spent in the past shouldn’t influence decisions you make in the present. It’s something that is simple in theory, but can be hard to apply in practice. In the podcast, Godin provides a great example of being in New York having bought tickets for a movie. When you’re on the way to the movie you run into an old friend and fall into a great conversation. Turns out the old friend is on their way to see Hamilton on Broadway, has spare tickets and offers them to you. If you are unwilling to accept sunk costs, you will refuse the offer. You have already spent money on the movie tickets, they’re non-refundable, you made plans and you always stick to them. If you’re willing to accept sunk costs, you’ll see the opportunity that presents itself for what it is and you’ll go and marvel at the vocal prowess of Leslie Odom Jr as he makes you cry in Dear Theodosia and have an amazing experience that you’ll remember forever.

The Dip is the idea that the path to achieving great things is rarely linear. Usually, there’s a period between starting out singing merrily along the way and achieving the goal where shit gets real and making progress requires more and more effort. What do you do then? Do you get comfortable and accept mediocrity or do you keep working toward your goal? Are they the only options?

Godin would say there’s another option that can also lead to success. Quitting and setting out on a new path. What option is right for you depends on if you’re on the right path or not. If you are confident you’re on the right path then you need to recognise that the dip is a normal part of the journey. If it was easy to achieve success and fulfillment, everyone would. Therefore, if you believe your goal is worth pursuing then you need to build the personal skills and capability to push through mediocre-ville and get to fulfillment land. But if you’re on the wrong path, if you’re not convinced your goal is worth it then it doesn’t pay off to push through the dip relentlessly at all costs. If you’re on the wrong path you’re probably better off trying to recognise it early, accept sunk costs, and shift to a new path doing something else. You’re still going to have to go through The Dip at some stage though, so build those personal skills and get resilient.

Theory is one thing, reality is another. Figuring out when to quit or persist is not easy. Assessing your options and what paths to pursue aren’t easy either. I don’t know what the answer is here, I just think it’s something worth talking about. I’ve seen a lot of my friends and colleagues going through this professional stage, and it’s been my reality for the past six years and counting. Not just the Traversity stuff, whether I want to continue being a Pharmacist or not. Whether it’s worth persisting with a PhD. So I’m by no means talking about this trying to act as an authority on the subject, I’m just thinking out loud trying to figure it out for myself and figure others might like to do the same.

If you’ve been thinking about switching paths professionally, then check out the book Dark Horse, it’s really worthwhile.

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