You won’t just build features, you’ll build your career - ownership and autonomy at AcuityMD

A recipe for a great job is one where you get a heap of ownership, a pile of autonomy, and are surrounded by a great team. AcuityMD is one of those rare places.

I've seen us shower ownership and autonomy on people in portions larger than those at my grandmother's dinners. Even more so than what you typically see at early stage startups. That's pretty fun all around.

I know, I know, every company says they're a great place to work. There's usually a happy picture of the team, which to you is really just a bunch of strangers.

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The goal of a culture post is to convey the type of environment so that people can either get excited if it’s what they're looking for, or evaluate if it's not a fit. And to do that, you need concrete data. So let’s give you that.

It’s not all sunshine and rainbows

We’re a company that’s growing quickly. That definitely comes with growing pains. Processes break down sometimes.

I find that to be super fun. There are new company milestones, new teammates, and new growth regularly. But it definitely can be frustrating for some. Do you expect a rigorous process for each team? Mature tools? Well, we’re still figuring a lot of those things out.

We give teams so much autonomy that we have some room to improve on how we communicate across teams. We’d rather teams go solve the most important problems impacting our customers. If that means we find ourselves investing in the same thing across two teams every once in a while, so be it. We want teams to feel responsibility for the outcomes they’re delivering for customers rather than worry too much about getting approvals to build everything. It’s a tradeoff we intentionally make.

We’re also not a 5 person startup. We have specialized roles and if you’re an engineer, you’re probably not going to be super exposed to our conference demand generation over in marketing. If you really want to touch everything, a tiny startup is likely a better bet.

And on the other end of the spectrum, if you want to work at Google and observe how technology at that scale is built, we are not that.

But if you want to grow more than you will at almost any other company with real hands on experience, we’re probably a good fit for you.

An exceptional year for me

I spent 2024 building and launching our AcuityMD Contracts product with a small, tight-knit, stellar team. It’s impressive how much autonomy I’ve been offered, and I’ve definitely made a bunch of mistakes. Yet, the ownership and autonomy remains. It’s been exceptionally fun.

In April of last year, I was demoing beta versions of the product and Mike, our CEO, set up time with one of our biggest customers to help us along. After the call, he sent me feedback that roughly paraphrases to “Thank god you didn’t go into sales engineering.” (I’m paraphrasing, the actual words he used were quite kind.)

Then, instead of getting me off customer demos, he offered extraordinarily useful feedback, a few pointers, and pretty quickly I had people asking me for tips on how to run a great demo. I can imagine so many other ways that could have gone where I wouldn’t get to learn and grow. But as a company, we choose to trust, help each other, and we’re better because of it.

Five months later, Ross, our VP of Data & Partnerships, asked me to run the demo as part of the product launch to hundreds of customers. Here’s me on stage at Flywheel, the annual AcuityMD customer conference, in September 2024. That was pretty cool.

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My role is officially in engineering, and I definitely do a lot of engineer things, but day-to-day I own an entire product. I own an entire customer journey across messaging, demos, onboarding, sales enablement, product development, and I’m doing it with world-class support from an experienced leadership team around me.

Those are skills I care about, and ones I’ll bring to every role in the future.

It’s not just me

My experience isn’t the same as the next person’s. Your mileage will vary. Not everybody is going to launch a new product, but that’s not really the point I’m making.

People of different experience levels, tenure at the company, and personal interests end up getting ownership and autonomy well beyond what I’ve seen at other startups, let alone larger companies. This translates to real growth.

Here’s an incomplete but representative list of accomplishments I’ve seen in my time here:

• Dan (senior engineer) joined, and noticed we were missing re-usable patterns for sending emails. Right away, he proposed a solution and spent a month building some absolutely stellar infra which has reshaped the projects other teams are willing to invest in.
• Shree (engineer) wrote her first project spec 3 months into her career. Not 3 months into the job, 3 months into her career. What’s more, it was great! She went from a one line customer problem statement to a spec that she then built and launched. At many companies, this doesn’t happen for very senior engineers (you often hear ”That’s product’s job”).
• Kev (senior engineer) had a vision for how our backend could evolve. Over the course of a year, he’s led an arc of projects that introduced new backend infrastructure which has become the de facto infra for most full stack teams. He’s had full autonomy (he gets feedback on his proposals), and he did all this while working on a product engineering team. As a management team, we recognized the need to carve out time away from his work on features because what he wanted to do made sense. That level of infra contribution from a product engineering team is something most companies struggle to achieve from an organizational standpoint. At most places, if you have ideas for infra, you go work on an infra team.
• Megan (senior product manager) successfully launched a new product - leading not only the product development, but also crafting the product marketing messaging and delivering customer pitches throughout the beta phase. Experiencing the whole customer journey from marketing message to demo to onboarding to features allows you to level up your skills at building products by a wide margin. All of our product managers end up doing product marketing and pitches in some form, which is so cool.
• Ishan (engineer) wanted to contribute to some infra and get exposure. Pretty quickly he got meaningful time away from product roadmap to contribute to local development which benefited the entire engineering org.

We’re very intent on encouraging people to just go make things happen. That’s something special and the impact of that type of culture is evident to me when looking at the ways people here get to own way more than I’ve seen even at companies much smaller than this one.

A sweet spot for ownership and autonomy

AcuityMD is in a sweet spot in a lot of ways. We’re at the size of company where there are people with real experience that you can learn quickly from, but there’s still just so much room to take ownership and push your boundaries. All without much bureaucracy. It’s a culture we’re intentional about.

Ownership and autonomy make people happy and allow them to do their best work. I’ve been at a number of different companies and I’m always happiest when I have a ton of ownership and autonomy coupled with a stellar team who is passionate about their work. That’s not easy to find.

There are more problems than we can solve, and lots of room for ambitious people to deliver real impact for our customers and patients. I think that's a pretty exciting place to be.

So here’s that picture again. Maybe next time we take a photo like this, it won’t just be a bunch of strangers to you anymore.

(Oh, and here’s the customary link to the careers page at the end of a post like this. And yes, we’re hiring.)