Tag Archives: Productivity

Patients’ patience: waiting costs us

Patient: n. an individual awaiting or under medical care and treatment

Patience: n. the quality of bearing pains or trials calmly or without complaint; manifesting forbearance under provocation or strain

For years my ex had an internist who habitually ran an hour behind. No matter what time he arrived for his appointment he was seen an hour later. He spoke to the administrator about it, he chewed out the doc, and even threatened to bill him for the wait time (he was a lawyer, and had billable hours down!). Finally he found a new doc.

Princeton economist Alan Krueger wrote about this a couple of days ago:

…Time is money. So, although it doesn’t currently enter into our national statistics, the time that patients spend getting health care services should be reflected in the way we calculate America’s national health care expenditures.

Any student of Econ 101 knows that economists measure costs by opportunity costs, meaning everything that is given up to get something else. Time spent interacting with the medical system could be used for other activities, like work and leisure. Moreover, spending time getting medical care is not fun. This time should be counted as part of the cost of health care.

He suggests that we undervalue the cost of health care by about 11% by excluding the opportunity costs of waiting for care, which he calculates at about 847 million hours annually. Valuing the time at an average of $17.43 he says Americans spent the equivalent of $240 billion waiting around in 2007.

He says that if we’re going to modernize health care record-keeping, we should be including patient time in the equation:

Failing to take account of patient time leads us to exaggerate the productivity of the health care sector, and to understate the cost of health care. The time that patients spend seeking, receiving and paying for health care services is just as real as the dollars they spend for medical services.

I know scheduling is a constant challenge because emergencies do arise, but other industries have figured out a way to keep irregular systems rolling; why can’t physicians?

Pressure to perform and produce

Pressure: the act of pressing or pushing; urgent claim or demand; a constraining influence upon the mind or will; a burdensome, distressing or weighty condition.

Perform: v. to begin and carry through to completion; to fulfill a promise or obligation; to carry on, function.

Produce: v. to bring forth; to create by mental or physical effort

The weather is lovely today – a clear fall morning, vine maples turning, mists rising from Salmon Creek where I walked with a friend, crystal air.I want to sit in the garden with a good book.

I said I’d write every day in my blog.

I don’t want to write today.
I definitely don’t want to write about politics.
I don’t even want to write about other matters.
I don’t want to do my laundry.
I don’t want to make the phone calls on my list.
I don’t want to clean up the kitchen or go to the grocery store.

My puritan head says MUST. KEEP. COMMITMENTS.

My pagan heart says not today.

It sure is hard to give myself permission to be a slacker.

Pity the poor political junkie! Play with productivity Legos instead

I am up to HERE with Republican perfidy and pugnacity.  I didn’t start 365 Words Beginning with P to write about POLITICs… though I am a political junkie. Unfortunately Politics and Palin and Putrid and Perfidy and Pugnacious and President all begin with P and when I’ve spent the past ten days watching two conventions (one inspiring, one frightening), I need to vent.

I’m over it…  at least till tomorrow.

Let’s talk instead about productivity, priorities and procrastination!

I stumbled on software developer Michael Hunger’s blog a couple of weeks ago in which he talked about his new method for keeping track of how he spends his time – his creative solution to the Time Log.

Why should we care about time logs?  Because most of us haven’t a clue where the minutes and hours go in the day.  “Where DID the time go????” we ask.  Taking a clue from the diet industry: if you’re trying to lose weight, the first and most crucial step in finding the unconsciously consumed calories is keeping a food diary — writing down every morsel you eat from dawn to dark.  Then it’s much harder to say, “I can’t believe I ate the whole thing!”

It’s even harder to record the hours in the day, because it’s so easy to get side-tracked. Michael Hunger makes time-keeping tactile and truly fun by using colored Legos.  You could think of it as Lego Logs.

Here’s the set he uses (available online for about $25):

And here is what a week of work looks like:

He describes his technique:

I chose a time partitioning of a quarter of an hour (each bump = 15 minutes). So I can use the lengths 1,2,3,4 to build 15,30,45 and 60 minutes worth of time in a row representing an hour .

Stacking these hourly rows on top of each other builds up the whole day. I use the different colors for the projects I’m involved in (8 are just enough), putting them on the stack whenever I want and have time to do so (but mostly quite instantly).

I made up a single width column as ruler for the work hours (from at around 10 am up to 6 pm). So I can easily see whats missing and at what time I did something. For the days of the workweek I chose the rainbow color scheme (red, orange, yellow, green, blue – Monday to Friday) for the longer base row that I stack my hours on. So I can gather a whole week of time tracking until I have to enter them in some time sheet (software). I put the columns of a whole week on top of a green building plate to fix them.

You can easily see how much work you did for any given project as you recognize the colored areas rather than time ranges (8:45-11:15). Having the relative time shares as part of this setup helps as well.

You can even plan your work by pre-building your days on temporary bases with the planned amount of time for each activity (or putting at least the estimated amount of bricks aside).

The benefits are obvious:

  • it works (for about 4 months now)
  • I have something to play with while pondering stuff
  • it looks great
  • it’s incredibly fast with no overhead
  • planning is possible

The single disadvantage:

  • coworkers coming to your place and disassembling your time tracks
  • He figures for an 8 hour day you need  5x8x4 = 160 bumps (1×1) minimum to do all your hours. 70% of Lego pack 6177 are one-rowers, so you get plenty.

    One challenge for me is tracking the roving nature of my work. Some is at my desk, some is in the kitchen, some is in the yard, some is around town. I’d just have to carry Legos in my purse at all times.   What color  for household chores? What color for naval-gazing? What color for getting lost on the world wide web? When is dish-washing, naval-gazing or web-browsing part of writing preparation?  I’d need some in-between colors to record these nebulous states.

    Professional or Pretender? writing as a JOB

    Professional: n, 1. one who is engaged in a particular occupation for pay;
    2. one who has great skill or competence in a particular field

    Pretender: n, one who simulates, claims or alleges falsely.

    I get paid to write articles on health issues, newsletters, reports and the like. This makes me a professional by the first definition – although as a free-lance gig the work is spotty and the pay paltry.  While I enjoy these assignments when they’re DONE, they don’t engage my heart.

    For years I said I would “Write a Book,” because that’s what writers are supposed to do. Unfortunately I have yet to focus on one topic long enough to spin it into a book, and furthermore I habitually hit the wall somewhere around 3000 words for a piece.

    When I read Steven Pressfield‘s The War of Art, it became clear that in this area of my life – writing something lengthy about what I wanted to write about – I was a pretender, an amateur. I was not a Professional Writer.

    He claims we all know how to be a professional in one area: our jobs – the ones we do successfully in our workaday lives.  He suggests we apply these qualities to our artistic aspirations:

    1. We show up every day.

    2. We show up every day no matter what, whether or not we feel like it.

    3. We stay on the job all day. Our minds may wander but our bodies remain at the wheel till the whistle blows.

    4. We’re committed over the long haul. We may change jobs, but until we hit the lottery we’ll be working.

    5. The stakes are high and real. We’re feeding ourselves and our families.

    6. We accept remuneration for our labor. We’re here for the money.

    7. We do not over-identify with our jobs.  We may take pride in our work, but we recognize we are not our job descriptions. The amateur takes his work so seriously it can paralyze him.

    8. We master the technique of our jobs.

    9. We have a sense of humor about our jobs.

    10. We receive praise or blame in the real world. If you’re praised for your work by your best friend, that’s not real-world feedback. A friend won’t send you a rejection slip. The real world will.

    Pressfield’s a hard-ass.  He wants those of us with creative aspirations to put up or shut up. The War of Art is really about Resistance as the implacable enemy of the artist. I wish Resistance were a P word, because I experience it every day (thanks Mom!) and it deserves a long post of its own. Read the book and you’ll see what I mean.

    365 P Words has provided the self-discipline I’ve needed to get my ass into the chair to write every day. Knowing others are out there reading this helps too.  Who knows, my new-found commitment to writing what I want to write might lead to something…

    What keeps YOU on the job?

    PocketMod, planner for a pauper’s pocket

    Found the coolest little portable pocket planner. Write your notes on it, stuff it in your pocket and toss when done. It’s called the PocketMod.

    It’s an easy do-it-yourself – where you add the mini-pages that suit your planning needs then print it, fold it. It’s a bit of an origami puzzle till you get the hang of it… – make sure you print out the assembly instructions on one of your demos so you can review the process offline.

    Postprandial plunge: to nap or not to nap?

    Postprandial: following a meal

    Plunge: to descend precipitously

    Perhaps I exaggerate – but plunge was the only p-word that comes close to what happens to me after lunch most days… (and after as little as one glass of wine w. dinner) – I want to get horizontal and shut my eyes.

    Supposedly it has something to do with blood sugar levels, but it doesn’t seem to matter whether I eat a low or high carb meal; I just get sleepy.

    And then I resist it.  I sit at my computer trying to write, trying to compute, trying to think through a problem — gaining no traction but refusing to succumb.  If I get up and tackle a physical chore I can sometimes barrel through it, but at a detriment to my effectiveness.

    Half an hour after a nap it’s as if I rebooted my whole system, and all the resource-hogging resident programs in my brain have cleared out.  My question to myself is this: why don’t I just go with the flow and make room in my schedule for a daily nap?

    Napping is a high art in some cultures; there’s no shame attached to it. It’s probably good for your health, as a recent study from Greece indicates.   From that story in the NY Times:

    Now, out of Greece, comes permission to do exactly that. A study of more than 23,000 adults shows that those who napped for about 30 minutes each week had a 37 percent lower risk of dying from a heart attack than those who did not.

    So this should mean that all working Americans will receive permission from their bosses to close their eyes every afternoon at about 4 p.m., right?

    Don’t bet your blankie on it.

    This is hardly the first study showing that sleep is more than simply time when we really should be at work. Other studies, though few as extensive as the Greek research, show that short periods of sleep during the day increase productivity and creativity while reducing stress. And even without surveys, we know this from experience.

    When you need a nap, you need a nap. Nothing — not caffeine, not a chocolate bar, not a pill — recharges the battery in the same way.

    I welcome you to join me…

    Pings and Productivity

    An article in today’s NY Times about the perils of “pinging” – my word for the constant interruptions we face in our modern daily lives.

    As the parent of young children, the pinging came from them: “Mom, I’m hungry (bored, tired, angry, mad at my brother, sick, in danger, have a dirty diaper); I need you NOW”. I don’t think I had a coherent thought for a seven-year period, except when they were in childcare. I was good only for low-level functions: buying and preparing food, cleaning up, running errands, arranging play dates.

    Now, kids long gone (chatty husband too) the distractions are back. But most of them are (or should be) under my own control. It’s between me and the internet. Ping! I’ve got email! I do research for an article on Vitamin D (thank you google) and suddenly I’ve gotten from Vitamin D to auto-immune disorders to fatigue to distraction to this article – and now instead of further work on Vitamin D I’m writing a post about being distracted.

    Maggie Jackson, author of Distracted: The Erosion of Attention and the Coming Dark Age has this to say:

    What’s needed is a renaissance of attention — a revaluing and cultivating of the art of attention, to help us achieve depth of thought and relations in this complex, high-tech time.

    The first step is to learn to speak a language of attention. The exciting news is that the enigma of attention has just begun to be mapped, tracked and decoded by neuroscientists who now consider attention to be a trio of skills: focus, awareness and so-called executive attention. Think of it this way: You can be “aware” that you’re in a beautiful garden and then you can “focus” on an individual flower. The last piece, “executive attention,” is the ability to plan and make decisions.

    Coincidentally I was dead-heading the amazing Westerlund rose earlier today in the garden. Hundreds of blooms in thick clusters. A few branches so heavy they had broken (below, the flowers on just two stalks). I was clip clip clipping but somewhere else in my head. Suddenly I realized I wasn’t present and began to focus on each spent head and the shattering petals that fell as I snipped. Such abundance! Wow.

    I used to do most of my writing on my laptop, which I keep offline. It is so much easier to focus when there’s no place else to go, no emails to worry about. I talk about self-discipline, but talk costs nothing. I feel myself with a big SHOULD coming on: I SHOULD ONLY CHECK EMAIL ONCE A DAY. I SHOULD ONLY CHECK DailyKos ONCE A DAY. I SHOULD ONLY….

    What will I actually DO????


    Procrastination: putting off intentionally something that should be done,
    from the Latin, pro (forward) and crastinus (of tomorrow)

    Ben Zimmer at Slate.com says

    How fitting that the word is lengthy and Latinate, taking its time to reach a conclusion. Alcoholics Anonymous founder Bill Wilson once wrote that procrastination is “really sloth in five syllables.” And yet the word denotes so much more than mere sloth or indolence: A procrastinator meticulously organizing a sock drawer or an iTunes library can’t exactly be accused of laziness. Likewise, procrastination is not simply the act of deferral or postponement. It implies an intentional avoidance of important tasks, putting off unpleasant responsibilities that one knows should be taken care of right away and setting them on the back burner for another day.

    Noting Ben Franklin’s dictum “never put off until tomorrow what should be done today,” Zimmer reminds us of MarkTwain’s response: “Never put off until tomorrow what you can do the day after tomorrow.”

    Which brings us to another great P-word perendinate, meaning “to put something off until the day after tomorrow.”

    And – picture stories being worth 1000 textual declamations -join me in procrastinating a minute longer with cartoonist Lev Yilmaz. Laugh while you wince in self-recognition.

    One of the main reasons I started this blog was to explore the P words that pave my path to Perfection. Procrastination is one of those words, and yet I’ve posted 60 entries on this blog without touching upon this pimple on the ass of Progress.

    When I was preparing for a party last week, I reorganized a couple of kitchen cabinets, gathered a box of books for the second-hand store, and hung a bunch of pictures. Today, in preparation for an appointment with my divorce* attorney, I’m writing in my blog about procrastination.

    John Perry, a Stanford philosophy professor whose public radio show Philosophy Talk is a favorite of mine, calls this “structured procrastination.”

    I have discovered an amazing strategy that converts procrastinators into effective human beings, respected and admired for all that they can accomplish and the good use they make of time. All procrastinators put off things they have to do. Structured procrastination is the art of making this bad trait work for you. The key idea is that procrastinating does not mean doing absolutely nothing. Procrastinators seldom do absolutely nothing; they do marginally useful things, like gardening or sharpening pencils or making a diagram of how they will reorganize their files when they get around to it. Why does the procrastinator do these things? Because they are a way of not doing something more important. If all the procrastinator had left to do was to sharpen some pencils, no force on earth could get him do it. However, the procrastinator can be motivated to do difficult, timely and important tasks, as long as these tasks are a way of not doing something more important.

    Structured procrastination means shaping the structure of the tasks one has to do in a way that exploits this fact. The list of tasks one has in mind will be ordered by importance. Tasks that seem most urgent and important are on top. But there are also worthwhile tasks to perform lower down on the list. Doing these tasks becomes a way of not doing the things higher up on the list. With this sort of appropriate task structure, the procrastinator becomes a useful citizen. Indeed, the procrastinator can even acquire, as I have, a reputation for getting a lot done.

    Ah. I feel better now.

    *Divorce – I’ve been separated for 7 years from my almost ex, but we have yet to finalize it. This gives you some sense of my capacity for procrastination.