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Scattered reports of defections from Apple’s team of health experts and researchers are symptoms of bigger problems at the company, a new report suggests, as the health team has become focused not on big health care challenges, but rather on “features geared to a broad population of healthy users.” Internal tensions have already pushed a number of key employees to leave for Anthem, the Gates Foundation, and Google, as Apple continues to slowly roll out new health initiatives for the Apple Watch and iPhone.

Apple’s health team is run by COO Jeff Williams, who was heavily involved in developing the Apple Watch and now also oversees the company’s design teams, among other responsibilities. According to a CNBC report today, Williams pushed the Watch team to dive deeper into health sensors and algorithms in 2016 as a means to increase interest in the wearable, a decision that broadened Apple’s involvement in health research and hiring of experts. Dr. Sumbul Desai, for instance, left a position running Stanford University’s digital health initiatives in 2017 to join Apple, where she now oversees Apple’s ECG app, heart study, health clinics, and health strategy.

The key problem Apple appears to face is employee discontent over direction. While some employees wanted to see the company tackle major initiatives from telemedicine and medical devices to health payments, Apple has largely focused on wellness and prevention. Instead of making immediate big dents in the medical world, Apple has continued to pursue a more incremental approach, gradually rolling out ECG functionality across multiple countries and attempting to increase medical records’ portability and accessibility for iPhone users. Beyond turning off particularly ambitious employees, Apple’s approach has left others “sidelined and unable to move their ideas forward,” allowing tensions that first surfaced years ago to increase in recent months.

As CNBC notes, Apple has lost multiple employees to health insurer Anthem, notably including health app business development director Dr. Warris Bokhari, while the Gates Foundation grabbed early Apple health hire Dr. Andrew Trister to head its digital health initiatives, and Google has hired both engineering and health talent. Other employees including product development, regulatory, and research experts have left the health team over the last two years for greener pastures, as well. Most of the departing employees are said to have been in Desai’s group.

Though its specific research programs are deliberately kept at least somewhat ambiguous for competitive reasons, Apple has made no secret of its ambitions in the health sector. The company actively began to pursue health initiatives after the untimely death of cofounder and CEO Steve Jobs from pancreatic cancer, and his successor Tim Cook has predicted that “Apple’s greatest contribution to mankind” will one day be its work in health.

In addition to its broader Apple Watch and health records initiatives, Apple has acquired sleep tracking company Beddit, and reportedly worked with medical researchers to bring a variety of complex health monitoring sensors to the wrist. Many potential hardware and software developments in the health sector are regulated by government agencies, however, creating testing, accuracy, and disclosure requirements that can delay the rollout of new offerings, stifling what might otherwise be a brisker pace of innovation.

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