How Do You Measure Productivity?

How Do You Measure Productivity?


Leonard Zwelling

In this article from The New York Times of August 15, Jodi Kantor and Arya Sundaram describe in detail the technology some companies are using to quantify the productivity of their workers and then employ these data to determine pay, promotions, bonuses, and firings. As is inevitable, these corporations are monitoring keyboard strokes as a metric of productivity. And it’s not limited to people with clerical jobs. Doctors and hospice chaplains are among the employees being tracked with software to make sure they are pulling their fair share of the workload. (How many CT scans did you read yesterday, Dr. Roentgen?) Personally, I would find this demeaning.

I have worked menial jobs. I was a stock boy punching a time clock at a department store in high school and a busboy and waiter in the Catskill Mountains working three meals a day and polishing silver in between meals. In those jobs, it was more about showing up than mouse clicks, of course. Then I became a professional (I track that to my internship). As an intern and resident, I was either working or sleeping. There was no time for anything else.

Eventually, I was in jobs where the work was what mattered. If my supervisor clearly elucidated what needed to be done and I did it, everyone was happy. No one counted the number of times I rounded on my patients at the National Cancer Institute, nor counted the number of test tubes I used doing experiments in the Laboratory of Molecular Pharmacology. Now, not so much. Who knows what they do to young physician-scientists?

Probably spurred on by the shift to at-home work that accompanied the pandemic, companies are using modern technology to make sure the volume of work that the boss thinks need get done is getting done. The entire long-form article makes no mention of how the supervisors know that the quality of the work being done is sufficient, just the quantity.

Not surprisingly, Amazon’s fulfillment centers were all over this making sure that quotas were met and workers were driven to fill as many orders as possible in a given work shift. Amazon monitored “time off task” as a measure used to fire employees. Companies use secret cameras to track what their employees are doing. You get the gist. Big brother may well be your manager and his/her/their corporate bosses.

I must admit I found this both disheartening and the logical conclusion of the computer age. These sorts of tools were not available to me as a manager, but I did use many metrics to track the work being done by the team I led. Why? It had nothing to do with measuring individuals’ performance, but rather of monitoring their work loads and making sure we were properly staffed to handle the work the faculty of MD Anderson was sending to our office so we could maintain what we hoped had become the expected level of service as we were entirely service overhead for the work of the faculty. I used numbers to quantify process and optimize staffing not to judge the productivity of those who worked in the Office of Research Administration.

I raise these issues because my guess is that if these metrics are not already affecting medicine, they will in the future. How many patients did you see in clinic today? How many slides did you read? How many MRIs? No one really knows if you got the reading right or the patient got better and patient satisfaction surveys are no substitute for actually knowing the technical quality of the medical care delivered not whether Dr. Smith spoke at exactly the right, “professional” tone (functional quality).

Work life is hard. I’m not a big fan of work-life balance as being the problem of the workplace leadership. Work-life balance is under the control of the worker and his or her or their psyche and its perception of balance.

Using the power of computers to spy on workers is a reversion to the sweat shop mentality of piece work on the lower East Side of Manhattan. If you get wind of this kind of tracking of the performance of doctors, nurses, physician extenders, social workers, chaplains or any other caregiver, please let me know. I’ll write about it.

It will be up to you to do something about it though.

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