First of all, it's not unlikely that the dentist is the owner. And in any case, when you have a small system of less than 150 people, it's easy enough for a handful of people to see what's actually going on.

Once you get to something in the thousands or tens of thousands, you just have spreadsheets; and anything that doesn't show up in that spreadsheet might as well not exist. Furthermore, you have competing business units, each of which want to externalize their costs to other business units.

Very similar to what GP described -- when I was in a small start-up, we had an admin assistant who did most of the receipt entry and what-not for our expense reports; and we were allowed to tell the company travel agent our travel constrants and give us options for flights. When we were acquired by a larger company, we had to do our own expense reports, and do our own flight searches. That was almost certainly a false economy.

And then when we became a major conglomerate, at some point they merged a bunch of IT functions; so the folks in California would make a change and go home, and those of us in Europe or the UK would come in to find all the networks broken, with no way to fix it until the people in California started coming in at 4pm.

In all cases, the dollars saved is clearly visible in the spreadsheet, while the "development velocity" lost is noisy, diffuse, and hard to quantify or pin down to any particular cause.

I suppose one way to quantify that would be to have the Engineering function track time spent doing admin work and charge that to the Finance function; and time spent idle due to IT outages and charge that to the IT department. But that has its own pitfalls, no doubt.

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listenallyall 2 days ago | parent [-]

Problem with this analogy is that software development != revenue. The developers and IT are a cost center. So yea in a huge org one of the goals is to reduce costs (admin) spent on supporting a cost center.

Doctors generate revenue directly and it can all be traced, so even an extra 20 minutes out of their day doing admin stuff instead of one more patient or procedure is easily noticeable, and affects revenue directly.

	▲	gwd a day ago \| parent [-]
		You mean, there's a 1-1 correlation between the amount of pointless admin a doctor has to do and the number of patients he sees (and thus the revenue of the clinic). It should be visible on the spreadsheet. Whereas, there's not a 1-1 correlation between the pointless admin a software engineer has to do and the number of paying customers a company gets. But then, why do large orgs try to "save costs" by having doctors do admin work? Somehow the wrong numbers get onto the spreadsheet. Size of the organization -- distance between the person looking at the spreadsheet and the reality of people doing the work -- likely plays a big part in that.