U.S. workers have gotten less productive – no one is sure why • Hacker News Board

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

#431

Post by peteradio » Mon, Oct 31, 2022, 10:02 PM UTC

conductr wrote: post #110

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…

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…

Mouse moves are crack for ml algorithms if the interface is maintained somehow.

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

#432

Post by throwaway894345 » Mon, Oct 31, 2022, 10:02 PM UTC

coxmichael wrote: post #311

throwaway894345 wrote: post #269

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. I don't think "by almost any measure" is right. I think…

Both can be true, and greater systems of medical research and analysis don’t necessarily lead to greater on-the-ground treatment. As you’ve pointed out, access to those information systems is critical. I’d add the distribution of that information as well as the right economic incentives to participate in using that information. I’m not sure we’ve really got any one of those things right. Edit: adding a bit of humanit…

> Both can be true

Not really. You can't say "doctors have become less productive" without accounting for the value incumbent in the increased documentation effort.

> greater systems of medical research and analysis don’t necessarily lead to greater on-the-ground treatment.

Maybe not "necessarily", but in practice they do. Perhaps not in every incidence, but broadly the analysis results in better outcomes or else there would be no economic incentive to facilitate medical research ("the incentive is to sell more drugs!" > Edit: adding a bit of humanity to the system, as the OP is hinting at, could very much be a part of the fix.

That's not how I understand the OP, but I doubt anyone would object to "adding a bit of humanity" (abstractly) to healthcare unless it implies a reduction in empirical rigor.

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

#433

Post by mcguire » Mon, Oct 31, 2022, 10:03 PM UTC

moffkalast wrote: post #398

mochomocha wrote: post #367

Earlier quoted context omitted.

It's definitely not an idiotic approach, and companies do keep buffers. In the most advanced cases, probabilistic models are devised to estimate how big these buffers should be. Asking for companies to keep buffers for unpredictable "once in a century"-type events is unrealistic.

Yeah that's the problem, those estimates are usually arounds zero it seems. I mean sure on paper it checks out to be most profitable and most of the time it also works in real life. But you end up with this rube goldberg supply chain machine that can't be stopped or you apparently end up with a cyclic dependency problem and you cannot restart your production. We build structures to take a one in a ten thousand year f…

Efficiency argues for keeping those buffers as small as possible. In a series of "normal years", a business that keeps their inventory down to what they need in the "normal case" will be more efficient than one which keeps a larger inventory to handle more rare events. As a result, the former will out-compete the latter in the market. (Inventory, in this example, is just one "buffered" resource that needs to be managed correctly under differing circumstances.)

Efficiency, past a point, is therefore the enemy of resiliency.

Until that day that something bad happens.

And then you have an issue where one business may be prepared for the bad event, but something downstream of it is not; they can produce all the widgets, but can't ship them anywhere for example.

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

#434

Post by throwaway894345 » Mon, Oct 31, 2022, 10:06 PM UTC

tsol wrote: post #420

throwaway894345 wrote: post #407

Earlier quoted context omitted.

> But you could probably reduce the paperwork that doctors do these days by a factor of 4 and not loose anything of value. Maybe, but this sounds like some vague hunch based on ???. I very highly doubt the healthcare industry would tolerate doctors wasting ~37.5% of their time (75% of paperwork time is wasteful * 50% of doctors' time spent on paperwork = minimum 37.5% of doctors time wasted). Doctors are expensive ,…

>I very highly doubt the healthcare industry would tolerate doctors wasting ~37.5% of their time (75% of paperwork time is wasteful * 50% of doctors' time spent on paperwork = minimum 37.5% of doctors time wasted). Doctors are expensive, so recouping anywhere near 40% of their time would be a priority. Doctors are expensive, but malpractice lawsuits are more expensive. Documentation is extremely important for lawsuit…

I don't dispute the value of documentation for CYA. I'm saying that if CYA were the motivating use case, electronic medical systems would look a lot more like a Word document than like Epic (Epic is designed to standardize patient histories so they can be analyzed for research, not for paralegal convenience).

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

#435

Post by [deleted] » Mon, Oct 31, 2022, 10:06 PM UTC

mochomocha wrote: post #367

moffkalast wrote: post #359

Earlier quoted context omitted.

> "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.

It's definitely not an idiotic approach, and companies do keep buffers. In the most advanced cases, probabilistic models are devised to estimate how big these buffers should be. Asking for companies to keep buffers for unpredictable "once in a century"-type events is unrealistic.

[deleted]

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

#436

Post by sinecure » Mon, Oct 31, 2022, 10:06 PM UTC

xab33 wrote: post #125

throwaway22032 wrote: post #27

I'm pretty sure I know why... The working environment changed. Bit by bit I moved from an environment with gentleman's agreements and so on towards something in which everything was codified, safetyism became rampant, etc. In the UK over the past few years I went from going into a nice office in a number of beautiful old buildings, getting my stuff done with cameraderie, having lunch together and playing board games,…

I totally agree. Where I work, in-person work became optional. Strangely, everyone 35 or younger decided to work from home (most of them don't have kids, which would be the one decent excuse), but the older people mostly come in. At 34, I'm sort of in-between, but enjoyed bantering with people my age or younger. So I get the worst of both worlds: my boss can still come in my office at any random time and bug me about…

This has been my experience as well at 32. The commercial real estate firm I work at has a 4 days in the office policy, so we have a fairly robust social atmosphere. You can't design a building on a webinar, you need to sit together in a conference room, roll the blueprints out on the table and point to things, sketch changes, review pro formas.. it can't be replaced digitally.

The young people we're getting are like they're from another planet. They think it's' fine to come in late and leave early every day, they only do the bare minimum of work assigned and show zero engagement to help the firm beyond the scope of their assigned tasks. They're all coming from colleges that were remote or jobs that were work from home. How can you learn as a young professional in a work from home setting? You need to sit in on meetings, phone calls and discussions, you need to absorb the whole office around you, not just sitting alone at your computer.

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

#437

Post by lowbloodsugar » Mon, Oct 31, 2022, 10:06 PM UTC

xab33 wrote: post #125

throwaway22032 wrote: post #27

I'm pretty sure I know why... The working environment changed. Bit by bit I moved from an environment with gentleman's agreements and so on towards something in which everything was codified, safetyism became rampant, etc. In the UK over the past few years I went from going into a nice office in a number of beautiful old buildings, getting my stuff done with cameraderie, having lunch together and playing board games,…

I totally agree. Where I work, in-person work became optional. Strangely, everyone 35 or younger decided to work from home (most of them don't have kids, which would be the one decent excuse), but the older people mostly come in. At 34, I'm sort of in-between, but enjoyed bantering with people my age or younger. So I get the worst of both worlds: my boss can still come in my office at any random time and bug me about…

>It turns out that even relatively motivated PhD students actually need in-person accountability and direction, or they just spin their wheels at best, or goof off at worst.

You don’t have the data to shows that in-person is necessary. And there are plenty of remote-only companies that make it work. It sounds like you’ve decided that there can only be one possible solution and then given up. That kind of thinking might explain a whole lot about the situation.

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

#438

Post by yamtaddle » Mon, Oct 31, 2022, 10:07 PM UTC

SoftTalker wrote: post #368

VLM wrote: post #328

Earlier quoted context omitted.

Classic business process mistake of trying to change a verbal contract into a form-letter. "I'd like a quarter pounder with cheese and fries" is utterly unacceptable for buying a house or taking out a car loan, but it's the ideal way to order lunch. The people marketing, designing, and writing the application software have never worked in the business, of course, lack of experience has never made people like that pau…

Exactly why I cannot stand using the kiosks to order food at a fast-food restaurant. They take what used to be a five-second process to verbally state an order, and turn it into a multi-minute agony of taps, reading, canceling suggested upsells, etc. before finally getting to completion. I guess the restaurant saves having to pay a person at the counter to take the orders, at the expense of massive customer frustrati…

Our nearest McDonalds has a Siri-like virtual assistant thing taking orders at the drive-through. They've had to add taped-on paper notes telling people what it expects them to say to end the order. If you order anything with a number in the name, it may give you that many of it instead of one of it. I don't know how well it does at modifying mistakes but I'd bet the answer is "it can't, it just tells you to pull forward and talk to a real person".

It sucks.

And yeah, the damn order-kiosks manage to take saying the words "large black coffee" and turn it into a two-minute process.

Like "automated" checkouts, they're not automation, they're just making customers do more work than paid workers used to, to achieve the same outcome. The work's still happening, and is less efficient, the businesses just aren't having to pay for it. That's not automation.

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

#439

Post by throwaway894345 » Mon, Oct 31, 2022, 10:10 PM UTC

bumby wrote: post #400

throwaway894345 wrote: post #269

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. I don't think "by almost any measure" is right. I think…

This is a really good point about how we myopically understand the value stream of a process. Often, steps that we feel are bureaucratic waste provide a lot of value to someone else in the process. With that said, I think most healthcare is correct to take a "patient centric" approach. What the OP seems to be making is a "doctor centric" take and, if one was to be overly cynical (I'm not), your post may skew to the s…

I don't think documentation precludes doctors from caring for their patients, but it does limit the number of patients they can handle. This implies that healthcare is more expensive, which maybe seems like a bad thing for patients, but I think it's more of an indicator that we need to find a way as a society to pay for the societal good that is data collection and research--"medicare for all" is one conceivable incarnation.

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

#440

Post by WalterBright » Mon, Oct 31, 2022, 10:12 PM UTC

pixl97 wrote: post #349

WalterBright wrote: post #212

Earlier quoted context omitted.

For the people who don't like my post, where does all the money come from that funds the government? Nothing is free.

Please stop being the highlight of zero sum thinking. Let's make up a hypothetical example. The government says you have to install a safety rail and the amortized cost is $1 a year. You: OMG, this is going to cost $100 over the next century, a huge loss, I am destroyed. Reality: Johnny doesn't fall of the equipment being coming paralyzed (costing you an immediate $200 in lawsuit and payout fees) and is able to produ…

Here ya go (not a hypothetical example):

https://slate.com/business/2022/10/san-francisco-toilet-mill...

They beat out Seattle, that spent $250,000 on a portable toilet a few years ago.

On my own street, the city water outfit installed a fire hydrant. It cost $10,000, including architectural drawings of the installation. When the crew came out to install the hydrant (the main water line runs under my property) I asked them if they'd seen the drawings. They said "what drawings?" They'd never seen nor talked to the engineer, nor had any idea there ever was one. I asked them what the hydrant cost. They said $2,000. They had a machine on the back of the truck that was able to dig the hole, drill the main, and clamp on the new hydrant in 15 minutes.

This was 20 some years ago, back when $10,000 was real money.

The IRS now requires any business that sends out payments to an individual of more than $600 per year now has to file 1099s. The threshold used to be $20,000. A lot of ebay-ers are in for a big surprise. Do you have receipts for what you paid for items you sold on ebay?