You can and you should avoid publications, big or small. I fell for the publication nonsense when I started here because "everybody said to". That was bad advice.

Now I submit nothing to anyone else's pubs. Why would I want to be lost in a crowd of other people? Why should I make it harder for people to notice me?

I have my own pubs, but they are only for the convenience of my readers who only want to see certain types of posts. I no longer solicit and do not accept submissions.

Medium seems to be trying very hard to make publications unnecessary. That's smart.