Are labs getting ensh***fied?

The term "enshittification" is having a moment right now. It was coined in 2022 by the author/essayist Cory Doctorow, and named the 2023 and 2024 word of the year by the American Dialect Society  and the Macquarie Dictionary, but the publication of the eponymous book is bringing it to the fore.

Enshittification is a one word term to answer the question, "Why is everything getting worse right now?" A very trendy sensation. But it's undeniable that user experiences on google, facebook, instagram, and twitter/X have been declining.The focus is on digital platforms, obviously, but as I finished the book this week, some words jumped out at me.

"1. Market participants have imperfect knowledge, which stops them from making the best transactions.

"2. Transactions have high friction, so even if you can get a better deal somewhere else (and therefore increase the success of the companies with the best deals and punish their inferior competitors), you might just sit pat and accept a worse offer from a company you're already doing business with because changing is a giant pain in the ass."

The last part really stuck out at me. I have seen a lot of labs accept bad deals, bad instruments, bad service, simply because they don't like changing from one diagnostic company to another. They accept inferior method performance delivered to the patient because it's more convenient for the laboratory operation and administration.

Another phrase that is used in the book, which probably hasn't been coined by Doctorow, is "when you're too big to fail, you're too big to care." The larger the company you're dealing with becomes, the more you are at their mercy. Epic's sorry Beaker software comes to mind: it's a clearly inferior product, but because Epic is so big, labs have to accept it in order to please their own administration.

As labs deal with larger and larger consolidated companies, remember that placing all your eggs in one basket might be more efficient, might get you a better deal, but it can also make you more vulnerable. Make sure you have promises and penalties in your contract that protect you.