U.S. workers have gotten less productive – no one is sure why
washingtonpost.com
washingtonpost.com
People in tech keep thinking more tech will solve problems and they keep underestimating the flexibility of the old models. For instance, most large companies used to be run by armies of secretaries, and the senior secretaries functioned as what we would now call "project managers" -- they made calendars, oversaw who was working on what, followed up to keep track on whether work was being done, and kept a close eye on what money was being spent. The crucial thing about having humans overseeing such work is that humans can take a flexible approach to the rules: they know when to break them. By contrast, systems that are highly dependent on software tend to be more rigid. Software doesn't know when its rules should be broken.
The flexibility of the old system is constantly underestimated, the rigidness of the new systems is often misunderstood.
In his book "The Design Of Design" Fred Brooks talks about the power of trust, and he contrasts that situations where everything needs to be first negotiated and specified in a contract. High trust systems are flexible and fast, whereas a system where every detail needs to be specified in a contract is slow and rigid. We should stop and ask ourselves, our favorite Agile methodology resembles which of these? Are specifying things with needless detail?
More recently in my field I've seen additional layers of documentation requirements that have nothing to do with insurance, that are entirely state law.
I have no doubt in my mind that if EHR rules didn't exist, they would have been adopted much more gradually, and selection would have been dictated by the ability of EHRs to supply features in demand. More competition would have existed and it would have cost less. Maybe some government regulation would have been needed in terms of interoperability standards but it could have been rolled out much much much better.
I don't think people fully comprehend the cost overruns associated with adoption of EHRs under government mandates, or how big of a shift there was from records being in-house flexible, and provider and patient-driven, to out-of-house inflexible, and IT-corporation-driven.
Cerner has a contract to fix that.
But if medical pricing was such that insurance wasn't required, then patients would better audit their own care receipts and this fraud issue would eliminate itself, and as a side benefit we'd have sane pricing for medical care.
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 liaison for the software evaluation. This is when I formed my “never replace a terminal based app, with a GUI based app and expect productivity gains” theory. Everyone working in the hospital knew the terminal app, they type in some random 3 letter code and a screen would pop up. Then they would memorize how many tabs each field was apart from each other. Without a mouse, people could just hum along imputing data a blazing speed once some muscle memory was in place. Everyone had little cheat sheets printed out for the less frequently used commands/codes. When you replace this with a browser/desktop GUI with selectors and drop downs and reactive components of GUI, it tends to 1) require mouse usage for most people and 2) lose the ability to do this quick data entry I described. The pretty interface becomes a steady stream of speed bumps that reduce productivity. Since then I’ve witnessed it in banking and other industries too.
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.
AFAI can tell, the effect of tech overall is to cut some jobs while making the remaining ones harder and more stressful, while increasing so-called context switching.
Remind me again why do I have to manage my own meetings and prepare so many powerpoints and fill in so many forms as a... well, my position doesn't matter, because everyone is doing the same, no matter their role?
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.
Also there are plenty of costs to employing others besides the hourly cost. Large organizations have huge fixed costs to cover them. Consider:
- liability
- maintaining of knowledge and training to hire help
- skill to source and hire people
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).
No, that's not it at all. What GP is saying is that they cut the human expertise low enough that full-time workers weren't needed. The manpower savings never materialized because an app built for experts is faster than one built for casual users, and also because those experts, even with the high training cost, were ultimately cheaper per hour than the highly compensated people who now have to do the job because we 'made it easy'. First you devalue those experts by making their job harder, then you get rid of the job and make it someone else's, split between entry level staff and your most expensive employees.
> AFAI can tell, the effect of tech overall is to cut some jobs while making the remaining ones harder and more stressful, while increasing so-called context switching.
You still got there in the end.
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).
It’s like cutting off a head when stitching a cut on the leg was the problem.
For those that seemed to transfer successfully, I noted that at Mayo Clinic, the doctors use live dictation software and dictate at least some of their notes into the system while the patient is present near the end. This immediate review sometimes brings up a few new questions (from either Dr or patient), and a bit more notetaking. So, it looks like a very efficient system. They also have no apparent shortage of staff organizing things.
That said, I doubt every medical organization and office has the same quality setup as a top world-class institution. At some level of degradation, the system becomes more of a hindrance than a help, and that point is likely fairly near the top levels (so most of it is a hindrance).
Edit: Also, I was generally quite impressed with their notes
What form would give validation error or warning that a note the Dr is making either raises a new question by the patient or is in conflict with something the patient knows?
(& yes, from what I could see, there were also fields for patient data, date, etc, that are presumably validation-checked)
What I've noticed is that EMR has greatly reduced the amounts of screw-ups or delays caused by not having the right information at hand, or having to repeat tests. Also, since there's now a terminal in every examining room, I can see what amount of effort is required to use the EMR tool (Epic in the case of my provider), and it doesn't seem all that onerous. I can guesstimate the additional amount of time that they spend outside of clinic hours, completing their records for the day, and again, it doesn't seem onerous.
For a few years I had to fill out a lengthy medical history form, every time I visited a clinic, but that's pretty much gone today. My primary care doctor just retired, and her replacement took up the baton without skipping a beat. She can also easily delegate to her physician's assistant or nurse practitioner, so they can all work as a team, with instant access to the same information.
Now I have noticed something interesting. The urgent and primary care clinics all have a terminal in every examining room, and the clinicians perform their examinations while seated at the terminal, except when they actually have to poke around. That's where it seems quite efficient.
In the hospital wards, they still don't have a terminal in each room, meaning that each clinician has to look things up at centralized terminals, remember them (or not), and has no access to information. If they need some information, they will come back with it, next time their make their rounds, which might be the next day. And they screw up. My dad had an episode that took him through an ER, to a regular hospital bed for a few days, then to a rehab ward. I had all of his records at my fingertips thanks to MyChart on my laptop. The doctors and nurses were lost, they completely overlooked the documented diagnosis that was at the root of is condition, and didn't believe me about it.
Some of the nurses in the hospitals now have a terminal on a wheeled cart, that they bring on their rounds.
What I'm guessing is that in the days of handwritten records, the doctors were mostly winging it.
100% agree.
The Office suite is, in some ways, the worst thing that happened to corporations. Thanks to computers, everyone can now easily write a report, fill in a spreadsheet, or manage their meetings. Which means that everyone now has to write reports, fill in spreadsheets and manage their calendars. This used to be a separate job. You had people specializing in those tasks, and they were focused and efficient at it. Now, everyone does it on their own, and not only we suck at this, it's also distracting us from the "main" job we're supposed to be doing.
The older I get, the more I feel computer revolution was in big part a bait-and-switch.
You're not the only one with that bait and switch feeling.
It was pre-AJAX and pre-"Javascript being useful", I think even pre-Firefox and was IE6 only. So it was loading java applets and stuff to just get some basic functionality
Going a little further, this was appealing in part to avoid simple medical errors & oversights. Losing the record, mixing up records, incomplete history, and so on. Eliminating medical error is incredibly valuable but doesn't show up as "productivity".
The problem is: how do you allow departments to retain their fiefdoms in a world of centralised data? The answer is to spend a fortune on management consulting.
https://en.m.wikipedia.org/wiki/VistA
It's actually public domain and open-source. Unfortunately the VA is in an ongoing project to replace it with Cerner Millennium.
The big issue from my EHR-adjacent vantage point is that all the money is in making giant, entrenched EHRs, whereas the future should be in lighter-weight services that conform to standards, and competition is between those services. That way you could gradually slice off VA functionality piece by piece, and have a successful, more efficient, gradual migration.
I guess they also make more sense to management since it looks like something they could do themselves, or at least understand.
It doesn’t help that the evaluators for a new system will also approach from the perspective of a new user, even though none of them will be a new user in some months.
I’ve so wanted to create auto-hot-keys for many tasks, but end up having to use (x,y) clicks where I get boned every design touch-up (deliberate or side-effect of another change).
Web tech broke all that:
- UI was/still is very high latency. Keystrokes input whilst the browser is waiting do not buffer, unlike in classical mainframe/terminal designs. They're just lost or worse might randomly interrupt your current transaction.
- HTML has no concept of keyboard shortcuts, accelerator keys, menus, context menus, command lines and other power user features that allow regular users to go fast.
We adopted web tech even for productivity/crud apps, because browsers solved distribution at a time when Microsoft was badly dropping the ball on it. That solved problems for developers and allowed more rapid iteration, but ended up yielding lower productivity than older generations of apps for people who became highly skilled.
HTML has had a limited concept of accelerator keys for years, but it's not pretty:
https://developer.mozilla.org/en-US/docs/Web/HTML/Global_att...
All of these (except logging on to the same data from all my devices, which is nice) benefit the developer at the expense of the user.
Glad you pointed that out. And, in the most prevalent application of Conway's law[0], those changes enabled and are entrenched by the "agile" practices in software development. Incremental work, continuous deployment, endless bugfixing and webapps fit each other like a glove (the latex kind that's used for deep examination of users' behavior).
It also enables data siloes and prevents any app from becoming a commodity - making software one of the strongest supplier-driven markets out there, which is why the frequent dismissal of legitimate complaints, "vote with your feet/wallet", does not work.
----
- Very high latency
- No support for online updates
- Impossible to easily administer
Cross platform was much less of a big deal when web apps started to get big. Windows just dominated in that time. Not many people cared about macOS Classic back then and desktop UNIX didn't matter at all. Browsers were nonetheless way easier to deal with than Windows itself.
Agree that killing piracy was a really big part of it. Of course, you can implement core logic and shared databases with non-web apps too, and the web has a semi-equivalent problem in the form of ad blockers.
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).
- 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 prescriptions provided to you from a previous doctor? Reduction in time to phone / fax the previous doctor. just click a button.
- Want to check if your insurance covers your procedure? Receptionist calls the carrier, sits on a 6.5 minute customer service wait queue, then gets the info versus 1-click.
- and, and...
It was always about productivity.
In general, I'll note producing documentation is fairly slow and tedious. It takes something like an order of magnitude longer to write a sentence than to read it. So this optimization is only going to be a productivity boost if this paperwork is accessed repeatedly, dozens of times in the course of treatment (the productive thing).
What paperwork creation increased as a result of digital record use?
I'm beginning to think y'all are conflating the increase of documentation with the use of digitalization. The two aren't mutually exclusive.
I think what we're talking about is a clear (if non-typical) example of the Jevons paradox[0]. Digitalization makes creating and processing paperwork more efficient, allowing the overall organization as a system to support/afford more of it. As a result, amount of documentation and form filling increases.
----
According to the Ford Motor Company, its fuel economy ranged between thirteen and twenty-one miles per gallon. There are vehicles on the road today that do worse than that; have we really made so little progress in more than a hundred years? But focussing on miles per gallon is the wrong way to assess the environmental impact of cars. Far more revealing is to consider the productivity of driving. Today, in contrast to the early nineteen-hundreds, any American with a license can cheaply travel almost anywhere, in almost any weather, in extraordinary comfort; can drive for thousands of miles with no maintenance other than refuelling; can easily find gas, food, lodging, and just about anything else within a short distance of almost any road; and can order and eat meals without undoing a seat belt or turning off the ceiling-mounted DVD player.
A modern driver, in other words, gets vastly more benefit from a gallon of gasoline—makes far more economical use of fuel—than any Model T owner ever did. Yet motorists’ energy consumption has grown by mind-boggling amounts, and, as the productivity of driving has increased and the cost of getting around has fallen, the global market for cars has surged. (Two of the biggest road-building efforts in the history of the world are currently under way in India and China.) And developing small, inexpensive vehicles that get a hundred miles to the gallon would only exacerbate that trend. The problem with efficiency gains is that we inevitably reinvest them in additional consumption.[0]
In other words, you're too narrowly focusing on "miles per gallon", not the fact that "any American with a license can cheaply travel almost anywhere, in almost any weather, in extraordinary comfort; can drive for thousands of miles with no maintenance other than refuelling; can easily find gas, food, lodging, and just about anything else within a short distance of almost any road; and can order and eat meals without undoing a seat belt or turning off the ceiling-mounted DVD player."
For example, in the show Mad Men, you'd see a whole floor full of human beings who's sole job was to type out letters on typewriters. Now, those jobs are obsolete and the white collar worker is responsible for them. Still bullshit paperwork, but the white collar worker now has to do them.
The overall trend for productivity since it was tracked in 1947 has been on an upward trend with its sharpest 1H downward trend ever this past year. Are you seriously suggesting white collar workers magically got more bullshit paperwork just these past 2 quarters?
[0] - https://www.newyorker.com/magazine/2010/12/20/the-efficiency...
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.
None those are related to use or lack of use of technology. Those are purely bureaucratic rules setup by insurance carriers.
> And back in the paper days, the staff would pull up the records for the days appointments.
And sometimes those papers would get lost, or maybe they're still sitting in the folder on a door because someone forget to clean them up, or they were in the wrong order so it took the person longer to find the person's name, appointments would shift, etc. etc.
I can't believe I'm having to explain to someone the productivity advantages of a system of record to a technology focused crowd...
They are very much related to use of technology, because they are enabled by technology. The degree of bullshit paperwork every white-collar worker has to deal with nowadays is a direct consequence of computers making it possible to make us do that work, and for the recipients to process it.
The benefits of those processes are whatever they are designed to be, but this creates a false image of net productivity, because the costs are now hidden, smeared across everyone's workload, adding to a vague sense of dissatisfaction and low productivity. In contrast, if you tried the same processes few decades ago, it would mean hiring dedicated people on both ends, and the costs - as measured by their salaries - would be clearly visible.
> I can't believe I'm having to explain to someone the productivity advantages of a system of record to a technology focused crowd...
You don't have to. But you're missing the disadvantages of the situation when maintenance of that system of records becomes a job distributed across everyone. It's not the digital recording per se that's the problem, but the fact that everyone is now also their own secretary.
These are bold claims backed up by little to no data other than your anecdotal observations. Productivity has generally been on a steady upward trend in the US since it was first measured in 1947. My own professional service business, which does require a decent amount of "bullshit paperwork" would not have been possible at the scale it achieved without technology.
> In contrast, if you tried the same processes few decades ago, it would mean hiring dedicated people on both ends, and the costs - as measured by their salaries - would be clearly visible.
Ever seen Mad Men? There was literally a full floor full of human beings typing out bullshit letters on typewriters because computers didn't exist in the era.
That's my point: those people received salaries for typing out those letters, making the cost of it clearly visible to the business.
Explain that one to me.
$68 Billion in medical fraud in the US
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139931/
Part of the opioid crisis caused by basically bribing doctors
Yes I’m well aware that when drug abuse was happening in the “inner cities” where the government looked the other way because it was more concerned with propping up countries during the Cold War, the same people who want to treat drug addiction like a “disease” when it’s happening in “rural America”, it blamed “single mothers” and “lack of morals”.
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.
Absolutely no way a modern system could be half as efficient, short of completely automating the whole job (which involved a lot of communication with other parties and basically freeform restrictions).
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..
In the EHR space, all the CMO (chief medical officer) cares about is it helps keep them in compliance. Why should they care if it’s hard for their office staff to use?
So there were two sides, the engine optimizations to assure things like tab orders on a form, and the was the actually writing the form descriptions. In the first couple organizations that adopted it I wrote the forms and the engine in parallel adding feature flags/controls as needed to support the desired UI outcomes. Later after I quit, the lady who wrote much of the RFP responses started writing the actual form descriptions because it was just as easy as drawing them out in the (visio?) plugin she was using with MS word and doing screen captures for the RFP. Then I guess because she knew how to do it, was doing the "tuning" as well.
The latter is definitely not the problem. Even the Twitter re-design from a couple years back still supports all the old hotkeys.
All it takes to at least support a tab-based workflow is using the "tabindex" property if your form isn't logically laid out already, and the rest can be done by capturing hotkeys.
Even multimedia content can be operated using hotkeys. Youtube is a good example. There's no excuse but laziness and incompetence IMO.
[1] https://developer.mozilla.org/en-US/docs/Web/HTML/Global_att...
If you watch people use the sabre command line interface (the one from the 1970s?), you can see some of what i'm talking about when people are just filling out the forms with the submission line, its less using the GUI and more just knowing some sequence of keystrokes that results in an action being taken.
AKA its possible to do both, without having the user wear out the tab key, or grabbing the mouse all the time.
A sign up form that a given user will only use once in their lifetime is another matter. It needs to be simple lest the user abandons the process. Most users in that case are not willing to learn keyboard shortcuts, tabbing over optional fields probably makes more sense here.
I'm constantly writing UI for sports teams who do not at all like to waste time with these kind of fiddly UI elements and flows. Most of them would likely stick to Excel if our solutions are more cumbersome (which is a high bar to meet/beat, but rightfully so). They need to be able to easily get to data and relevant, connected pieces of data, quickly enter data into relatively complex forms, and have it all be clear, reliable, and fault-tolerant. This means making some tradeoffs, particularly around what is considered modern UI aesthetics, and doing things most UI developers don't need to do such as automating little things, adding hotkeys, etc.
Kind of a hard core position in my opinion considering it's ignoring the sometimes advantages / use cases for client side code (like complicated SPAs where the user is explicitly buying into the idea of running lots of code in their browser, figma comes to mind) but I still like to think about it here and there.
99% of web applications are not Figma and probably do not need any client side JavaScript. The amount of JavaScript that's actually just wrong is incredible.
1. I don't care what your client side validation thinks. That is my email address.
2. Why are you serving people all of the news story if you are going to then hide it? We can block the JavaScript and read the news.
So I don't disagree on merit alone, but it seems if we wanna do a good capitalism, we need to make sure people are actually giving us real emails apparently
In fact, it makes the experience generally worse.
Tying this back to the top-level comment: at some point I've realized that so many SaaS would be better off as an Excel sheet, because they're fundamentally just a slower, buggier, much less productive and uglier version of one. But the point isn't efficiency and empowerment. The point is control: the SaaS forces the user to a specific workflow. One that makes it easier for developers to develop (by constraining the problem space), or for company to monetize, or for corporate to retain legibility - but rarely to actually help the end-user.
As an end user from a generation that was taught Excel and MS Access at school, I'd go as far as saying that 50+% of web applications I use would be an order of magnitude more useful if the UX was that of Excel or Access.
I preach this all the time. Anyone who has to enter data really wants excel and not the fancy wizardized stepped workflow that seems to be the norm nowadays
I suspect an overwhelming majority of use cases is for this reason alone.
As you say the web is a culprit but so is attempting to shoehorn mobile designs into desktop.
With some OS's you can't even have fine grained control over those defaults anymore. Dark modes have brought some of it back, so its better now than 5 years ago, but still worse than 20 years ago. But people pretend that having a dark/light switch is the same thing as being able to customize the color of just about every layer of the UI and have the vast majority of the applications honor it.
Where we partially lost that is when UX started to get async. It's not fundamentally incompatible with well-ordered input messages, but in practice, people who write async code all too often forget that it's async all the way (and not just for their favorite scenario). And so you get travesties such as textboxes that let you type text into them, and then erase all that when the app or the page is "fully loaded".
I was at the post office here in Australia a few years ago and saw the screen. It was one of those DOS-era full screen red and blue text interfaces. She was flying through hotkeys and getting things done. People can learn, so much software treats them as infants.
And you know there's definitely someone looking at replacing that software with a modern GUI.
You should see the customized JBHIFI terminal + keyboard.
Bloomberg terminals also have a custom keyboard and are essentially a terminal program.
It was supposed to be read:
A [ncurses or gum] workflow.
Gum being an alternative method of making a Bash UI.
At the time I had no idea why. In hindsight, it's hilarious. I'm guessing it was the result of a clash between someone that wanted to use modern tech for the sake of it and someone representing the users that told them to get fucked, probably went through 15 meetings before eventually getting palmed off on the intern so it didn't pick up too much steam (probably the only good decision that was made in the whole process).
So learning an interface is frowned upon. Every interface must be designed as if the user has never seen it before.
Which is ok, as long as there’s also an alternative path which may take time and effort to learn but leads to increased efficiency and productivity.
Unfortunately, that alternate path takes a lot of effort. And worse, it leads to very few extra sales. The company which puts in the effort to build a complex but efficient workflow in addition to the initial easy workflow will get beat in the market by competitors who only focus on the easy workflow that looks great in demos leading to the C-suiters to buy it.
The best example is the pioneer of both these trends. Apple. It used to be that Apple insisted on a single button mouse so the primary interface was extremely easy to use. Yet, it spent a lot of effort including keyboard shortcuts, which were prominently displayed, everywhere. Unlike Windows, which basically only had Ctrl/Alt modifier keys, Apple has had the Ctrl/CMD/Opt modifier keys as integral parts for a very long time, encouraging those shortcuts. Apple also put s lot of effort to make their, and 3rd party applications easily scriptable (the choice of AppleScript however always held this back). The most MS did was VBA for Office.
But once Apple entered the iEra, it realized it didn’t need any of this to sell products anymore. The massive lag in supporting basic keyboard shortcuts on the iPad when using a keyboard is one of the strongest evidence for this.
Completely agree with all of this.
Adding that it's not even web technologies that can't be used. My work Mac had an issue with a Bluetooth mouse, removing and adding a Bluetooth device with the keyboard is basically impossible using tab as nothing gets highlighted to show you switched to it and some of the crucial parts don't get toggled through.
Modern GUIs are absolutely not fit for purpose.
No one knows what they really want till the software starts getting written and someone finds out they can't do their job, then come change requests (made a lot of money off of them). You kind of just get numb to it all.
---
The system distinguished between errors that halted the machine, requiring a restart, and errors which merely paused the machine (which allowed operators to continue with the same settings using a keypress). However, some errors which endangered the patient merely paused the machine, and the frequent occurrence of minor errors caused operators to become accustomed to habitually unpausing the machine.
One failure occurred when a particular sequence of keystrokes was entered on the VT-100 terminal which controlled the PDP-11 computer: if the operator were to press "X" to (erroneously) select 25 MeV photon mode, then use "cursor up" to edit the input to "E" to (correctly) select 25 MeV Electron mode, then "Enter", all within eight seconds of the first keypress, well within the capability of an experienced user of the machine. These edits weren't noticed as it would take 8 seconds for startup, so it would go with the default setup.[3]
---
... which allowed the electron beam to be set for X-ray mode without the X-ray target being in place. A second fault allowed the electron beam to activate during field-light mode, during which no beam scanner was active or target was in place.
Previous models had hardware interlocks to prevent such faults, but the Therac-25 had removed them, depending instead on software checks for safety.
The high-current electron beam struck the patients with approximately 100 times the intended dose of radiation, and over a narrower area, delivering a potentially lethal dose of beta radiation. The feeling was described by patient Ray Cox as "an intense electric shock", causing him to scream and run out of the treatment room.[4] Several days later, radiation burns appeared, and the patients showed the symptoms of radiation poisoning; in three cases, the injured patients later died as a result of the overdose.[5]
---
In response to incidents like those associated with Therac-25, the IEC 62304 standard was created, which introduces development life cycle standards for medical device software and specific guidance on using software of unknown pedigree.[7]
You also have a hardware lock on the power - this can be as simple as a hardware timer (a RC circuit siffices) which limits how long the emitter can be on within in a given window to be safe.
Never trust the software. If you must trust some software, create a minimal set you CAN trust which isolates the rest of the software from the hardware.
You are correct, the discussion about how to exercise this bug (fast UI, blah blah) is interesting to hear but totally irrelevant to the lesson (don't trust software).
Not in medicine (run a small e-commerce business selling mostly used video games), but definitely noticed the same thing for us.
We have some terminal-based Python scripts I wrote to automate a lot of the data entry tasks like listing and shipping (entering tracking numbers, printing labels).
Everyone that uses the scripts is initially apprehensive, but then after maybe a day of getting used to the terminal turns into a powerful data entry God and they love it. Even had an employee gush about our shipping tool to a random supplier.
The greenscreen data entry was highly optimised to not even require tabbing to different fields, but just run the values together in a large single field and the software would split them into fields and validate them.
I assume it was very fast and efficient for the experienced operators.
I can imagine this being true. It seems that almost the whole software industry has failed to grasp the distinction between an appliance and a tool. An appliance you expect almost anyone to be able to use without training. A tool, well you are expected to learn how to use it, and after that, you are much more productive than before. And most software seems to be moving towards appliance.
Well, EHR is a glorified billing platform.
Thing to remember finance/economists/rentiers have a different definition of efficiency and productivity than you do. In this case the productivity has to do with billing not the uninteresting things that doctors do. By reducing the cost of billing and forcing doctors to document more things to be billed more money can be extracted.
Productivity is indeed a selling point.
I will also tell you that EHR software is universally hated by doctors. Does not matter who makes it. The company that cracks that will make billions.
One interesting idea was a voice assistant wired up to take inputs as doctors did their work. I don't think it went anywhere (yet).
Considering how often I have to fill out the same goddamn forms (sometimes literally down the hall in the same building as another doctor), I think that goal failed miserably.
While in the hospital, the phlebotomists came after me for routine lab work at hospital prices. I declined and then I had a conversation with the nurse about releasing my labs from June to them. On script, she said "Mmm, 4 months is kinda old! We'd rather do our own!" so I filled out the ROI anyway, and curiously nobody offered to draw my blood again.
This comports with my most recent experience using SAP in 2018. I know, I know, SAP has GUIs and such now. This well known and profitable corporation under the Blackstone umbrella, though? Nope. It was exactly as you describe.
Those who had the time-in-service or the mentality to accept it excelled at their job, but uniformly skewed older (late 40s and up) or younger (under 25). At the time, almost everyone aged in between was entirely befuddled by it all.
Context: supply chain, procurement, purchasing, logistics, maintenance, work orders, inventory
First, yes, productivity was one of the goals of the forced move to electronic health records systems. The federal government passed the HITECH Act in 2009 creating economic incentives for doctors to switch to EHRs because it would be better for public health, Medicare billing, and also because it would supposedly unlock doctors to spend more time with patients and be more productive, via the use of technology.
The reason that third thing has failed, to my mind, is largely because the government, in the same act, required a HUGE list of requirements be met by the software designers making the EHRs. This list, by law, needs to be prioritized in scrums over customer requests and design thinking. Sometimes it makes good UX impossible.
Ironically, the government, hearing this feedback, actually added a new requirement to the list: "Safety-Enhanced Design" [0].
Go read that regulatory requirement and see if it makes any sense to you. That's why design sucks in EHRs.
[0] https://www.healthit.gov/test-method/safety-enhanced-design
I will say that small, private clinics who only accept private insurance don't necessarily need to use a federally certified EHR. They are legally allowed to build their own system. One example is OneMedical. When you ask the doctors/PAs/nurses at OneMedical about their EHR, they actually love it.
I think the first step would be validating my anecdotal experience here by polling doctors using non-certified EHRs to see if they like them more. If they do by an overwhelming amount, I'd first take that evidence to the Office of the National Coordinator (the government agency created by the aforementioned HITECH Act who makes the certification criteria). I'd tell them that if they vastly simplify the criteria and add more flexibility, they'd make doctors happier.
I guess the problem is that happy doctors, unfortunately, isn't necessarily aligned with the existing federal laws. Probably you'd need to pass a new statute at Congress, this time around with the benefit of talking to a lot of people with experience making EHRs.
I considered targeting standardization in health tech for a while and uncovered a similar layer of red tape as you describe. We can't continue to let our medical system continue to lag behind the rest of the world's and good EHRs are a part of that.
I'm not entirely sure about this. During the early digitization era productivity was a big driver. Modern word processors are a godsend if you've ever tried to typewrite a document for publication (forget anything with complex formulae) or dealt with actual physical spreadsheets? Office itself and it's now many clones is a fantastic set of tools for productivity.
My opinion is that we've created a world in technology now that drives technology for the sake of tech and financial drivers. I regularly deal with people who think it would be a great idea to build a system to automate some aspect of business that's already well optimized or generalize something they thing is general but is really quite niche.
There are certainly cases where it makes sense to develop a system around something but you need to consider the full cost/benefit tradeoffs, not just benefits which industry tends to do.
As the company customized more and more of the code base, upgrades to the system became more and more difficult. Every upgrade required a manual comparison of custom code to be merged with the baseline code. This led to skipped upgrades, and eventually a cessation of upgrades. Of course, after no upgrades over a long period of time it was eventually decided to move to a new ERP system.
I am still appalled at the things sacrificed to prevent disruption of a small group of peoples work flow.
If it can't be upgraded, it's not because of its a terminal app, it's because it's poorly designed.
It’s less the software, and more the users, site-specific configuration and the environment they work in.
Non-US Epic users spend 20-60% less time on various EHR activities than their US counterparts. One of the most dramatic differences is time spent on ordering, which you would think would be as optimized as it could be.
Time spent documenting was 40 minutes/day for US users and 30 for non-US on average. Maybe some spend 50%, but that’s far from average.
https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Another study found US clinicians write 4x longer notes (cited in above).
Now, does any of this improve clinical outcomes?
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.
How does this reduce/eliminate the “better document this thoroughly in case I get sued” work?
Or are the legal worries overblown/over-relied upon for over-documentation?
I think the legal worries, when it’s in concierge medicine, are over blown because at that point you are seeing a physician that is doing more quality than quantity to make ends meet. You don’t need to document to appease the biller but document enough to know what you did and so that you could share your chart notes with other providers in case the patient ever moved to another provider or (super rare) if they were admitted into the hospital and they needed some documentation for whatever reason. DPC, you are the boss and control how many patients you want to take on. In general private practice, you are at the mercy of the hospital system, payers, etc etc and are pulled in 7 different ways to make money which only benefits them and not the physician. Even then, with primary care, you are told you are a “loss leader” since we aren’t specialists and generally dumped on in the medical field.
In “private” practice, you need to see 20-30/day patients to make your salary (break even) without bonuses within a hospital/health system. That means about 400-450 patients per month. Major payers limit you to 3,000 patients under your care overall.
Studies show that 1,000:1 should be the max patient:physician ratio but many of us are around the 2-3k mark. In a true concierge medicine/direct primacy care model, since it’s mostly cash/subscription model, most of physicians average 300-500 patient panel per year which is about 4-6 patients a day. If you want to see more and make more on the side, see 400-600 patients. Are you an older doc who wants to practice but not see many patients, see 2-4 patients a day, 1-2 days a week and cover costs and still make a comfortable living.
Like I said, something is going break in the medical system and it’s only a matter of time. When it does, the healthcare disparities and inequalities will really become more apparent. Hospital systems/admins/insurance companies are now leaning on mid-levels like NPs/PAs as a bandaid to the issues of patient access but what will happen when you burn them out too?
/rant
Tldr, concierge medicine, your own boss, do whatever you want with your charting. You can chart 5 words or 5 paragraphs. Most physicians will chart enough to document well for medical and legal reasons and not have to worry about billers muddying the waters to over-document. Quality time with patients = less legal risk.
These automated analyses don’t capture whether the extra content is beneficial or not (it might be!).
I know many Drs and especially nurses who CYA on all their documentation otherwise insurance will try to pin them on an adverse reaction.
You will also find many cases where even good providers let things slip through the cracks and fail to give some patients the appropriate level of care. For example, diabetics should generally receive annual foot exams, eye exams, and hemoglobin A1c tests. If the payer doesn't see evidence of those in the EHR then they can prompt the doctor to resolve that care quality gap.
Related to this, but in a completely different context, I have had similar thoughts lately when eating out at restaurants in Spain. It's incredibly frustrating from a customer's point of view when the waiter taking your group's order has to use a newfangled tablet or phone-like device and tap through each individual order, often depending on the peculiarities of the app's UI and how the designers expect the process to carry out: “Are you all having the set menu? No? OK, first I need to know how many of you are having it?" [taps count on screen] "Right, now I need the starters but ONLY for the set menu orders..." etcetera—you get the idea. Then, while going through this unnecessarily slow process, God forbid someone who ordered from the set menu wants to change their main while the waiter is already taking the à la carte orders.
Meanwhile, in restaurants that haven't unnecessarily techified the procesz, the waiter can take the order in the way that's most practical given the circumstances and that best fits his way of taking notes. Ah, but then how does the order reach the kitchen without the tech? I have no idea, all I can say is that it worked fine before these things were put in place, and the manual system is by far the quickest and most flexible from a customer's point of view.
Though Quebec, Canada, had such a problem with “zappers” that would delete orders from the electronic system that every restaurant now must be online with the tax authority and every receipt has a tax authority response code on the top.
There’s so many things we keep trying to shoehorn tech into that don’t need it— electronic ordering/serving food, planning a small gathering of friends, making a smoothie [1], “smart” fridges/toasters/stoves… these are all adding unnecessary knobs and bobbles to things humanity has gotten by just fine with for ages (the first since the dawn of civilization!)
As a general rule to “will this be tech useful” I think in terms of scale— is this new tech enabling/helping me to do/manage something 10x-100x better than I could with existing tools? Sure, I can organize a single dinner/cocktail party of a couple dozen people via paper invites or text messages and phone calls to caterers, and using tech for that is likely introducing unnecessary overhead, but if I’m a planner organizing many weddings of 100+ for a living then, yeah, obviously a party-planning management software will be of use.
If not, its value is likely not worth the hassle.
[1] https://amp.theguardian.com/technology/2017/sep/01/juicero-s...
At least they don't require that we install an App. But I'm sure someone's thinking that would be a good idea.
"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 pause, so they have peculiar ideas resulting in enforcement of weird and unproductive business processes.
I guess the restaurant saves having to pay a person at the counter to take the orders, at the expense of massive customer frustration to the point where I hardly ever go to these places anymore. And then they wonder why their year-over-year sales are declining.
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.
Voice assistants are still stuck at that 90% point of "good enough to be impressive, bad enough to not work in practice". The selling point of free-form voice recognition is that you don't have to learn the language of the computer. I still believe this is bullshit. You have to do it anyway, but there are no references for it. Hell, even the developers don't know what the "language of the computer" is, because it's defined as "whatever the ML model doesn't choke on".
It would be much better if we stuck to structured natural-language queries with controlled vocabulary[0]. People would quickly pick up on it, and even if it sounded a bit artificial (not much worse than interacting with voice assistants sounds anyway), it would at least work.
> 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.
The older I get the more I see it, that it's literally most software in a nutshell. Starting with Office suite - yes, the word processors, calendars and spreadsheets - that killed dedicated secretarial jobs and distributed the work they did evenly across everyone.
----
This is how the restaurant chain deploying those kiosks sees it.
> the restaurant saves having to pay a person at the counter to take the orders, at the expense of massive customer frustration to the point where I hardly ever go to these places anymore
This is self-correcting over time, as more and more places adopt such systems. It's just another supplier-driven market. Fast-food restaurant meals are not really commodities. If I'm in a mood for, say, a McDonald's cheeseburger, there is no other vendor I can get it from[0], so I'm going to suffer through the kiosk experience. It's calibrated to be just about bearable enough that I'm not going to skip the meal because of it.
Everything seems to become more and more like this, in every market - burgers, fridges, cars, phones, webapps, everything. As annoying and abusive as possible without making it a deal-breaker, offered on a supplier-driven market, so the non-annoying, non-abusive alternatives don't exist.
----
[0] - Yes, Burger King next door may have similar cheeseburgers, but they feel and taste different enough to be non-substitutable. But even if, guess what, they also have those stupid kiosks.
For another example see touch-screen automotive UIs, universally hated by everyone except the bean counters, so we're stuck with them forever.
Also WRT the BK next door, its probably 5 minutes away by car or 30 minutes away on foot, which explains the corporate push toward "Walkable cities" and so forth. At my last onsite office job, there was a deli on the first floor and we were essentially captive customers; in theory there were plenty of places to walk within a half hour walk, but in practice its raining and 40 degrees so we were forced to shop at the company store, so to speak.
He habitually called me "friend" and was very frank about my insurance not paying for stuff I was asking about, which I appreciated. He also once profusely apologized to me for placing a computer in between us. He said the new requirements of his practice made it so he had to pay more attention to the computer than to me, and we were both sad about that.
The doctors I got after that make no such apologies.
It may or may not be true (I suspect some of the stories on that site are made from whole cloth), but it speaks to your post.
The latter in my experience ends up providing better results to physicians as they have been employed as domain experts in building the software solution to their specific workflow. I've seen it done for in ophthalmology, specific disease/injury specific radiology, and diabetic specific checkup and appointments where I've seen as much as a 75% reduction in the amount of time the physician has to dedicate lookup up info, cross-referencing, and documenting.
Then you upgrade and everything breaks!
But it’s an age old battle for and against standardization. I just walk around with several charging cables because each is “the best” for charging a small li-ion battery.
In a way, all might be a huge early optimization.
I'm not sure whether this choice was a case of incompetence or corruption, but the end result is clearly a giant waste of money. Maybe it generates a lot of data, but efficiency would be way more important for an organization like this which is chronically underfunded and staffed.
I don't think "by almost any measure" is right. I think in a very narrow sense they've become less productive (they see fewer patients), but by your own admission they're building databases of patient data, which you seem to suppose are only useful to the likes of Epic, but obviously Epic has customers--notably healthcare researchers use this data to improve patient care, develop new medicines, and to precisely identify which medicines are likely to help on a particular patient (and which medicines may even harm them!). This is stuff clearly benefits society, and doctors' role in this should be counted as "productive", although we can quibble about the relative value of facilitating healthcare research versus seeing more patients.
Note that this isn't meant to vouch for Epic--I work for a company that consumes their data and anyone who has to integrate with them has nothing good to say about the software, but the role it plays is still incredibly important.
The point of extensive documentation is shielding from the worst of malpractice lawsuits. The legal system is still of the legacy opinion that doctors have a responsibility to their patients as opposed to the more modern understanding of responsibility toward pharma company bottom lines, and all patients legally deserve the 100% successful participation trophy, so a documented decision with only 95% chance of success means insurance payouts about 5% of the time, unless its carefully documented it was all the patients fault or at least the MD could not have known the outcome in advance.
This is blatantly false. Pharma spends tons of money to buy this data for their armies of researchers in order to determine outcomes. There's an entire very lucrative industry (that I work in) which exists to source this data from hospitals and refine it for researchers.
If the point of documentation was CYA, then you wouldn't need complicated systems like Epic to standardize the documentation and make it available for electronic processing (you would just have some paralegal pour over the records of the individual patient).
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 humanity to the system, as the OP is hinting at, could very much be a part of the fix.
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!" <- insurance companies aren't going to pay for those drugs if they aren't proven to work).
> 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.
This is true to a degree, but outcomes for real healthcare rely on much more than research, as you’ve indicated.
Documentation is part of that research, of course, and whether they have short-term or long-term effects for researchers’ ability to work out better treatment is relatively lossy.
Actual treatment also includes the rest of healthcare (training, hell, even their housing costs), and rules-based or centralised administrative systems backed by insurance don’t necessarily create the right environment for that information to be propagated more widely.
People training to be health workers don’t use the frequency or quality of medical research papers to decide whether to become a doctor.
I think there’s a view you can take on the information topology here that’s a little odd in how it’s currently set up — documentation for front-line workers and information wealth for researchers feels like it’s relatively polarised.
The majority of the notes being written by doctors now is boilerplate. A lot of it is copy-pasted. It's written because of insurance companies (which have incentive to deny claims), because of liability (which gives incentive to leave a lot of notes behind to make it looks like you thought about everything under the sun even if it wasn't applicable), and because of well-meaning but ultimately overly broad laws adding additional requirements even when they don't quite make sense.
I'm sure there is a treasure-trove of valuable data in there, especially compared to when it was all hidden away on physical paper. 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, so recouping anywhere near 40% of their time would be a priority.
It seems more likely that the paperwork is actually pretty useful (but the utility is not obvious to the lay observer), or at least useful enough that the wasted time isn't significant to the healthcare industry (which is already struggling with margins and personnel).
Doctors are expensive, but malpractice lawsuits are more expensive. Documentation is extremely important for lawsuits. If you get sued because a patient you saw last year later died and they're alleging improper health care(just to use a random example), it's highly dependent on having meticulously documented notes that document every single examination finding and treatment administered. Your memory isn't going to be accurate, and the prosecutor is going to be looking for any errors in documentation they can use.
I am sorry, have you been in the workplace in the past 20 years and have you tried adding up all the meeting that get shoved into your calendar? I am lucky if 50% of my day is not taken away from me
To imply that someone from higher up wouldn't tolerate' that most of my time is spent in meetings is simply laughable, they are the ones creating them!
You mention profit efficiency, but all three of my points make sense even in light of that: (i) insurance is literally the way doctors get paid; (ii) lawsuits are hella expensive, and (iii) regardless of profit incentives you can't not follow the law.
The software that doctors use is terrible. It's a perfect combination of extreme complexity, domination by just a couple companies (Epic and Cerner), legacy software (some still written in mumps, I hear!), and tons and tons of regulation.
I believe the VA has poured literally billions over the last decade to fully modernize it. It hasn't happened yet to my knowledge.
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 side of a "researcher centric" or "societal centric" approach. Doctors should do what's best for their patient, not necessarily what's best for society, or themselves, or a lawyer, or a research lab. It's easy if you work in one of those tangential areas to take your eye off the ball.
Or, by extension, it limits the amount of time with each patient if they have a throughput constraint to stay solvent.
Tbf, I’m not sure the data supports the claim that doctors spend less time with patients, but the increase in documentation does seem to correlate with doctor burnout.
Just to provide an example of this I ran into today: I'm doing a medical physics residency, and my supervisor was explaining that a new "fail-safe" incorporated into the software that reverted the collimator after every scan was now making the phototimer tests take twice as long, because we had to go back into the room and reset the collimator repeatedly. We tested a machine with the new system and one with the old system and it did in fact turn a 15-minute task into around 35 minutes.
To contrast, my first job was an accounting program. We spent weeks on making sure everything works via just the keyboard and some operations are as streamlined as possible. Because in some cases it was going to be used by people creating hundreds of invoices per day.
In case it's of interest I wrote an article a couple of days ago on how "Digital Systems Fail Institutions" [1].
[1] https://techrights.org/2022/10/26/when-digital-systems-fail/
Everyone was very busy but it was very hard to get actual care.
I'd ask another question: did lawsuits decrease? I'd imagine that a lot of this software is to avoid lawsuits. America is especially litigious and that's got to correlate strongly with the increase bureaucracy.
I also suspect that a factor at play is that people are losing trust in the whole system. Most people now know that productivity has skyrocketed while salaries have remained relatively flat. With increasing economic disparity (not even just the West) it is no wonder that people become less productive. Who tries hard at a game that they believe is rigged against them? (doesn't matter if it is or isn't, just the belief)
> People in tech keep thinking more tech will solve problems
Because historically it has. But there are different types of tech. Tech enabled the modern world. It is the new medicines we have to cure illnesses that devastated populations. It is the chemicals that enable us to grow enough food to sustain our populations. It is everything from a wheel to the computers we use to make more efficient wheels that use less resources. But it is also naive to think that tech alone can solve every problem. It is also naive to think that tech can't create new problems. To create tech that solves problems we need to think long and hard about the intricate complexities involved and gather the expertise from relevant domains (an often missed, but essential, component). The other problem is that people hand wave away things like climate change saying "tech will solve it" rather than investing in said technology and waiting for it to magically appear. I do think tech is an important tool in solving many of the problems we face, but you're right that they are not all technology dependent (which is a continuous scale of weights, not a binary option).
Also, we're a tech forum. Peoples' expertise here is in tech. So they see things through that lens and it is also very likely that the most we/they can contribute to solving these problems is, in fact, through technological means. The trick is to remember that tech isn't a cure-all and that the problems we face are exceedingly complex. Over simplifying is often harmful.
With big systems though I honestly think GUIs can only go so far, even at their very best, and any system that is required to be complex at some level will require expert knowledge of the system itself. That’s extra work and an extra burden for someone with the critical experience that an organization relies on.
For doctors and the like it would make sense to try a system where the critical person/expert has an assistant who is a systems expert and does a lot of the needed data entry and the like. Doctor doesn’t have to worry about the system, they can talk to the assistant who manages all the extra work. If the system needs to change for any reason the assistant manages that and the doctor doesn’t have to worry about it.
I think of this assistant role as the human API layer. It’s not far off from some social programs like insurance navigators, who help individuals find health insurance, including working through options and even—critically—filling out forms for folks.
ETA: It’s a thing! I didn’t know: https://en.wikipedia.org/wiki/Medical_scribe
My daughter works at Epic, and she explained that one (though not the only one) of the big reasons health care is so expensive is because Drs have so many record-keeping requirements, and one reason they have these is because of liability. It would greatly help if Americans weren't so lawsuit trigger-happy. The real winners are the lawyers (and insurance companies).
Figuring out the right amount of automation in business is hard. Too much automation makes the company too rigid to the point of breaking but too little reduces productivity. This is a dilemma that factories/companies have to constantly re-learn. We see it regularly. A new manager comes in and decides that a company can save a truck load of money by completely automating production. But soon finds out that there are too many variables in life and that total automation can't work. The goal should be to find the sweet spot that produces the maximum while being flexible to change. But I don't think this is why productivity is dropping.
I suspect it's related to the reduction of reliance on foreign factories. The US wants to reduce the reliance on foreign manufacturing and bring all of that production back to the US. That will take time, capital and ability to learn how to do the work here. That will hit productivity hard. All than change won't happen cost free in terms of productivity and assets. The change started a few years ago. We are beginning to see the result.
I recognized this problem in the 90's because I worked at a manufacturing plant where the software, even then, was getting in the way of workers needing to do something a bit non-standard (they developed workarounds over time).
It's also why I'm a big fan of the 80% solution, I think there's a level of hubris involved in going for the 100% solution for everything.
To your point about trust, it's something I've been thinking about recently. Not trust, but the authoritarian nature of software, which expresses itself and is purchased for the ability to distrust. You'll see this in things like debates about whether or not developers should be allowed to affect the deployment via yaml files or not. What makes it difficult is there is often a legitimate need for these sorts of systems, especially for regulatory compliance, but more often than not they just get in the way of actual work.
What's the source?
I love our current preschool precisely because they use very little technology: we actually talk to the teachers during drop-off and pick-up if needed, and get maybe one email a month. Their expressed philosphy is to be "present" with the kids and spend as little time as possible on other (administrative) things.
You are high if you think we are better off with paper than an ePCR.
Sometimes we have to default back to paper, some times the pt record system goes down.
When that does happen, it's a literal fucking nightmare in the ER.
We plan on it happening and we train for it happening, but ePCRs have made our lives so much fucking easier. Simple fucking fact.
Have you ever had to read the pissed off notes in a hand-written chart from the last nurse who has been working 48 hours straight, taking care of 12 critical care pts? Huh? Give that a try sometime.
Our apps security policy put the kibosh on that and I had to destroy my account once I realized it would not be feasible to keep it going forward.
My employer is really conservative about allowing 3rd-party apps, which is great for security, and puts us in a veritable Stone Age of productivity.
But even here, the purity of the labor market is hampered by rules designed to protect the laborer- osha rules, overtime rules, rules about how much a person can be controlled, and so forth. If you eliminate all those, and focus only on the making labor freely able to be bought and sold, you can begin to see what a completely pure free market for abstracted, commodity labor would look like.
It is this: The most pure example of a free market for labor is a slave auction.
Computers are just state machines, without determinism and a few other properties they do not perform work. Determinism means there is only one next possible state/action.
Breaking rules would imply there are two or more possible states or actions, and that is a class of problems that computers cannot solve (they talk about this in compiler design courses). Most people subscribe to magical thinking because they don't know how computers work, or what they are even.
Now, your company pays insane amounts of $ for software, systems, and data! You have to do your job, schedule your meetings, keep up with the ungodly amount of email, instant message, SLACK, enter the data in your CRM, talk on the phone, schedule the video meetings, etc. while also keeping track of your personal phone because your partner called or the school called and your dog is sick. There's just so much distraction now by not having "office hours" and having our whole lives in our pockets and constant reach that I think productivity has to go down. It's impossible to focus on anything for any amount of time anymore with how accessible we are expected to be.
To be concerned about the current level of productivity requires either the attention span or the intelligence of a goldfish.
Which, in generating lots of hate clicks, is a huge economic boost in terms of Nonfarm Business Sector Labor Productivity!
You may kindly shove it, NYT. I'm not going back.
https://www.nytimes.com/2022/10/29/technology/return-to-offi...
Every time I've read that section, it felt like product placement for luxury home realtors and commercial property owners.
> Quiet quitters continue to fulfill their primary responsibilities, but they’re less willing to engage in activities known as citizenship behaviors: no more staying late, showing up early, or attending non-mandatory meetings.
Yes, we should all bereave the withering of classical virtues—like sacrificing our health and time with loved ones in order to provide free labor.
The fed is increasing interest rates to keep dollars attractive as a world currency and allows the US governments to keep increase national debt whithout sending interest rate of through the roof.
It may seem counter-intuitive, but letting inflation going out of control would have a major negative impact on demand of debt issued in dollar or, to make it short, US government debt.
The only alternative would be to fund government spending with government revenues. Which means, increase taxes for categories of revenues which amount the most in national revenues.
It seems like the median journalistic piece assumes this of the reader anyways?
It annoys me that an article about a big drop in workplace productivity doesn't actually say how big the drop is. If it's only 3.6%, then that explains why they glossed over that part, as it would have undermined their narrative.
Given the sharpness of the drop, the timing with wonkiness in a whole slew of other economic indicators, it's bizarre to me that the author (and experts interviewed) would immediately assume that something changed with workers vs the metric is behaving weirdly.
My niche has shot through the roof for demand salary and remote with no sign of turning back.
My only macro explanation is 20% left the gig totally.
Good thing I have both.
Productivity is based on the value of the work done, not any profitability assessment. The original post which set off this chain asserted it was about not how much workers get done but how much money is made off of what workers get done ... which is unambiguously wrong.
I don't believe the difference is consequential here, since the originating point still holds even using your definition. I wouldn't say it's "wrong" so much as imprecise, as the way I interpreted the statement would encompass your more detailed description.
It's like when I ask people "how much money" they make, I intend them to include non-cash compensation in the number (in dollar equivalent), and pretty much all do without additional prompting.
I was playing loose with the jargon meaning for sure, but I'm pulling out to what articles in the Washington Post or other economics-focused media really care about: the impact to corporate bottom line.
Here's another example: you volunteer at a homeless shelter, where you serve food on a soup kitchen line. You have contributed to the GDP of the United States. By all means, feel free to fit this into your preferred framework.
The input to labor productivity is how many hours are worked, correct? And no one is measuring output in terms of the number of bowls of soup produced by homeless shelters; those are converted to dollars based on a current index price.
So you have economic activity, how much money changes hands, compared to labor inputs, how much workers work. Simple?
"GDP measures the market value of the goods and services a nation produces. Unpaid work that people do for themselves and their families isn't traded in the marketplace, so there are no transactions to track. ... The lack of reliable data influenced the decision to leave household production out of GDP in the internationally accepted guidelines for national accounting." (https://www.bea.gov/help/faq/1297)
"Economic activity" that does not equate to "money changing hands" in some form, isn't an "economic activity" that counts for GDP or productivity, right?
The Bureau of Labor Statistics does have multiple teams dedicated to documenting how price is related to quantity of output. They don't literally count bowls of soup at every homeless shelter, but they do document millions of price vs quantity measurements on a regular basis. This data is then used in the calculation of productivity.
So you can make a beautiful thing for your home - not GDP. Make it and give it to someone - not GDP either.
Pretty sure money has to change hands, or in the case of government, we measure it as $ spent.
So if the amount of money that is exchanging hands goes up but the amount of goods and services produced stays the same, then the measured productivity does not go up.
You may be thinking about how GDP is calculated, specifically regarding government employees. For this category of spending, the "quantity" measured for the dollars-to-quantity ratio is simply the number of government employees. So as long as the government is hiring more people, the money they spend on those people counts towards real GDP, regardless of what those people are doing.
However, government spending is not used in calculating productivity, which measures only certain parts of the private sector where it is possible to also measure output of goods and services instead of relying on measures like 'employee counting'.
Productivity is not a measure of prices, profitability or anything similar. It’s a measure of output per unit of input.
Classic HN downvote fest because people incorrectly disagree with a factual post.
The solow residual is technically total factor productivity but is generally accepted as labor productivity. it's just an accounting identity that is estimated along with GDP and other vaguely useful but not very accurate measurements like the unemployement numbers.
This is so true. The amount of bureaucracy has actually increased. This makes every worker work more. But this bureaucracy is unproductive work, thus does not lead to a rise in income (for the company).
E.g. my healthcare provider uses fax machines (yes that FAX) to communicate with insurance providers. Fax is asynchronous and without confirmation/tracking of work done. Often, the fax is sent but the other side simply files it in a random place or forgets to process the work. So, I (the patient) now needs to follow up for weeks with insurance and healthcare provider to check on the status of that FAX.
This is unproductive work and yet, it is taking a toll on every individual involved in this process.
In addition to being weirdly defined, productivity is, as the graph demonstrates, very unstable over the short term.
If you want a longer version of the graph in the article, see "The 1990s Acceleration in Labor Productivity: Causes and Measurement" from 2006 (https://files.stlouisfed.org/files/htdocs/publications/revie...), page 190 (10 of 22).
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.
We build structures to take a one in a ten thousand year flood or earthquake, but it's too much to expect corporations to keep more than 2 weeks of stock? Sure.
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.
Panic buying of paper towels early on in the pandemic, as an example, was not predictable.
What? It was entirely predictable, except maybe for those high-end executives who live in hotels and/or with full-time house service, and are thus completely detached from life of ordinary people.
The panic buying was limited to the most obvious category of goods: basic consumables with some degree of shelf life, prioritized by survival and then comfort. This means food (particularly canned, shelf-stable, or freezable - plus baby food and pet food - and ingredients, including flour, yeast and baking soda), hygiene (soap, toilet paper!, and - perhaps specific to pandemic - hand sanitizers and masks), fuel, household cleaning (including cleaning agents and, surprise surprise, paper towels), comfort consumables (coffee).
It's not hindsight on my part - think of how people individually decided what to buy. They didn't buy whatever they see everyone else buying. They just asked themselves: what do I eat? How do I keep myself and the household clean? What else do I buy on a regular basis? What do I need to maintain a semblance of my current lifestyle? The answers, prioritized, were what everyone then went to stock up on.
*in the USA.
The post-bretton woods era is one of globalization, with American jobs being sent overseas (to more productive labor forces)
This doesn't even account for the incredible decline in civility from customers if you work a customer-facing job. The slightest inconvenience or mistake can end up in a tantrum by an American adult that only sometimes gets captured on video. And in the meantime, a bunch of people walk around opining that "Nobody wants to work anymore" as if they deserve to be waited on hand and foot regardless of circumstance.
This year, companies expect workers to return to office, despite little change in conditions, except now we have to deal with all of the above issues you've just mentioned, AND the fact that employees have now proven they can work remotely perfectly well.
It should neither be surprising that in a system where healthcare is tied to employment, that productivity jumped while people were locking themselves in their houses from a plague, or that productivity dropped afterwards, or that it might drop given the complete callousness of our current system.
In support of this—part of it!—here’s one paper of many: “The Neurobiology of Long COVID” by M. Monje, neurobiologist at Stanford, and A. Iwasaki, immunologist at Yale.
https://doi.org/10.1016/j.neuron.2022.10.006
People with measurable neurobiological issues will show a measurable productivity drop.
[1] https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
Low cortisol is very common. That’s just one example. With low cortisol it’s hard to feel good or function 100%.
One paper of many that show this kind of relationship (a preprint): “Distinguishing features of Long COVID identified through immune profiling” — https://doi.org/10.1101/2022.08.09.22278592
It’s also important to note that there was a study that seemed to show that Long COVID was just anxiety or in people’s imagination. Because people who said they had Long COVID didn’t have SARS-CoV-2 antibodies. The thing is that not everybody seroconverts. Not everybody actually produces antibodies after infection; We simply can’t exclude Long COVID diagnoses based on looking at those particular antibodies. So that study can’t show what it has been said to show. (I can provide sources for this but am out of time. It’s on my honor.)
Either way, the treatment should be the same. Take a corticosteroid to lower the IL6 & 10 levels, ensure the patient is getting proper sleep and nutrients, and not doing anything to exacerbate lowered serotonin/dopamine levels, and cross your fingers.
I've started to hear of companies that are testing for elevated cytokines as a proof of long covid, and my family member's hospital has started educating their staff on cytokine release syndrome in the rare patient who has a reaction to a vaccine shot, both of which, for me, imply the industry might be moving in this direction for explanation. fingers crossed
60% of 160 million is 96 million. So 5% of that is 4.6 million people or so with at least a solid portion of a year of symptoms.
There's mounting evidence that some of the damage could take years to recover or even be lifelong.
The current word from the Mayo Clinic is about 20% of folks have what they're calling Post-COVID Syndrome between one month and one year after an infection, with at least one symptom likely from the viral infection. https://www.mayoclinic.org/diseases-conditions/coronavirus/i...
If we look at 20% of 60% of the workforce that's around 19 million people symptomatic for over a month after the initial positive test. Twelve percent, almost one in eight people in the workplace.
It’s a bit worse than a cold but much better for than the flu. So, yes, for us life just goes on with COVID. No need to change anything.
https://www.webmd.com/lung/news/20220707/each-covid-19-reinf...
Not necessarily worse, but there is cumulative damage.
In the UK, about 7% of COVID cases that get medical attention are now re-infections. That number increases with time; it was only 4% last February. Immunity from getting COVID is time-limited and not that long. One study said "time between reinfections ranged from 90 to 650 days, with the average being 343 days".
Over a decade, this might gradually debilitate most of the population.
Paper: Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection – https://doi.org/10.1038/s41590-021-01113-x
Paper: “Excess risk for acute myocardial infarction mortality during the COVID-19 pandemic” — https://doi.org/10.1002/jmv.28187
Paper: “p53/NF-kB Balance in SARS-CoV-2 Infection: From OMICs, Genomics and Pharmacogenomics Insights to Tailored Therapeutic Perspectives (COVIDomics)” — https://doi.org/10.3389/fphar.2022.871583
SARS-CoV-2 directly and indirectly interferes with p53 expression and balance.
On p53: “p53, cellular tumor antigen p53 (UniProt name); p53 proteins are crucial in vertebrates, where they prevent cancer formation. As such, p53 has been described as "the guardian of the genome" because of its role in conserving stability by preventing genome mutation. Hence TP53 is classified as a tumor suppressor gene.” — https://en.wikipedia.org/wiki/P53
The literature goes on and on and on. People really are not okay after contracting this virus. I know plenty of people who simply are not recovering after COVID illness. Friends. Close family. Kids.
We are being warned.
And crucially: We can clean this crap out of the air. Nobody has to breathe in SARS-CoV-2. We absolutely must demand that something is done. There’s lots and lots that can be done.
> We can clean this crap out of the air. Nobody has to breathe in SARS-CoV-2.
?? What do you even mean. Maybe if the vaccine prevented spreading the virus we could but until we develop that I don't see how that is possible.
Re. cleaning it out of the air: It’s literally airborne and it can literally be cleaned out of the air.
When infected, people emit tiny fluid particles which contain the virus. These are so small that they don’t fall to the ground. Filter materials like in HEPA filters and respirator masks strip these particles out of the air. Very effectively. (Surgical masks don’t work. Same kind of material, gaps at the sides. It doesn’t work.)
We can literally clean the air. We do not have to breathe this virus in. That’s just one of the things we can do.
Paper: “Effectiveness of HEPA Filters at Removing Infectious SARS-CoV-2 from the Air” – https://doi.org/10.1128/msphere.00086-22
Paper: “The Removal of Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Microbial Bioaerosols by Air Filtration on Coronavirus Disease 2019 (COVID-19) Surge Units” – https://doi.org/10.1093/cid/ciab933
“Ten scientific reasons in support of airborne transmission of SARS-CoV-2” – https://doi.org/10.1016/s0140-6736(21)00869-2
Why am I saying all of this?
Because I have a moral obligation to do so.
Why do I know this?
I don’t know anything. I’ve just read those scientific papers.
Why did I read them?
Because high-risk pregnancy.
But does it apply outside of high-risk pregnancy?
Yes.
It's shocking how much this can help with other things e.g. asthma or allergies.
I abandoned it some time ago because it is now a "pro-union eco-chamber".
I once advocated serious changes to the labour laws are what is needed, and was inundated with "join a union" posts.
It really speaks to just how out-of-touch these people are.
Unions only care about large corporations because they can get a lot of members and union dues. The issue with this logic is that small businesses are often totally out of the unions reach and laws benefit EVERYONE. The other issue they overlook is Union contracts only apply to those in the union and can change greatly from one union to the next.
As i said, i just found it shocking that "join a union" was their only response.
Labour laws impact everyone, union contracts don't.
AFAIK, unionized companies in Norway statistically were more profitable than ununionized ones.
This might of course be because it is more tempting to unionize when there is a lot of money to be had, but I remember one extra detail:
In between (friendly) ribbing I also remember the union people here being focused on working efficient so that our bonus would increase :-)
Strong unions are the way to get changes in labor laws and how to get collective action.
If we could all just magically come together without any organizational structure in order to effect change in the government and laws we would have already gotten it done.
There isn't a way out that doesn't involve organized collective action and something that looks very much like unions. Individualism doesn't work to effect the kinds of changes that are necessary.
People were inundating you telling you that you needed a Union because what you want is a magical pony, and unfortunately you're the one that is out-of-touch (although in another sense you're not at all out-of-touch since most people believe that there simply MUST be some way to effect change without collective action--which continues to fail but nobody will give up on the dream).
I do not believe for one second that the person selected for this interview was a good representative for the cause ( although I am sure there are some goofballs, who can't seem to present a coherent case even on hostile territory that is Fox News ). I did not follow story that closely, but I believe the person that took the interview got serious blowback from its reddit friends.
The sad thing is a lot of people will form their entire opinion of it based on this one interview. To me it is OWS all over again ( I do not count BLM as that since it had Democrat political machine, and later business machine, backing ).
That's 10 days where one of the parents has to work from home and be horribly unproductive because they are watching a child at the same time. And you can get COVID repeatedly. It often from the daycare itself, but also from a sibling who is in school. Even with full, boosted vaccinations, they can still catch it. They don't get very sick, but they have to quarantine.
It's unsustainable.
I'm sure that's not the only cause, but it's definitely a factor.
The remaining Covid policies are stupidly inconsistent anyway.
RSV is far more dangerous to children, but that is allowed to go unchecked. Hell, you have to pay $250+ just to get tested for it. Rhinovirus/influenza/norovirus/rotavirus/other coronaviruses are all OK, with kids leaking from both nostrils in the classroom.
But one kid or adult gets Covid and things have to close? Covid tests are paid for by government, but testing for all the other viruses costs hundreds of dollars? What a farce.
Could you imagine if there was some test that showed you all the viruses that are circulating in your system at any given moment? If we applied the same rules as we do for covid to such a test, people would literally never be able to leave their house...
None of the other viruses have caused a pandemic, and changed the course of human history (except influenza, but that was almost a century ago).
Have people literally forgotten that entire countries' health systems were overwhelmed by this virus? Seems like it would be prudent to keep infected individuals out of our public school systems for a few more years.
https://www.reddit.com/r/medicine/comments/ydhvbs/how_are_my...
Although, the whole hospital volume thing is now wrapped up in pay shortages and rationing of healthcare, so do not really know how much the spread of virus is contributing and how much the lack of resources being put towards healthcare, and specifically pediatric healthcare is contributing.
> Seems like it would be prudent to keep infected individuals out of our public school systems for a few more years.
This is not possible unless you quarantine toddlers and young kids from each other for years, and I am not willing to pay the price of my kids’ development.
Not to mention that parents need to earn incomes to shelter and feed their kids.
Also, I have had 5 Covid vaccine injections, my kids have had 2, but there exists no RSV vaccine. And RSV is specifically bad for kids, causing a fever almost every time. Given the lack of voting power for those affected, I imagine there is not much political will to spend money on expediting R&D for an RSV vaccine. Just like how pediatric healthcare gets reimbursed at 60% to 75% of adult healthcare.
I mean, sooner or later the people working in schools are going to be fed up with parents' constant refrain of "The whole world needs to sacrifice their health so I don't have to keep my kids at home for an extra week."
Somewhat similar to the healthcare workers' issues you mention in your comment.
But the huge, unavoidable disruption that comes from a positive test result certainly doesn't encourage frequent at-home testing. I think at this point most daycare parents test when the school tells them to, and don't test otherwise.
now at my kids preschool, if a kid gets sick they stay home, if they are better the next day they come back. no PCR tests, no missing 2 weeks if any member of the family was sick, its great
Well, you kids have fun.
sound of me closing the door in my pyjamas with a nice hot coffee in my other hand
Not sure if you're in a customer facing job, but I've personally noticed that there seem to be noticeably fewer Karens now compared to pre-pandemic levels. (There was a spike during the first lockdown, but that died down within a few months.)
Everyone seems to be used to random disruptions now, and I think all of the campaigns about retail worker abuse have really made customers stop and think.
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, having a laugh in the board room, perhaps a pub visit after work - to sitting alone at home for 8 hours staring at a screen.
So I quit. My productivity - gone. And I fear it's never coming back unless that environment comes back; because I can't effectively function at a "job" with zero human interaction for an entire day, I've had to replace traditional work with other activities.
But is it just me? My friends in retail and other low skill jobs - half the workforce seems to have disappeared so they're all being asked to do far more than is realistically possible. My friends who are in education - the entire job changed, no more giggling and laughing children, you were playing a video game with half the class absent. Perhaps they're back now - but they're dysfunctional because their development was neglected for years. My friends who are in law - the entire job changed, no more travel, no dressing up, sit at home with a screen. My friends who are in medicine - christ, let's not even go there, eh?
I can't speak for those people. But I know that I need a reset, because this "new world" is one I'm just not built for.
No. I go into the office every day because I feel the same. I need to get out of the house and see people. (It is OK if you, reader, do not feel this way! People are different!) There's a handful of other folks who come in every day. I'm starting up a project this week to revive our office culture a bit, to try to spring back from the COVID devastation.
I appreciate your message. Good luck.
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 been some wins. My team went fully remote for 2 years and now most people still work 3 days a week from home. We were able to build up a large and talented team during the lockdowns with most of my co-workers and those I manage 3 timezones away. We adopted more flexible working hours and we've never been happier. My manager can take time in the morning to get his kids to creche and I can take a longer lunch to check in on elderly relatives. I no longer spend 2 hours a day stuck in traffic. Our productivity has skyrocketed. We may be privileged tech workers, but the change in work styles has definitely boosted our company as a whole.
You just say that like it's a fact, but... why would that be the case?
So I get the worst of both worlds: my boss can still come in my office at any random time and bug me about whatever, but not the social life or the ability to bounce ideas off each other when designing a new system. All-online communication simply does not work for creative or complex tasks.
The youngsters get practically nothing done -- I worked with them for several years before the pandemic, so I know for a fact that their productivity specifically went down 90% -- and guess who gets to pick up the slack? 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. No matter what excuses they make, it's not good for them in the long run, since it will be reflected in their CV. I'm not against fun, even during work hours, but you have to get the job done.
It's a medical research institution with a small clinic, so there are, as you suggest, additional issues there. I think science, in particular, requires in-depth, in-person conversations and that is where most of the really good ideas come from.
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.
just curious, why do you think that is? I spent several years working on project sharing and data visualization features for an architectural CAD program. you could show/hide/recolor all your objects on the fly to emphasize key details, sketch on top of viewports, play around with a clip cube in 3D (personally fixed a lot of bugs with that one...), and sync all your changes back to the main project file to share with colleagues. some of these features were a bit rough around the edges, admittedly, but I always got the impression they were pretty popular with our customers. I'm a little stunned to hear that you and your colleagues just want to print out a couple viewports and look at them on a piece of paper.
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.
Still trying to figure out whats next for me. This WFH shit is gonna stick around in our industry for a while... and it just isn't compatible with how I function. I have no clue what to do next.
Just wanted you to know that you're not alone.
That said, I don't have an overly long commute, so I totally get it for those that are able to be more productive due to not spending hours in the car every day.
I notice that when I'm working from home, I'm much more likely to goof off and be less focused. Plus my wife being there is always distracting me with one thing or another. I'm pretty sure I'm quite a bit less productive working from home.
More generically: young kids require attention, then we grow up and most adults desire attention but only get a little.
Even very high status individuals often seek attention (Elon & sinks?). I wonder how much of our status economy is about getting attention?
Giving great attention can be quite the aphrodisiac.
I'm an introverted person, I like solitude. But I guess all things in balance, it would be nice to talk to another adult once in a while about something that's not work.
I got really into Crypto, because Crypto seems to have a heavy focus on community. It was fun to fly to NY and talk to others in the community. But then I flew home, and the spot was missing again.
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 some sort of abberation with how the complex statistic or productivity was calculated (e.g. inflation was actually here earlier than measured by CPI, and output was deflated incorrectly).
Either way, this is much more likely a pandemic related disruption and return to normalcy, rather than an indication that anything fundamental is "broken"
Now with everything reopened there are many more options.
Productivity almost always goes up in a recession, especially one accompanied with massive layoffs (like early COVID).
Productivity is going down right now compared to 2020 because we are pretty much at full employment.
These productivity measurements aren’t really tracking individual productivity at all.
So the measurement during periods of recession or expansion will always be artificially elevated or suppressed.
Their chart shows we are far below any sort of pre-pandemic baseline.
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."
The chart is showing "annual percentage change in labor output", not "gross productivity" which I think supports the OPs point.
If it went up 10% in 2020, and 6.3% in 2021 (or whatever the graph is showing), just because there is a -7.4% drop in 2022 doesn't mean its "far below any pre-pandemic baseline".
In fact it's probably ABOVE pre-pandemic levels, even with the drop. I can't be certain from graph.
Musical instruments from the 30’s are legendary.
https://www.epi.org/productivity-pay-gap/
Productivity kept on climbing and wages stagnated post ~1980
Time for the workers to reap some of that benefit.
The trend is towards less immigration and thus lower demand for goods/services and lower supply of labor.
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, IMO, attributed to NIMBYism, mixed with a nationwide inability to build densely or build public transportation infrastructure).
edit/ And let's not forget, there have also been 2 disastrous, major wars, one of which inarguably never should have occurred.
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.
https://www.pewresearch.org/fact-tank/2021/11/04/amid-the-pa...
But what if people realized that it was only a delusion, that it can never be that everyone is rich, because then who would do the dirty jobs? There is no social pyramid without a base, this system is litterally designed to have a class of poor people forced to do shitty jobs to survive.
If you take away the hope of a wealthy future, there are no reasons left to slave away your life on a corporate ladder.
At the same time, corporate outsourcing reached epic proportions, with the associated transfer of power in the HR and Exec realms.
The growth of government sopped up the difference. Nothing the government does comes for free, and then there's all the additional costs of complying with regulations and doing all the paperwork.
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 produce economic product over the next few decades bringing in $400 to the economy. Net win for everyone.
That's where the money comes from. Or would you rather be like Russia where you have a giant potential economy that outputs less than Italy and doesn't give a damned about corruption and has terrible quality of living standards/longevity?
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?
That hydrant was probably too expensive (maybe; insufficient data to say for sure). The damage if a fire breaks out and no municipal fire system is available in a modern city is catastrophic.
I gave real examples, not hypotheticals.
I never said government spending was zero-sum.
> That hydrant was probably too expensive
The bill was $10,000 for a $3,000 job.
> The damage if a fire breaks out and no municipal fire system is available in a modern city is catastrophic.
At $10,000 a pop there'll be a lot fewer hydrants installed, and hence greater risk of catastrophic fire.
China's GDP growth consistently out-paces the US. Canada continues to do well. Germany has consistently positive GDP growth with a few exceptions related to international downturns. And, of course, if you're talking about countries that use economic stimulus, you'll have to include the United States, which has the largest GDP in the world. I think your claim requires a tighter definition of "economy" and "do poorly" to hold merit.
Everybody is doing more poorly than growth estimates, but (a) COVID just happened and (b) everyone always does worse than growth estimates; growth estimates are the rewarded metric and therefore incentives are high to over-estimate it in extrapolation as another form of incentive (i.e. aim higher than you want to hit).
The second issue is your overall thesis seems to be "the government is inefficient," which is fine to say and to criticize, it certainly is inefficient by many measures, but I feel like you're hinting at some kind of alternative that I can't possibly guess at. Usually these discussions take two routes: the capitalist one, wherein you argue that private industry is more efficient, which even if we accept that efficiency is the only valid measure of how we should choose to do things (amazon builds road faster and cheaper than government: then puts a toll on it so only the rich are allowed to use it. this is bad), is probably not true[0] or possibly the opposite of the truth. Maybe you're more anarchist in your leanings, in which case you're arguing for more distributed and local management of these kinds of services? That could be a really interesting conversation, is that what you're suggesting?
[0] https://gsdrc.org/document-library/is-the-private-sector-mor...
1. the amount of money it spends
2. the amount of interference in the workings of the marketplace, usually called "unfunded mandates" where they put burdens on businesses
> I feel like you're hinting at some kind of alternative that I can't possibly guess at.
A much more limited government.
yes, government spending increases, always. I'd need to be convinced this is inherently bad lol
2. the amount of interference in the workings of the marketplace, usually called "unfunded mandates" where they put burdens on businesses
What about subsidies, when businesses only exist because of government intervention at all? What about Harley Davidson? The banking sector?
> A much more limited government.
How limited? Is it allowed to prevent monopoly? You seem to know enough about the subject to know that making the state too limited will merely lead to the establishment of state power by monopolistic corporations instead, from plenty of historical examples.
It's no different than me 20 years ago installing a server for a client. I would go out slap it in and turn it on. I did not architect the applications on it, nor configure the firewall rules on the router for it to work.
News articles are written about exceptional things, not the mundane.
Besides, everyone knew the flow was sufficient because it would be the only hydrant upstream of a flow reducer in the main line. I.e. there was plenty of pressure in the line.
The drawings were completely superfluous to a bog-standard install.
> News articles are written about exceptional things
That's true. The hydrant wasn't in the news. Want another one that wasn't exceptional enough to make the news? A nearby one mile stretch of road has been undergoing repaving for THREE YEARS now.
BTW, did you read the article about SF? It blames the permitting process which takes forever and $$$$. That affects everything in SF.
The history of that EPI report is useful to know. Early versions of it showed a large gap between rising productivity and stagnating employee compensation.
Some critics then pointed out problems with the analysis [1]. The report performed an apples-to-oranges comparison of productivity of (A) all non-farm workers adjusted over time with a (B) GDP deflator-based inflation index compared with the compensation of (A) a limited subset of employees adjusted over time with a (B) CPI-based inflation index. A more useful comparison would use the same inflation index for both data sets and would exclude from the productivity measure the workers that are also excluded from the compensation measure. When this is done, the growth in productivity and pay rise and nearly in lockstep, thus effectively refuting the majority of the point that the original report was trying to make.
Since then, the EPI report has been updated to be more nuanced, which can be especially seen when one expands the 'click here for more...' sections. The new conclusion from the report is that productivity and compensation increases have been increasing primarily for a subset of workers while a broad subset of workers have not seen large productivity and compensation growth. This is true (as far as I can tell), but it's also a different story with different policy implications than the original story which implied diverging productivity and pay within the same set of workers.
[1] https://www.heritage.org/jobs-and-labor/report/workers-compe...
Salaries aren't growing that fast.
Personally, I love what do, and this fact didn't affect the ability to work. However, I can imagine some people can get seriously affected by that.
https://www.macrotrends.net/stocks/charts/KR/kroger/profit-m...
Of course, a business with sub 3% profit margins maintaining sub 3% profit margins is hardly news, but inciting anger for no reason does result in more clicks.
I remember tons of studies showing that remote work had caused unprecedented increases in productivity so it seems plausible to me that companies ending it caused the productivity drop which caused the minor recession earlier this year (the big one due to the Fed's rate hikes is, I believe, still in the future). The article itself even acknowledges that remote work increased productivity yet ignores the 50 foot tall elephant in the room that is RTO.
Edit: Also, what does "torturing ICs with RTO for reasons of executive vanity" even mean? Have we come so far that working from an office is now "torture"? If so, the level of privilege is simply astounding...
When I see phrases like "executive vanity", I immediately picture a manager, who saw the productivity numbers gained and decided that those do no matter ( and some of us did go above and beyond specifically to show that there is a benefit to WFH for companies ) and instead opted for butts in chairs for no other reason than "I want to feel like I still matter". Some executives refers to this as management by walking.
<< Have we come so far that working from an office is now "torture"?
It is kinda like this. We all know WFH is possible. We know it results in good results for the company and yet management opts to RTO. They want me to commute, force me to get up extra early, almost kill people on the way two work if I do drive by car ( because I am sleepy; not because I am postal ) and somehow match the productivity that was happening precisely because we implemented WFH? Yes, by comparison it is torture. I had a glimpse of heaven and it was forcibly taken away from me ( it wasn't taken from me, but please understand that this is the mindset ).
edit: And, if you buy into one specific poem I will not name, hell is everyone but heaven and therefore torture.
Whether you agree with it or not is irrelevant. Put yourself in their shoes. See the world through their eyes.
If not, a good chunk of the people, who managed to keep the companies afloat during covid will bounce ( and some did ), because those are the people that actually knew what to do when SHTF.
"Between 2019 and 2021, the number of people primarily working from home tripled from 5.7% (roughly 9 million people) to 17.9% (27.6 million people), according to new 2021 American Community Survey (ACS) 1-year estimates released today by the U.S. Census Bureau."
I Initially thought maybe the issue is average reported over years, but that does not seem to match either so I went to BLS[2] and the 7% number is there, but it is for for April 2022 and not its peak.
Chart data suggests double digit average.
Please correct me if I am misreading something.
[1]https://www.census.gov/newsroom/press-releases/2022/people-w... [2]https://www.bls.gov/opub/ted/2022/7-7-percent-of-workers-tel...
That is, I can't rule this out. But I would also not bet against reversion to the mean. Such that the actual waterline on productivity is probably not known, just yet.
IMHO traditional economic metrics are not well adjusted to an economy where output is largely independent of effort or hours worked, particularly not when measured on a quarterly basis. I work for a (remarkably slow and bloated) tech company. If I choose to do nothing other than post on Hacker News, that will not become apparent in company performance for ~2 years, because that's the median time for a project to make it out to market and start having an effect on consumer behavior. The company could lay me off and it wouldn't affect the bottom line at all, but it'd boost productivity. Conversely, if I hire a new person, I don't see significant gains in output for ~2 years, but employment and hours worked has gone up, and so productivity is down.
The limiting case for this is algorithmic cryptocurrency trading with mark-to-market accounting (of which there was plenty in 2021). Here, you have computers trading virtual assets back and forth at ever increasing prices. Because prices are going up, the value of everyone's assets increases, and with mark-to-market accounting you'd show a profit. And yet nobody is employed and no real work is being done. Productivity is effectively infinite, but it means nothing.
If you think you're working towards something good: a family, home ownership, kids, a reasonable amount of life enjoyment in terms of leisure, a stable society, and a pleasant retirement where you can enjoy seeing your grandkids and participate in some hobbies for a decade or so before your mind or body collapse....you might be willing to push yourself to achieve as much as you possibly can, even if you're a lowly cashier or janitor.
But who wants to go the extra mile for this degenerate and hopeless society where your money is being destroyed and you have grave concerns about many things? Whether rightly or wrongly, everybody is seeing fucked up things in the world and many people are feeling much greater concern about the future than we've ever seen before. This isn't a recipe for going the extra mile at work or harnessing the energy of society to achieve something great.
> The productivity plunge is perplexing, because productivity took off to levels not seen in decades when the coronavirus pandemic forced an overnight switch to remote work
It also comes at a time when many employers are shifting back to hybrid schedules and RTO, despite employee claims that remote work allowed flexibility helped them work more efficiently
.
What a mystery.
Without seeing those numbers, my assumption -- and what seems to be implied here -- is that productivity rose in early 2020 with remote work, and it is now dropping to pre-pandemic levels.
I don't think anyone is going to argue about the conveniences this WFH culture has brought. And I'm certain there quite a number of people who can prove how much better their work has been because of this shift. Those who are being far less productive, though, are kinda ruining it for the rest of us and lots of managers know it. I think Satya is on point when he talked about what employers say about productivity and what their managers think is actually happening.
From personal experience, it was incredibly easy to do nothing when working from the office while remote you’re more held to your deliverables. In an office, it’s very common to see people look busy, but are just doing unrelated things.
The only difference is that in an office people mask their lack of productivity by pretending to be busy, whereas remote you don’t have to do that.
I honestly do not count "is he in chair staring at screen" as productivity. I count successfully finished projects as such, which brings to question what those managers are trying to measure if they are clearly failing so badly at this. I said before and I will say it again. Managers in US had an easy ride for the past 7 or so decades. Now they are actually asked to work instead of 'managing by walking' and they can't handle it. They need 'throw away their skill set due to Covid'. See twin trail of tears in my eyes?
Managers have all the tools they need and then some. The sheer amount of corporate monitoring software on corporate lappy is beyond astounding. Our manager does not seem to care, but I am horrified to think what other managers use it for. It is very, very intrusive. In other words, if managers can't measure even with those ridiculous and invasive tools at their disposal, what are they doing exactly?
<<I think Satya is on point when he talked about what employers say about productivity and what their managers think is actually happening.
Satya may be repeating what the managers are saying, but managers are saying that they have to actually work for morale and motivation. The horror.
<<Those who are being far less productive, though, are kinda ruining it for the rest of us and lots of managers know it.
Well, is it not manager's job to motivate and coach the less productive employee?
> Since the pandemic started, “the link between hard work and reward has been broken”
More like "since the 1970s"
"Real compensation" is "Employer costs for wages, salaries, and employee benefits", adjusted for inflation.
Why bother, nothing means anything anyways? Why bother chasing the dream, if it doesn't come true?
People have increasingly been losing meaning and purpose in their lives. Old dreams like home ownership, family (including extended), close knit friendships, and eventual financial freedom/security have been supplanted by travel (broken by inflation & lockdowns, made fake by social media), fur babies (due to gender disparagement and estrangement), workplace politics / friends for a season (as we move for work, and have increasingly tighter requirements for friend groups due to technology (ie you can find people who agree with you online, so no need to befriend the neighbor with slightly annoying political beliefs), and life time of debt and little investment value[1].
So people are simply burned out being asked to pursue a long run strategy w/ a "promised" dream. The people delivered on their end of the bargain, but the dream makers didnt.
[1]: https://www.macrotrends.net/2324/sp-500-historical-chart-dat... From late 1999 to 2016 returns on .inx after inflation have been down or flat. People no longer believe the "Buy the index and you will see profits" after 20 years of contrary evidence. Over the past 30 yrs the index using the "8% per year" usual claim, should have returned 10x but it actually only returned 1/2 that.
Why try, it's not going to work anyways?
Most of us are now paid less in real terms for our efforts than we were 1-2 years ago. If you convert your labor to something invariant, like carrots, you just aren't given as many for a day of hard work. So, to the degree that we are rational beings and have agency on the matter, we scale our output accordingly.
Over the course of my 10+ year programming career, I've seen this effect steadily increase. Promotions seem to come or not come regardless of how hard you work. Looking back at older books about the tech industry (and comics such as dilbert), it seems like this effect isn't new, but could be something that ebbs and flows over time.
> Productivity tends to move in cycles of 10 to 20 years
See this is what I mean. Perhaps there's a megatrend going on here. Promotions go to those who don't deserve it, so companies self-destruct in their own incompetence, and a new crop of companies rise up, promoting those who are actually productive, and they reign supreme for 10-20 years, before they too become bloated and start promoting under-performers (who look good on paper). And the cycle repeats itself.
I wonder how much bias affects the reported measurements? I doubt businesses outside of manufacturing can actually discern a 2% change in productivity, when screening for other factors, and some of them can't discern a 5% change.
They don’t, because productivity is not self-reported. It’s also not measured the way you imply.
Personal projects (software and art), learning skills (programming, instruments, video editing), improving at video games and sports. Not to mention leisure. All done "on the clock." To be honest, maybe the majority of the 40hrs I get "paid" for is actually used for this instead of company output?
the hardest part is the tension with the external guilt - but that is the point of the guilt after all
Labor power in the face of a recession comes from dwindling labor supply. 360k boomers retire each month in the US. 1.8 million people over the age of 55 die every year. Not enough folks to backfill.
https://archive.ph/2022.10.27-015740/https://www.businessins...
https://www.pewresearch.org/fact-tank/2020/11/09/the-pace-of...
https://www.daytondailynews.com/local/rising-number-of-baby-...
Everything still runs at McDonalds if there are half as many cashiers, but it will take a lot longer to get your Big Mac.
Everything still runs at the hospital if there are half as many nurses, but the level of care is much worse.
You get the idea.
With the McDs i've went into recently it appears everything still runs even if there are zero cashiers being that you can click your order in a big touchscreen.
Turns out that cooks seem more important that cashiers. Course we'll see see how much of that can be replaced by robots in the next few decades.
the reality is, companies absolutely will save significantly _more_ money by automating office jobs that cost significantly more than a cashier.
i’m not a luddite. i live, breathe, play in and firmly believe technology has _potential_ to liberate us, but anyone who celebrates that job automation will harm “the poors” but fails to see that obviously companies will automate their expensive mid/high tier employees asap is allowing their class snobbishness to blind them.
everyone in tech is familiar with the joke, “don’t screw with me or i’ll write a bash script that can replace you.”
Not exactly. Unless 100% of workers are only working 4 day work weeks, it's impossible to account for the confounding variable of other workers picking up the slack when analyzing these trends from a macro view.
This is very different from pre-WFH where I could physically find the person on Friday and stand there until they did whatever needed to be done.
I'm also a huge proponent of our new WFH world, but even I notice and can admit this disappearance of Fridays.
I try to fight back by only having TikTok installed on a Chromebook that I don’t often use and for YouTube Shorts, I count the number I have watched.
On my cellphone, if I want to waste time, I prefer a quick game of Chess.
I strongly recommend the https://freedom.to service as well as their podcasts.
I think a closely related issue is how everyone, everywhere, all the time seems to be arguing about political ideologies, or making every issue about red vs. blue or liberal vs. conservative or racist vs. antiracist or whatever other way people want to split others up and then talk about it all day.
I get that it's an election year in the US and people have done this for a long time, but I swear it feels like it is reaching an absolute fever pitch these past years that is different than before.
Because it seems so all-consuming, I think it distracts people from work even more than in the past.
This is very different from cocaine which can cause humans to perceive stimuli as more important and potentially more rewarding even without any rewarding component to the stimuli at all.
Using a computer is not a drug. Stimuli on a screen are no different from stimuli from looking at something else. Using a smart phone does not give you "hits" of dopamine. Stop conflating normal environmental stimuli with drugs that act directly in the brain. It is dangerous because the way governments deal with drugs, and the very real addictions possible, is violence. Bringing violence into this non-violent non-coercive context is immoral.
I believe this is one of the avenues argued for "Tech Addictive"/"Screens Bad" - that the intrinsic value of bzzzzzt could, at least hypothetically, be as high as, say, nudes or an "omw" text, or even your dealer texting he's 5min away; and that this inflated value is in turn projected, however briefly, onto every once-in-a-lifetime sale and useless 3am app notification about an icon set update or something.
There's also obviously the much-written-about addictive UI/UX features employed in various places. I vaguely recall one or two unfortunate email chains, maybe, but am assuming most product teams didn't go into meetings with nefarious intentions of getting their users psychologically addicted.
Nevertheless, addictions can be triggered by adjacent things, and however little dopamine "all the little red little circles all over the place" release in my grandmother's brain is probably very different from a chainsmoking coke user taking a swig from his bottle as he picks up his phone to see: - 32 New Facebook notifications! - Your dispensary order is ready for pickup! - sexybabe_notabot69 liked your profile! - Your bank account is overdrawn! - 18 new Twitter notifications! - ALL NEW SLOT MACHINES! NOW WITH DIFFERENT KINDS OF FRUIT AND SHAPES! - You're never gonna learn Spanish if you keep doing drugs, Carl! - DON'T MISS OUT! JIMMY BUFFET LIVE AT THE CASINO THIS WEEKEND! - Your order has shipped! - YOU'RE GONNA LOSE YOUR VIP STATUS IF YOU DON'T COME BACK HERE AND GAMBLE - Re: Hey - THIS WEEKEND ONLY!!!! ANNUAL ONCE-IN-A-LIFETIME SALE!
I think I could probably make the argument that maximizing for, say, MAUs/DAUs, is essentially an addictive cycle - a la "valueless reward" - in the business process, probably citing lots of business types who have written lots about how optimizing for the wrong metrics will leave your company broke and homeless too.
So, I guess I'm saying "Using a computer is not a drug", particularly as you used it, is nearly indisputably true, but somewhat misses the conversation being had (however dumb), and that it's worth looking at all of the links in the causal chain and examining how, for example, alarm fatigue and <sleep stuff> compare and contrast (and occur comorbidly with) actual addictive and/or depressive syndromes - for exactly the reasons you listed, like:
"We've found that homeless people using Facebook are xy.z% more likely to relapse on heroin, don't understand statistics, and therefore don't allow our clients to use the internet, except for this one from 2005 that lets them digitally sign the form we need to get reimbursed for the bed."
Bottom line, more competition is good for end customers, and good for productivity as well.
* My buddies in trade-based fields say they are working harder than ever, as their backlog has only increased in size
* Less scrutiny when working from home, more fooling around, less work
* Feeling that "grass is greener" elsewhere, therefore no longer being committed
* Polling has shown that their ideal job for Gen-Z is being a CEO of a company, but few seem motivated to start their own business as those stats have been down. Clearly there's a gap in motivation or understanding
Everything else about starting a business is far, far easier than ever. Almost every state in the US has streamlined the business formation process, made it cheaper and faster, etc.
It is trivial to go to healthcare.gov and buy the same health insurance an employer subsidizes for employees.
This is so shockingly false in most states that I don't understand how you feel you have enough personal experience to state this so confidently.
Neither California nor Texas have any PPO-style plans available on healthcare.gov. For all the public / self-employed plans, "Out-of-network" means "Pay for it yourself, this is not covered at all." That's a huge barrier to care when you need an urgent care and it's not clear which doctor at which urgent care might be covered.
Additionally the rates aren't just different due to subsidy, but due to quality of the participant pool. Many large employers are self-insured / self-funded, and the insurance company just administrates the fund, reimbursements, etc. However, the unsubsidized rates (made known to us via COBRA) are still much, much lower than the healthcare.gov rates because the participants are generally healthy, wealthy, and young.
When you buy healthcare.gov you get the shitty rates. This isn't just a difference of degree ... having a $100 deductible vs. a $6,000 deductible, or a $1,000 OOP max vs. a $22,000 OOP max literally makes the difference whether I can get my gastrointestinal cancer kept in check every year or not. I can afford the COBRA premiums for that $1,000 OOP max, but I absolutely cannot afford the healthcare.gov plan with >$15,000 in premiums on top of the $22,000 OOP max that I'm guaranteed to hit every. single. year. to get the care I need.
Anyone who is pro-business, pro-entrepreneur, should generally be for good public healthcare. This would relieve businesses of a LOT of administrative burden and overhead to let them focus on their core value proposition. It would also facilitate a lot of good startups by freeing people to go build something great. A lot of potential capital growth, innovation, and disruption is being wasted because the people who can do this are stuck in place.
Everyone can find out the cost of their health insurance including employer subsidized in box 12 code DD of W-2. Mine have been very close to the healthcare.gov prices, which NJ conveniently lists here: https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra...
Also, the individual maximum out of pocket maximum is much less than $22k:
https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
>Anyone who is pro-business, pro-entrepreneur, should generally be for good public healthcare. This would relieve businesses of a LOT of administrative burden and overhead to let them focus on their core value proposition.
The current situation where businesses get to silo wealthy, young, white collar workers into healthier pools of insureds, and the ability to purchase insurance with pre tax money rather than post tax for individuals whose employer does not subsidize is all beneficial to large employers. Which is how they like it.
If the US is going to stick with insurance system, then at least everyone should be dumped on healthcare.gov and employers completely removed from the equation.
2. select a plan
3. pay for it
4. congrats, you now have healthcare.
During industrialization "extended" rests where added before they where required by labor protection because they increased productivity.
Multiple experiments have shown that in some situations software companies can be nearly as productive with a 32h week then a 40h week.
As far as I can tell the US has been moving in the opposite direction, dismantling or avoiding labor protection and sometimes outright forcing people to work multiple jobs.
Similar having long term health issues you can't treat because you can't afford it isn't grate for productivity. One of the more successful (non-private) health insurances in Germany is also one which also covers comparatively many precautionary health checks/things. As it turns out making it easier for people to less likely get serious sick is cheaper in the long run.
Add to this that a lot of IT systems where added but in my experience many of this IT systems are designed for middle/high level management to look nice, instead of being designed with and for the people which use them.
Lastly add to it that the future prospects look not so grate for a lot of citizens (not just limited to the US) which kills motivation (positive motivations works in general better long term then threads).
So I'm not surprised.
People don't work harder because their work is unfulfilling, their pay is underwhelming, and their hours are exhausting. Inflation just went through the roof and half of all price increases in domestic product are directly corperate profits and even the most uneducated among us are aware that every single part of this system is rigged.
and the Washington post claims "no one is sure why" but in reality they mean "nobody in a position of privilege that we would hire or talk to has an excuse that doesn't point out the obvious things we can't say about class struggle and income inequality"
There is inherently a tradeoff here. Don't trust and verify takes longer than trust and don't verify.
At least when I worked in fast food, sure there'd be the nightly dinner rush, but that only lasted about two hours, then everything would quiet down and you'd get to take a breather, take your time, goof off with coworkers, put a movie in the VCR in the breakroom (it was a long time ago), etc.
Usually I at least take it a little easy the day we finish a sprint, but I still have to 'report what I did yesterday' in the sprint meeting the day after, so I have to have done enough to have some progress to report the next day. And then it's off to the races again. It's fucking exhausting.
They admit knowledge worker productivity if ‘tricky’ to measure, yet are somehow sure it has decreased drastically, with no link to evidence.
A quick glance at the chart in the article suggests that the variance of this metric is huge. It is more or less a white noise source with a small DC offset. Given the formula the BLS uses, I would be hard pressed to calculate my own productivity (outside of lawyers and people working on assembly lines or at fast food establishments most people do not keep track of their hours). If I can't measure my own 'productivity' then I have no idea how the hell the BLS is going to do it.
The best connection I could think of is something related to the company output, but in a market downturn I could be working 12 hour days, and the company would still be doing worse...
I think it's largely a monetary artifact. A bunch of money sloshed around the system. Those transactions inflated GDP. Then, with a lag, official inflation numbers caught up. Now "productivity" is lower than it had been at the peak, just because transients pass through our measurement systems.
Something about using the word "productivity" for this particular measurement feels borderline evil. So much that is productive in the vernacular sense is not productive in the GDP sense, and vice versa.
Having and raising children is productive (of human beings!), but it only enters GDP stats insofar as you buy formula, diapers, and college tuitions.
If you care for your own ageing parents, or if you raise your own children, GDP goes down. But if you take a job and pay somebody else to be a caregiver, then GDP goes up. Consider the extreme example of two women who pay each other to raise each other's children.
In Ukraine, wheat production is down. Some unmeasurable production of defense services is way up. Since the soldiers don't pay their squadmates to lay down covering fire, that working-together isn't captured by GDP.
We call it "productivity", but it's just a measure of intermediation by money. It'd be like measuring "social activity" as aggregate Facebook likes across the country.
The first sentence lists cause and effect (though it makes the same mistake of fact that leads to the mystification here): “As workers slowly return to offices after the pandemic, productivity has been dropping in the U.S. economy.”
It is not “after the pandemic”, it just after everyone has decided to quit acknowledging the pandemic. But COVID doesn’t give a rats ass about whether people acknowledge it, so when you stop control measures (by having “workers return to offices”) and stop accommodation measures (like additional paid sick leave) you get more people catching COVID at work, and more working hours where workers are impacted by the effects of acute or long COVID.
There are lots of people out of the labor force due to long COVID (which is part of the reason for the tight labor market), but there are also even more people in the labor force, and working, with long COVID; see, e.g., https://www.brookings.edu/research/new-data-shows-long-covid...
In the last year or two, at the peak of the employment boom, the answer was almost certainly to bide your time. If and when the supply chain returned to normal, you would then be in a good position to restore output to meet demand. If you had laid off a bunch of folks, you would have found yourself scrambling to rehire in one of the worst employment markets (for employers) in history.
However, with interest rates rising and a potential recession in the near term horizon, that equation might change. We could (and already) seeing more layoffs. I think after a year or two, we are going to start seeing productivity snap back as a result.
We're talking about a 4% change? That's the "plunge"? When it spiked during the pandemic, they were ready to conclude that it would always be like that, forever and ever, if not continuing to grow higher and higher? Both these positions are ridiculous, given how small the differences in both cases are, and how squishy a measurement productivity is in the first place. "If these trends continue, nobody will be doing any work in twenty years, and we won't even be able to tell you about it because we won't be working either!!!"
1. At the macro level, the increase was heavily driven by the fact that the least productive jobs were simply not being done. Blue collar workers were not working while white collar workers were.
2. At an individual level a massive increase in productivity was a result of people not having anything else to do so they were working a lot more.
Remote work might have led to an increase in productivity but these 2 factors definitely did. Yet people have been talking as if all the productivity increase was entirely because of remote work when it was almost certainly behind at least these 2 factors.
Otherwise well, less crap produced and reaching the global market is already something nice to hear I guess.
if I had another guess, and I pulled from my experience as a software developer, I would say that the desire to have continuous productivity from all employees has created environments which throttle talented employees and asphyxiate those who are learning because they can't contribute immediately.
I see this all the time in my own life. I can contribute a great deal if I am left alone to do work that I see needs done, and I have demonstrated this multiple times. but if you don't understand this about me and you want daily stand-ups where I explain what I am doing, all I get is challenge from everyone on the call. "why are you doing that? we want you providing value. you should pair more." I promise, and I have delivered previously, that if you just leave me alone I can do great things, but when every last person on a call gets a say in what I work on, you render me completely ineffective, and that's where I am now. this is a direct consequence of technical leaders having MBAs and no understanding of people or the work they are doing.
Perplexing,really ? I do not find this perplexing at all. Maybe productivity increased at the beginning of the pandemic because people were afraid of losing their jobs. Maybe once people realized they could work from home and not worry too much about getting fired, they are simply letting gravity take its course and finding out how little they need to do to keep their jobs, or if they even care if they keep their jobs.
Look what has happened to remote education. We may now have a damaged generation.
Yes, for certain people in certain jobs, working from home can be a productivity boost. This is not true for the general population.
Here's the fed numbers: https://fred.stlouisfed.org/series/OPHNFB
The productivity drop the OP is referring to is that little blip downwards at the end. Hell, here's the Fed asking a year ago if the pandemic boosted productivity: https://fredblog.stlouisfed.org/2021/07/has-the-pandemic-boo...
Basically all the chatter in these comments are irrational speculation, based on a false premise, and flatly wrong.
It's really common in news about the economy. I guess the outcome is really important, but we only have these instantaneous signals. So something like superstition kicks in (when we're not carefully considering what is stated).
So companies are giving the intrinsic motivation spiel. Fine. Who doesn't want to gaze at the majesty of creation from the peak of the Maslow pyramid/hierarchy?
Yet this year has shown that at the first sign of trouble, even with billions parked in the bank, shareholders and not employees come first. Or if you are a startup then leadership mismanagement and bad decisions are absolved with layoffs (and some tiers). That bottom unsexy part of the Maslow pyramid where basic needs exist are looking very shaky. Hats off to you if you can keep the company and vision your number 1 goal at the looming expense of your family's well-being!
Come on people, be at least somewhat scientific.
These are theories of course, but I don't think one has to always look for very complex or technology related answers.
Just a brief glance at the first chart in the article, and last year was a bigger increase (6%) than this year's decrease (4%), and 2020 had the largest increase ever (10%).
I didn't even bother reading the rest of the article after seeing that.
The current involution is even deeper: most people nowadays own really nothing in IT terms since they live on someone else computers at someone else rules.
IF we came back to classic desktops, with their document UI, their end-user programming concepts AND classic HUMAN networking and organization in a far less near-flat pyramid than productivity will skyrocket.
Oh in other philosophical terms: free people are FAR more productive than slaves, since the modern world is more and more based on slavery...
Keep your worker bees happy and they will be productive.
Today, workers have shit pay compared to the CEOs and other C-level executives with multimillion dollar salaries, bonuses, and golden parachutes. Many people work multiple jobs just to pay rent. Unions mostly busted. Erosion of safety nets, and other public services. Those same CEOs even work with other companies in the same industry to artificially keep worker pay as low as possible by having an informal agreement to not recruit and hire from companies that have this agreement.
In other words, "worker productivity" is a nonsense metric. It'd be more instructive to graph the variables that go into it, going deeper until you find something that makes some intuitive sense.
That should mean lots of people who would not otherwise be part of the labor market are getting low wage/low productivity jobs. So in an aggregate measure dollars of output over hours worked, you’re raising the numerator at slower rate than you’re raising the denominator.
Early in the pandemic, high wage white collar workers stayed home and kept their jobs. Low wage service workers were furloughed. -> labor productivity goes up. Service workers get hired again-> labor productivity drops.
> Labor productivity, or output per hour, is calculated by dividing an index of real output by an index of hours worked by all persons, including employees, proprietors, and unpaid family workers.
This metric IMO seems to be sensitive to other macro indicators. The recent economic slow down means less real output while the tight labor market means the same or more nominal hours worked. The slowdown in any industry sensitive to interest rates means a lot of people talking and waiting on how to adapt but fewer projects and products developed and delivered.
I mean look at the chart showing the change in productivity. It's all over the place. Productivity is a cultural thing that doesn't suddenly jumps up and down.
Real wages are up a bit, but revenues are way up despite the supply chain issues. People are being forced back into offices who don't need to be there. Maybe morale is low. I know of concrete instances of low morale, and I'm sure there are others.
People's life changing because of RTO requires attention.
People are often looking to move or to change jobs recently, which requires attention.
Millions of people have been ill with a respiratory/vascular virus which sometimes causes long term damage. More than a million in the US have died from it. Survivors often have pulmonary issues and long-term mental fog which may be permanent or take years to recover. They have less energy and stamina. It's harder for many of them to concentrate. Some of those who died were in the workforce, and whatever knowledge they had about their job died with them. Other deaths were people's family and friends. Funerals, cleaning out houses, donating their belongings, and the grief itself aren't exactly good for worker productivity but they are things humans need to do.
Lots of micromanagers exist. For people who haven't returned to office with no open floor plan to walk around, many of them use a messaging app like Slack to micromanage. Water cooler conversation is in Slack channels. Meetings are in Slack, Teams, or Zoom or something else, and everyone's supposed to be engaged rather than working on their laptop until it's their turn to speak. There are often more officially designated meetings because people can't drop by one another's offices. Lots of work is concentration-based work, or "flow" work. Constant interruptions are bad for anyway, but when it takes 20 or 30 minutes to get all the context in your head to solve a problem and a three-minute interruption to lose all of that, more interruptions can be catastrophic for productivity.
Some types of business have minimum staffing requirements. You can cut staff and try to "right size", but you need enough staff to keep the place open if that's your goal. If orders are down enough, your staff will sometimes have less to do. If because of the shortages mentioned before your ability to fill orders is down, the same thing applies. You have a choice of eating some less profitable quarters until the supply chain levels out or just closing shop. You can't lay off 100% of your trained staff and count on rehiring them later.
Companies decided employees weren’t worth raises. Employees left. Companies need to value employees more with pay if they want them to stick around and keep all that institutional knowledge.
If you believe Zuckerberg chasing the Metaverse has misallocated resources, his company has shipped less 'product' per employee. Does that really mean employees have been less 'productive'?
Cheap money the last 13 years = hire more people who do less and get paid more. Or even hiring people for positions that aren't needed.
The efficiencies derived by working 10-20 years in the same field and even the same position are lost with the modern workforce that barely gets trained to competency before leaving let alone staying long enough to build true efficiency and thus greater productivity.
The circumstances make it so that we're incentivized to do enough to not get fired
Numerically, I make substantially more than I did 5 years ago. In terms of relative value, while I do have a fancier title, I barely make more than I did when my job was easier. If someone were to ask me "what are you career goals", I'd struggle to tell them any at this point because I have little reason to do more than what I already do. What, I'm supposed to want to take on more responsibilities only to find the economy adjust itself so my lifestyle barely changes? I know some people have a frankly ridiculous form of workaholism that allows them to persevere, but I see them as the horse from Animal Farm. Eventually they will lose the energy to do what they do effectively and the system is not going to support them in proportion for their loyalty, to say the least.
The protocol of working and the order of things is just more fucked up these days than it was in the past.
Whenever there is a problem people look for someone to blame.
The easiest thing is to create a new process to avoid this in the future, and be protected against blame.
If this proceeds unchecked, the process grows and grows until every little thing takes forever. The processes need to be pruned sometimes too, not just added onto.
Something similar happened in the mid-seventies.
The execs love how cheap their GCCs in India are, but they're somehow unaware that these folks can take months to do tasks that should take less than an hour.
That and the exponentially growing parasite of tech-enabled bureaucracy, but we already knew that.
That and being forced back into offices after working remotely for 2 years.
Now, what if instead my company hires some other external business, to perform the same function with the same people at the same price? What happens to productivity?
We live in a society where every single thing is a rent seeking and nobody believes in anything besides winning because everything of substance has been hollowed out.
In aggregate you measure it based on how much the company spends vs how much it makes off sold product. It's a measure of the efficiency of the company to its holders of capital.
But there are a bunch of ways to measure it, that generally comes down to some comparison of inputs vs outputs and those inputs and outputs have to be measurable in some way in aggregate.
If you Google for "economic productivity" or "labor productivity" you can find better explanations of the details than I'm likely to give.
What does it mean that a software engineer is less productive? Or a stock trader? Or various other knowledge jobs?
Its worth pointing out that the economic indicator of productivity is basically GDP divided by worker-years-equivalent worked. So if its double-plus ungoodthink to ever report a decline in GDP, we can still, for now, report a decline in productivity while also reporting unemployment remains mostly constant, as long as no one makes the connection and cancels them for reporting disinformation.
Its not a "recession" of course, that would be badthink of the highest order, its just a mysterious decline in the productivity metric, and nobody can talk about why while remaining politically correct. Its a good demonstration of how effective censorship can be. Why, I hear times are so good, the party is increasing the chocolate ration.
Decrease in productivity in the last six months.
It must be all the remote workers!
Ignore the return to office push, inflation, burnout, and every other possible factor.
It’s going to take a year or more before people feel like they’ve recovered.
I do hope we find a way to recover.
U.S. media has gotten less informative -- no one is sure why
Could the effect be caused by the US onshoring industries that have lower productivity?
of course they would be concerned about productivity of all folks
No one is sure why. Its just a mystery.
Fuck off, Jeff.
Pay your FUCKING TAXES, Jeff.
You are an asshole, JEFF.
Its obvious that much of the GDP is based on low aptitude/low skilled products and services (i call it fat juice and fat juice filtering, looking at buffetts investing advice). An unhealthy environment is not something to grow old with.
In the states, we can see that the illegal migration dumping is caused by the unskilled labor needed to support archaic GDP numbers.
As a technology native, I was too young to work when the H1-B economy started to spring up, but the linear from that is easy to see.
And somewhat off-topic, it looks like with the UK's PM, we get to see more of the effects that infosys played on the economy.
Businesses that outsourced gave away their whole business model is an easy conclusion, so now they all have lower quality/priced competition (obviously speculation, but plausible remains entertaining).
Looking at Walmart, I could never understand why they left their workforce in servitude, without paving the way for a future. The irony that "merica'" is filled with products from a communist country still astounds. They have no prospects for the future and supplement incomes with foodstamps and welfare.
Even quiet quitting is easy to decipher. Its an unhealthy environment.
Its simple. The healthy people moved away.
And I should have linked a source, but business outsourcing was more of referring to manufacturing in china and the counterfit goods. Software is obviously easier to hijack too.
It is cool seeing the karma go up and down on this post. Its back to (1) :)
A global forum is always fun :p
Its simple. The healthy people moved away.
But let me try to respond anyway even though I am unsure of your point:
>In the states, we can see that the illegal migration dumping is caused by the unskilled labor needed to support archaic GDP numbers.
The native population's costs to maintain those jobs locally would make the underlying business untenable. Perhaps this is the end state of all these businesses taken by illegal immigration. Maybe robotics might save the day. People are not going to pay for 14-20$/hr picked strawberries. Maybe they will but that 20$/hr will eventually become 30$/hr and so on.
>As a technology native, I was too young to work when the H1-B economy started to spring up, but the linear from that is easy to see.
H1-B was a miracle program that allowed numerous non-white people a sliver of a chance to experience the fruits of the western empire. A large portion of the white population came over to the new world without any papers and/or none of the roadblocks that current immigrants face. After they established themselves, they slammed the door on everyone else. At the same time, the third world is recovering at a snails pace from decades of exploitation and wealth extraction by the western nations. Put yourself in the shoes of people who want to experience a kind of life that westerners live. What options do they have? They can't easily just waltz into the western countries like their white counterparts did...meanwhile they were born into an environment that was fundamentally destroyed and stripped bare by those same western powers. They can't fight back to take that wealth back because the western military might will crush them, they can't improve their countries in any reasonable timeframe because there are too many forces working against them. But then comes along H1-B and it gives many ambitious people an opportunity to get exploited by the ownership class in exchange for an economy class seat into the first world. Who are the healthy people in this scenario? The white American working class whose ancestors walked into abundance with much less effort than people today and whose descendants couldn't muster up the effort to fill those in demand tech jobs? From the point of view of the ownership class, they were never in the game to begin with. From my point of view, the healthy people are the H1-B people.
>Businesses that outsourced gave away their whole business model is an easy conclusion, so now they all have lower quality/priced competition (obviously speculation, but plausible remains entertaining).
Maybe the ownership class is smarter than you. China and the rest of the Asian workshops are aging much faster than the US. China is projected to drop to 600 Million by the end of the century. The current state of them taking all the healthy people is a mirage.
Did the buffett joke about purchasing soda and dialysis stocks even make you laugh?
We are also on the cusp of automation, so unskilled is just an afterthought.
You can get 3 slivers for the price of one. Economics was never pretty words, its just a number.
https://www.sdrplay.com/beware-fake-sdrplay-devices/
I happen to look at their devices and see where increased support costs and possibly lower sales impacted their business model. I'm sure there are more if I look.
The world keeps on spinning. I can't say you even understood the "no one is sure why" speculation in the title.
Its simple. The healthy people like to laugh :p
I'm a midwesterner and half of my siblings, most of my wife's siblings, and some of my friends' siblings are in their late 20s, have no jobs (or <10 hrs a week), and live with their parents.
From the outside, they look nervous / afraid to try to get into the job market or to date people. Men & women, but it leans men. The ones in poorer families stay home all day and play video games, and the richer ones venture out to spend their parent's money at restaurants or on trips but otherwise do the same. Half of them were doing minimum-wage work and left at the start of the pandemic and the other half have never had jobs.
I could just be in a local pocket of people like this, but I'm worried about how many people must have fallen off of the wagon and will never get back on.
Trying to get a skilled entry-level job after having done literally nothing for 5 years is hard for a lot of reasons. One being the mental hurdle you have to get over: you know you'll face a lot of rejection, you're out of practice, and your work peers will be a lot younger.
--------------
Controversial opinion: The whole thing has burnt me on UBI. I am afraid that the average American doesn't have the discipline to be productive if we introduce too much free income / free state of subsistence.
A great counter-argument is "well why does someone have to be productive? why should anyone have to work?". I don't know anything, but I suspect that we get to ask that question because of how dominant/rich the US is, and that is bound to end if we aren't more than competitive against countries that work their asses off.
Another counter is something like: exceptional people are responsible for the 10x-1000x outcomes that carry the economy, but those individuals are only the catalyst and do it on the backs of the rest of us. Takes all parts to make the machine work.
--------------
Back on topic. Here's some graphs:
FRED Graphs:
Hours worked by full-time and part-time employees by year: https://fred.stlouisfed.org/series/B4701C0A222NBEA
US Pop: https://fred.stlouisfed.org/series/POPTOTUSA647NWDB
Median weekly real earnings: https://fred.stlouisfed.org/series/LES1252881600Q
Employment-Population Ratio - 25-54 Yrs.: https://fred.stlouisfed.org/series/LNS12300060
Real gross domestic product per capita https://fred.stlouisfed.org/series/A939RX0Q048SBEA --------
US Employment rate by age 2000-2021: https://www.statista.com/statistics/217899/us-employment-rat...
If your local economy is in decline, you see more people demoralized and jobs dry up in a cycle.
I think I read the term “futureless generation” recently and that stuck with me.
$7.25
As for me personally, I don't think I could be more productive if I tried. I finish work and then look to pick something up - are there isn't anything ready. If I try to make something ready, people want everything run past a committee to gain consensus. Twice in the past 6 months, I've spent 2 weeks developing a plan, running things past people, and then I come to a single question and the response is "hmm, you know, let's not work on this right now".
This morning I was on an email chain in which one executive had committed us to paying $$$$ for some consultants to do something, and he wanted the CTO to do some checks to make sure our system could handle it. But what exactly? The CTO had no idea what he was asking for. They went back and forth, and I'm nearly positive that they were both acting in good faith, but for the life of them they couldn't communicate. And so a bunch of workers are going to sit around with nothing to do, collecting their paycheck.
I've been doing this now for over 20 years, I'm fairly senior, and I deal with executive-level people a lot. I've never seen anything like what's going on, and it's totally unfair to blame this entirely on workers (they aren't blameless either, tbh).
1) the first start up I ever joined, I ended up owning 10% of the platform and grinding frequent 70+ hr work weeks. I desperately wanted to spread my wings and make suggestions (you know, career advancement type bullshit) but I was consistently treated like I had only been hired because there was a talent shortage, and that I was expected to follow orders and shut the fuck up. Execs sold the company 3 years later for $50M. I got $6,000 from the deal.
2) Amazon is a multi trillion dollar company, with huge talent sourcing issues. Why? Employees are grist for the mill. When I interviewed, beginning SE’s were salary capped and offered a tops of $40k in stock options that vested over 4 years. Most devs don’t last more than 2.
These can’t be unique stories. I’m of the opinion that money and control need a fierce decoupling. I’d give a shit about implementing big visions if I were treated like it matters that I care and if I were presented a fair stake in the company. Until then, I’m going to worry about pursuing my personal projects more often than not.