The significance of this to me is by contrast to most of the valley companies (FAANG and their offshoots). Over the last 20+ years, people have been trying to build a mission-oriented company with a great culture, and confident enough to build their own tools. That was the default story.

It turns out companies are transient or have been internally infiltrated by such (outsourcing- and ambition-driven) politics that any mission is more supplement than reality, and there's no sense of controlling your own destiny.

So perhaps the dream persists out in the tech boonies in the ultra-sticky EHR domain, goosed by the Obama/insurance mandates to digitize, where developers are trapped by unportable skills. (Or perhaps in smaller B2B companies filling a niche.)