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10 Ways to Make Doctors More Productive


Given all the changes and demands on the sick-care system, many experts are suggesting ways to increase sick care worker productivity.

practice management, primary care, hospital medicine

The economists tell us that labor productivity is a measure of the amount of goods and services that the average worker produces in an hour of work. The level of productivity is the single most important determinant of a country’s standard of living, with faster productivity growth leading to an increasingly better standard of living. Given recent stagnation in wages, however, some are re-examining the link. It turns out if you make more things or produce more services, you don't necessarily make more money.

Given all the changes and demands on the sick-care system, many experts are suggesting ways to increase sick care worker productivity. If you are a clinician, the measure now is straight forward, i.e. the number of relative value units you can generate and how much revenue and reimbursement that translates to for you or your employer. Some are trying to move the goalposts or change how we keep score, but, for now, most doctors are being measured and compensated by how many points they put on the board. One of these days, though, CFOs are going to have to figure out what to do with all those doctor cash cows.

Charles Duhigg has written about what makes people productive in his book, Smarter, Faster, Better. For those of you who just read the conclusions sections of scientific and medical journal articles, here are the takeaways as they could potentially apply to sick-care workers:

1. Make people feel like they are owners, not renters. Expand their locus of control, constantly reminding them about how the work they do is about something they care about. Remind yourself and co-workers that you are building a cathedral, not just laying stones.

2. Choose a stretch goal and break it down into SMART (specific, measurable, achievable, realistic, timeline) objectives. When it comes to innovation, though, some think DUMB goals make more sense than SMART goals.

3. Start with the end in mind, create a retrograde pathway, and focus. Ask, "What next and by when?"

4. Envision multiple futures and open yourself to multiple options.

5. Make teams more effective by focusing on the “how” (give everyone a chance to speak and feel safe) instead of the “who.”

6. Push decision making to the person closest to the problem. Rule makers, managers, bureaucrats, and many physician executives have a very hard time with this one.

7. Innovation is mostly about doing old things in new ways. To connect the dots and harvest institutional history, become an “innovation broker.” Innovation brokers don't just build network pipes and pumps, but instead accelerate the flow of information and fix the pipes that are clogged.

8. Customers buy emotionally and justify rationally. Inventors and innovators should do the same. The user-defined value of an idea or invention is often more aptly measured by how it makes you feel, not what you think about it.

9. The productivity curve maxes out at some mean level of stress. Something that is boring or a task that is overwhelming does not drive productivity. In fact, excessive stress, change fatigue, and administrivia crush productivity. Some seem to think that the way to make doctors more productive is to make them conform to rules and mandates telling them how to be more productive.

10. Just because you have realized a creative breakthrough does not mean it will create user-defined value. Be open to the fact that your baby might, in fact, be ugly. Statistically, most are.

Virtual and face to face mentors help too.

Sick-care labor economists debate whether productivity is increasing or decreasing and whether it is contributing to an increased standard of living. If you want one answer, ask your neighbor, the pediatrician.

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