3 ms·

If they have time to be friendly, perhaps they aren't so overworked and can really treat you more effectively. It sounds like an indicator of better treatment.

If they have time to be friendly, perhaps they aren't so overworked and can really treat you more effectively. It sounds like an indicator of better treatment. If doctors are always rushed off their feet, that's probably not an ideal hospital to be in. It sounds like mismanagement. We wouldn't accept it in most other industries.

kom107 11y ago
It's not mismanagement. It's a matter of applying business concepts of productivity to the healthcare setting. Ex: In business, if Joe the factory worker can make 100 widgets in an hour, and Mike can make 150 in an hour, with the same number of defects, Mike is more productive than Joe. So now let's apply this to the ED: If Joe the nurse can discharge or admit 10 patients in an hour, and Mike can admit or discharge 15 in an hour, Mike is more productive, right? Well, no, because maybe Mike had patients that were triaged as low priority, but Joe was working Level 1 trauma side. Or you have patients presenting with the same things, but one is a healthy 30 year old and another is 80-something with multiple comorbidities. I've seen Baumol's Cost Disease used to explain why we see the healthcare industry grappling with rapidly increasing costs, especially wage costs: because we can't measure productivity. I'd argue, from what I've seen, that in fact, that's not true. I even came up with a formula to measure nursing staff productivity relative to patient acuity levels, but never had any buyers. Why? You start getting into questions about actual patients that no one wants to answer, because they're uncomfortable ethical questions, and reimbursements will drop regardless of the answers. Being treated effectively at this point is being treated as a human, and either bringing the disease under control, or getting rid of the disease. We need to undersand that although these healthcare workers are in caring professions, their work is being increasingly shifted from what we all think effective treatement should be, to what the business thinks effective treatment should be (read: profitable). You do accept this kind of rushing in other industries, because you believe in productivity. And that's fine. It's also fine to believe in productivity in healthcare (I do), but not in the patients/hour concept. As a country, we need to change this model. I'd encourage you to advocate for safer staffing ratios, at a minimum, for nurses and doctors.

kom107 11y ago

It's not mismanagement. It's a matter of applying business concepts of productivity to the healthcare setting. Ex: In business, if Joe the factory worker can make 100 widgets in an hour, and Mike can make 150 in an hour, with the same number of defects, Mike is more productive than Joe. So now let's apply this to the ED: If Joe the nurse can discharge or admit 10 patients in an hour, and Mike can admit or discharge 15 in an hour, Mike is more productive, right? Well, no, because maybe Mike had patients that were triaged as low priority, but Joe was working Level 1 trauma side. Or you have patients presenting with the same things, but one is a healthy 30 year old and another is 80-something with multiple comorbidities. I've seen Baumol's Cost Disease used to explain why we see the healthcare industry grappling with rapidly increasing costs, especially wage costs: because we can't measure productivity. I'd argue, from what I've seen, that in fact, that's not true. I even came up with a formula to measure nursing staff productivity relative to patient acuity levels, but never had any buyers. Why? You start getting into questions about actual patients that no one wants to answer, because they're uncomfortable ethical questions, and reimbursements will drop regardless of the answers. Being treated effectively at this point is being treated as a human, and either bringing the disease under control, or getting rid of the disease. We need to undersand that although these healthcare workers are in caring professions, their work is being increasingly shifted from what we all think effective treatement should be, to what the business thinks effective treatment should be (read: profitable). You do accept this kind of rushing in other industries, because you believe in productivity. And that's fine. It's also fine to believe in productivity in healthcare (I do), but not in the patients/hour concept. As a country, we need to change this model. I'd encourage you to advocate for safer staffing ratios, at a minimum, for nurses and doctors.