Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

U.S. workers have gotten less productive – no one is sure why

washingtonpost.com

Post reply on HN
Print view View original

351–360 of 751 posts

Re: U.S. workers have gotten less productive – no one is sure why

#351

Post by ocbyc »

lkrubner wrote: post #88

I'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…

To get anything done, it seems I must speak to >=2 people on any customer support line.

Re: U.S. workers have gotten less productive – no one is sure why

#352

Post by Dylan16807 »

onlyrealcuzzo wrote: post #197
Scoundreller wrote: post #188

Earlier quoted context omitted.

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).

You can reduce 90% of the work - but if the remaining 10% is shifted to someone that gets paid 50x as much, it's still a loss.

I, yes, that was their point. You're just saying the same thing with different numbers.

Re: U.S. workers have gotten less productive – no one is sure why

#353

Post by scarface74 »

badpun wrote: post #296
conductr wrote: post #273

Earlier quoted context omitted.

It's also because it's enterprise software. Which actually isn't software, it's more of a platform. You have to do so much implementation detail that the GUI is just the result of some form-builder type module. Everything I've ever encountered that was enterprise software, felt like it's GUI was not made by humans at all. I don't actually know how they get built but they're almost never optimized for humans or the us…

Nobody wants to pay for better GUIs in enterprise software, so no vendor puts any attention into them. An Enterprise Architect explicitly explained to me (when I was raising a point of choosing a software package that had much better UI) that good UX is a small factor and company (a bank in that case) would rather buy cheaper software and just have its workers suffer more, because it's deemed more cost-effective.

The definition of enterprise software is “the customer is not the user”. You don’t have to make the user happy, just the CxO.

Re: U.S. workers have gotten less productive – no one is sure why

#354

Post by SoftTalker »

marginalia_nu wrote: post #207
mbesto wrote: post #192

Earlier quoted context omitted.

> 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).

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.

That also never happened, did it?

Is there a "standard" medical record, or does each system implement its own proprietary format? Are the records transferrable? If so, why am I asked to fill out a complete medical history form on paper every time I visit the a doctor, as if I'm a new patient, when all the doctors I see are in the same network and presumably use the same EHR system.

Re: U.S. workers have gotten less productive – no one is sure why

#355

Post by thot_experiment »

jbm wrote: post #277
jimlongton wrote: post #58

Earlier quoted context omitted.

> towards something in which everything was codified, safetyism became rampant Those "gentleman's agreements" were not that great if you happened to be a woman, gay or any other minority. The upsides to HR, employment regulation and so on has been making the office a far better place to work for a lot of people. While I agree that there are rampant problems in a lot of sectors, from low skilled to medical, there have…

Quoted post unavailable.

I feel like this is a very real concern? In general I'm in favor of playing fast and loose with rules, and don't put a lot of stock into codifying anything because I feel like it's overall a huge negative when you're trying to get things done.

That all being said this particular arena is one that's so fraught with tiny little edges that all stack up to benefit certain classes of people unequally it unfortunately feels necessary to be explicit and precise. Ultimately this power is a zero sum game, and for and a more equal world means we must take power from some people and give it to others. That's almost never a thing that happens voluntarily, even if the will is there. It's very easy to argue for a status quo that benefits you, especially if the advantages you gain are easy to lie to yourself about.

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair

Re: U.S. workers have gotten less productive – no one is sure why

#357

Post by vanc_cefepime »

dan_quixote wrote: post #322
Scoundreller wrote: post #115

Earlier quoted context omitted.

> I'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. It’s less the software, and more the users, site-specif…

> Another study found US clinicians write 4x longer notes I wasn't aware of this, but as the spouse of a medical provider I know that most US providers are burdened with an ever-present worry about malpractice.

This. So much this. In residency we are taught “document, document, document” and “this is a medical legal document” which leads to defensive medicine. Another point of why we spend more time documenting is billing. Coders/billers continue to come back and asking us to add more details about a diagnosis. More details = more charges to bill or up level. So the next progress note or office visit, I go back to add more. More time is spent fighting the notes. Terrible EMRs that destroy notes is one that leads to more time spent as well. Looking at you Allscripts (aka Allshits in my office). Overall it’s a sad state of medicine in the USA, which is terrible as when I was younger the whole point of medicine for me was to help people and focus on the patient and the issues that are ailing them. Now, patients are still important to me but it’s a race to the bottom trying to document while in seeing the patients so I can go home without paperwork and live my life. I got bills to pay, a 6 figure student loan that will take me another decade to pay off. At some point, it’s all going break down. Few of us are doing the concierge direct primary care model to avoid all this which will unfortunately lead to more health disparities and inequalities.

Re: U.S. workers have gotten less productive – no one is sure why

#358

Post by cashsterling »

postalrat wrote: post #272
dcolkitt wrote: post #128

The very important context is that productivity sharply rose in 2020, in the middle of the Covid recession. The recent drop in productivity is mostly just a return to pre-pandemic baseline. The simplest explanation is probably just that the workers who were laid off during Covid were the least productive, and so average worker output went up, then fell as they re-entered the labor force. Or maybe even just there was…

Did you even bother to click on the article before typing your opinion of what happened? Their chart shows we are far below any sort of pre-pandemic baseline.

it reads "annual percentage change in labor output"... which I take to mean "rate of change of per capita productivity" over time, not actual measured productivity.

So that graph does not say we've dropped below pre-pandemic levels.... according to this report (https://www.bls.gov/news.release/prod2.nr0.htm): "Output and hours worked in the nonfarm business sector are now 3.1 percent and 1.5 percent above their fourth-quarter 2019 levels, respectively."

Re: U.S. workers have gotten less productive – no one is sure why

#359

Post by moffkalast »

mcguire wrote: post #124
stormbrew wrote: post #74

These things always really need a giant flashing neon note that "productivity" doesn't mean how much workers get done but how much money is made off of what workers get done. They're only loosely connected, and most productivity gains have come from workers having to "do less" to "make more".

Weird story: From the mid-1970s to the mid-1990s, as-measured productivity significantly declined and then stayed at a lower level. This was during the initial few generations of technological impact on industry, including "just-in-time" inventory which kind of requires computerization. Yet, at this same time, "bosses and economists" were seen in public wondering if computers weren't a net negative on industrial prod…

> "just-in-time" inventory

That really was a net negative eventually. Covid managed to completely wreck the worldwide supply chains because of that idiotic approach. God forbid anyone keep any buffer in case anything happens.

Re: U.S. workers have gotten less productive – no one is sure why

#360

Post by danabrams »

lkrubner wrote: post #88

I'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…

We just had a baby this month, and I was shocked by how much time the medical staff was spending entering data into Epic. So much that they couldn’t actually fully concentrate on giving medical care.

Everyone was very busy but it was very hard to get actual care.

Post reply on HN