AMERICAN SWEAT SHOP.


There is a curse that inhabits the American work place. We have become slaves to profitability and not to best outcomes. The primacy of profits has led us to misunderstand the nature of work and the importance of worker satisfaction. Making ever-increasing profits is the goal but how we get there makes a difference. Some employers have lost their focus. Sustained profitability is about worker satisfaction. In many fields lip service is paid to the worker, while they are trapped under inhumane work conditions. Fortunately work conditions in the developed world are better than they were. However, we still have a way to go before we can claim victory over poor working conditions. The severity of the impact of poor conditions is dependent on your industry. In health care the impact can be life threatening.

Our culture for too long as valued hard work over smart work. We seem to believe that the worker that workers longer hours is more noble and deserving of praise. This misplaced praise has led to continued poor choices and has led to the misery and burn out of the American middle class. The depth of the problem continues to go unnoticed and unacknowledged. Poor outcomes continue to be placed at the feet of poor training and individuals are blamed. I too have a tendency to blame the individual. The truth is that sometimes the individual is to be blamed, but we too often neglect to evaluated the conditions under which mistakes are made. The systems under which most of us work are archaic, inefficient and are undermining our ability to be the best we can be.

I will be attacked for my stand but the truth needs be told. I love my work because it gives me the opportunity to help my fellow humans at a time when they are most in need. From my limited experience that help is best delivered when I am well rested. Some may consider me weak for insisting that adequate rest is required for best productivity and patient safety. I, however, would rather follow the evidence that suggests that efficiency and safety are best attained with a well rested and optimally trained work force. The conditions of many operating rooms where staff can work full daytime shift and take overnight call then work a full day shift is putting our patients at risk.

The unfortunate problem is that when a staff member makes a mistake that harms a patient she alone is blamed. The idea that she needs to take personal responsibility for her mistake is commendable , but essentially is a cop-out. Her bosses are just as culpable, because they have put in place a system that does not allow her to work at her best. The continued scapegoating of individuals is a sickness in our system that needs to be driven into the grave. Our success is dependent on the balance and efficiency of the systems we construct. Spending money on technology is commendable and necessary but alone will not improve patient outcomes.

Better pay is a great place to start, but is a poor quality band-aid when one works under mentally oppressive conditions. Improving the system starts by focusing on the best assets of the system. Our human capital is our best asset and must be treated as such. We are not robots, we are better. We may not be able to work as long hours and we get bored easily; but until robots can think intuitively and problem solve on the fly we will continue to be the best part of the workflow equation. Functioning at maximum efficiency must be out foremost goal. For humans to be focused and efficient we must have adequate rest and distraction. If we would focus on those areas many of our problems would be resolved without the need for expensive investments in equipment.

Let us invest in our best and most productive assets, our people.

WHAT SAY YOU?


Have you ever wondered why your antibiotic is so expensive? The answer is not as simple as it would seem. The answer is much more simple. The drug company is doing the imperative of every company in the capitalist paradigm. Making the maximum return on investment  is the paramount objective. If the company is privately or publicly owned there is no difference.

A key component of profitability is the company’s ability to have “pricing power” in the marketplace. In lay terms, can the company price its products to maximize profits per item? A key component of pricing power is the presence of or not of competition. Competition reduces pricing power; without which pricing power can be maximized. Consequently, the ability to decrease competitive risk is vital. A not often examined part of the profitability paradigm is the patent system.

Most of us know enough about patents to continue to support their continued presence and influence over our economy. Unfortunately, what we know is inadequate to make good decisions. The patent system was designed to give inventors the ability to protect their work for a finite period from theft while allowing others to see the details of a novel work. At the birth of the system it was argued that it would encourage inventors to develop on the works of others while allowing the original developer to have protection from loss of economic benefit. It can be argued that the system has worked very well. However, the current incarnation of the American patent system has drifted significantly away from the original intent.

With the only goal of modern corporations being to maximize profitability the patent system as been adjusted significantly to make it work for big business. The protected period as lengthened over the years. Various legal and technical methods have been used to extend the protected period. This time is used to maximize pricing and profits from the protected product. This is not a bad thing for the company that is benefiting. It is following the primary objective of capitalism, maximize return on investment.

For the individual that is not a shareholder the system is not as beneficial. There are two things that disadvantages the individual, she is deprived of the potential of a better product from the work of another developers improvement on the original and she is deprived of making a better return on her resources secondary to the excessive cost of the product she is buying. The lack of competition is further detrimental to the community as a whole for the same reasons. Even the company that is doing all to maintain its competitive edge by excluding others from the marketplace is losing. The company loses by the loss of the competition that would push it to bring a much improved product to the marketplace.

If the system is objectively examined there is only one conclusion, the patent system as significantly deviated from the original design and should be abolished. I would completely abolish the patent system and unleash real competition into the marketplace. What say you?