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U.S. workers have gotten less productive – no one is sure why
241–250 of 751 posts
Re: U.S. workers have gotten less productive – no one is sure why
#242I've read that doctors now spend as much as 50% of their time documenting their work. Companies such as Epic, which provide the software that hospitals use to build databases of patient data, have been big winners in the new world of hospitals-depending-on-software. But did the doctors become more productive? By almost any measure, they became less productive. People in tech keep thinking more tech will solve problem…
I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Doctors fought it as long as they could because they knew what it meant for them. I remember pretty early demos in early/mid 2000s when I was doing some clinical grunt work in college. I had written some software to make my department’s life easier so I was offered up as the hospital’s…
IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies.
Early GUI's didn't have the problem you describe because they were designed as discovery mechanisms to the underlying function. AKA, the idea was that after clicking File->Save a dozen times you would remember the keyboard accelerators displayed on the right hand side of the menu. Or if nothing else, Remember that the F in File was underlined along with the "S" in Save (or whatever). Which would lead people to just press ctrl-s, or Alt-F, S. Then part of testing was making sure that that the tab key moved appropriately from field to field,etc.
I remember in the 1990's spending a fair amount of time doing keyboard optimization in a "reporting" application I wrote (which also had an early touchscreen) for use by people who's main job wasn't using a computer. Then we would have "training" classes and watch how they learned to use it.
So, much of this has been lost with modern "GUI's", even the OS vendors which should have been keeping their human interface guidelines updated, did stupid things like _HIDE_ the accelerator keys in windows if the user wasn't pressing the Alt key. Which destroys discoverability, because now users don't have the shortcut in their face. Nevermind the recent crazy nonsense where links and buttons are basically the same thing, sometimes triggering crazy behaviors like context menus and the like. Or just designing UI's where its impossible to know if something is actually a button because the link text is the same color as the rest of the text on the screen..
Re: U.S. workers have gotten less productive – no one is sure why
#243Costs went up like 20-30% but we didn't give out 20-30% raises. Perhaps workers are leveling their productivity to the purchasing power of their salary?
Re: U.S. workers have gotten less productive – no one is sure why
#244Earlier quoted context omitted.
Right, but it's the records that are standard, digital and transferrable; not the work. So what you end up optimizing for is producing paperwork.
huh? if the records are "standard, digital and transferrable", it means all of the work associated with those records is sped up. - Need to retrieve past doctor visits about a patient? person at front desk no longer needs to walk to the folder closet, then scan the whole thing to find your name and then read through all of the documents to find the relevant visits. just click a button. - How about getting the prescri…
It is more productive if the person just knows if the procedure is covered because the insurance companies have stable standards and trust the medical providers rather than having it all be JIT decisions based on rules that either constantly shift or are so vague/low trust as to be "you medical person yourself can't decide if this procedure is covered, you have to call us."
And back in the paper days, the staff would pull up the records for the days appointments. ER visits would have less data but normal medical care would be fine.
Re: U.S. workers have gotten less productive – no one is sure why
#245Earlier quoted context omitted.
I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Doctors fought it as long as they could because they knew what it meant for them. I remember pretty early demos in early/mid 2000s when I was doing some clinical grunt work in college. I had written some software to make my department’s life easier so I was offered up as the hospital’s…
> It was to have a record that is standard, digital, transferable, etc. Which translates into productivity. If something is standard, digital and transferable it means you can increase the rate of output in relation to its input (which is the definition of productivity).
You are optimizing the downstream consumers of the records not _necessarily_ care, which is what you probably _want_ to optimize.
Re: U.S. workers have gotten less productive – no one is sure why
#246The best way to understand this is to compare Tesla's R&D expenses to Twitter's R&D expenses. If you got into the details you would see MANY MANY meetings at Twitter with literally nothing was accomplished.
Re: U.S. workers have gotten less productive – no one is sure why
#247Earlier quoted context omitted.
They also fought it because they didn't go to medical school and survive residency to fill out forms all damn day—and they didn't used to have to, they had staff for that. Then the computerized systems "replaced" that staff but all that really means is they cut the human time needed low enough that full-time workers weren't needed, but didn't eliminate it, so now that's another thing doctors have to do themselves. AF…
Some healthcare provider organizations now employ medical scribes who follow physicians around and do all their EHR data entry. This is expensive, but can be cost effective because then the physicians have more time to perform billable procedures.
The least capable doctor's time is worth $300/hr. The scribe is paid what, $25/hr?
This is so much like hearing of engineers that will not hire a $20/hr maid due to egalitarian reasons so they squat in filth or waste all their free hours cleaning, all while capable and willing cleaners starve. Insane.
Re: U.S. workers have gotten less productive – no one is sure why
#248Earlier quoted context omitted.
Assuming that's true--and I'm not sure it is--mass retirement of baby boomers, which has already begun due to forced retirement during the pandemic, is going to absolutely decimate the labour supply, which has enormous knock-on effects (including a rise in inflation).
You can go back to the year 2000 and find Fox News and CNN talking heads warning us about the impending doom of baby boomers retiring and taking the economy with them. Any year now... What has actually transpired in the meantime has been record breaking bailouts, corporate handouts, and profits, while workers pay remains in stagnation and housing market inflation goes through the roof (because of slow development, IM…
> You can go back to the year 2000 and find Fox News and CNN talking heads warning us about the impending doom of baby boomers retiring and taking the economy with them. Any year now...
Yeah. And now it's happening.
Back in 2000 the average baby boomer was 35-55, far from retirement age.
The average baby boomer is now 55-75, and after COVID forced a ton of them out of the labour force, they're choosing not to come back.
See, you can report about a thing that's likely to happen in the future before it actually happens, and in the intervening period, while it may not be happening, that doesn't mean the reporting is wrong.
Or are you also one of those types that thinks the media was overblowing the whole global warming thing because they deigned to report about it before we saw some of the more dramatic and visible effects?
Frankly, I don't know what you're going on about in the rest of your comment. I made no claim that baby boomers aging out of the workforce explains All The Things. I certainly didn't make the claim that it explains trends in the economy up to this point. My point is that it's now a major factor in the economy going forward and we can expect major changes as a consequence.
Re: U.S. workers have gotten less productive – no one is sure why
#249Earlier quoted context omitted.
I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Doctors fought it as long as they could because they knew what it meant for them. I remember pretty early demos in early/mid 2000s when I was doing some clinical grunt work in college. I had written some software to make my department’s life easier so I was offered up as the hospital’s…
They also fought it because they didn't go to medical school and survive residency to fill out forms all damn day—and they didn't used to have to, they had staff for that. Then the computerized systems "replaced" that staff but all that really means is they cut the human time needed low enough that full-time workers weren't needed, but didn't eliminate it, so now that's another thing doctors have to do themselves. AF…
But the doctors almost always were taking notes anyway. My step father (A doctor) fought a losing battle against electronic records because he had _decades_ of paper records stored in the "records" room of his office. That was largely the responsibility of the front desk to pull the patients records and have them ready for him to read/check before seeing the patient. Then clean them up and refile them. Long term patients had pages and pages of hand written notes, prescription histories, etc.
So a part of the job has always been the record keeping, OTOH, as one of the other users mentioned, I've seen enough Dr's using their computer records systems to know that software is mostly garbage. The Dr's spend 2-4x the time dealing with the shitty UI as actually typing in the notes now.
(In the end he basically retired instead of convert to electronic records).
Re: U.S. workers have gotten less productive – no one is sure why
#250Earlier quoted context omitted.
They also fought it because they didn't go to medical school and survive residency to fill out forms all damn day—and they didn't used to have to, they had staff for that. Then the computerized systems "replaced" that staff but all that really means is they cut the human time needed low enough that full-time workers weren't needed, but didn't eliminate it, so now that's another thing doctors have to do themselves. AF…
Seems an artefact of doctors not being employees. If their employment status was the same as everyone else’s, there wouldn’t be any effort to replace admin staff with someone getting paid 10x as much unless there was actually a 90% reduction in work (doubtful).
Laughs from academia....