Pros
-- Office is comfortable; -- Work/life balance is mostly OK; -- Atmosphere of a growing leader in the market (however, the ones who really benefit from it are the managers with great stock plans).
Cons
-- Ideas that come from you mean nothing when the ideas that come from managers go other direction; -- Projects you do can be stopped or transferred to other people; -- Results you produce get filtered by people whose position in the company depends on them; -- Career development is totally under manager's control: they decide what role you will take; strange and unclear promotion policy: some people gets promotion unreportedly, some are reported; -- Older developers keep the same role for years, without any promotion; -- Most alarming to me is that the marketing and market promotion strategies for the product seem to be delivering a perfect positive message to customers, while the side-effects and failures to improve the product are strictly confidential among a narrow circle of manager/clinical guys who do not uncover them since that will ruin the perfect picture and their careers in particular; not sure how doctors treat Align, but I suspect the smart ones know it can be tricky and dangerous.