[esel2k]

I would add to your list of problems: Decades of easy-money milk-the-cow style companies (Often CROs) with very outdated systems with folks sittings in cheap countries to do some data change requests and manual tests. Truely horrible and outdated tech, mixed with bad salaries, high turnover and bad management. I used to work for a company were because of timezone issues a wrong date was entered, CRA requested correction (edit manually, sign, scan) and wrong assumptions etc we had to change 7 times the whole thing and send CRA onsite and recorrect the mess. In short: Inefficient mess.

I left that industry quickly and can say I that others are better. Lab tracking is way better with diagnostic samples with private labs or when mixed with good logistics partners. It is not everywhere as bad as this.

TLDR: add outdated tech, greed and bad management