All of Us

Let’s Make Work Healthier

by Mike Critelli

The changes in daily work routines that Covid directives abruptly introduced into employer-employee relationships were not planned in advance and were not done with consideration of whether they would contribute to emotional, career, social, or spiritual well-being. They were done for the sole purpose of virus containment.

Others can debate their effectiveness, but we are indisputably dealing with the wreckage they created in so many employment environments. 

The pandemic moreover uncovered and amplified structural and emerging workplace issues, giving employers and employees the opportunity now to reflect on what needs to change.

Reflections and recommendations, offered here, are informed by our own software-driven augmented analytics. 

Time vs Results

I started my career as a private-practice attorney. Then, as now, attorneys were rewarded for maximizing “billable hours.” Firms and clients believed that longer hours on assignments translated into higher quality results. 

More generally, the term “facetime” used to refer to being visible at work, especially outside of normal business hours. 

Taken to an extreme, measuring value in terms of time tends to breed inefficiency, poor work performance, and burnout. This is perhaps especially obvious in healthcare.

How Medicare and commercial insurance pay private healthcare professionals forces them to work longer hours and deliver substandard care to make an adequate living. They are paid too little for the valuable consultative process that helps build productive physicians-patient relationships. 

As a result, physicians in the “fee-for-service” system who want normal workdays have the unenviable choice of either spending a mere seven minutes on each patient — which leads to unnecessary diagnostic tests and procedures and prescriptions — or, to work the extra hours needed to devote adequate time to patients. 

The annual Dartmouth Atlas Survey, started in 1967, compares spending and health outcome trends across over 300 Physician Service Areas. It consistently finds that more spending does not produce better outcomes. Communities that focus on prevention and thorough physician consultation spend less and out-perform communities that spend more time and money on technology and pharmaceutical intensive treatments.

Performance deteriorates when employees are fatigued from being rewarded or induced to work too many hours. Until the 1980’s, medical school residents worked over 100 hours per week. Highly publicized deaths from medical errors caused national medical school accrediting bodies to set 80-hour-per-week limits on resident work hours. 

Going the extra mile for employers should not be about hours worked, but tasks completed well.

Where, How, and When Work is Performed

Pre-Covid, most work was performed at employer workplaces, often in scheduled or impromptu meetings. During Covid, video conference meetings, often called “Zoom meetings” replaced a lot of in-person work.

The need for Zoom meetings enabled employers to avoid the issue of too many long, pre-scheduled meetings with too many attendees at inconvenient times. Sitting in meetings for long periods of time is unhealthy, and it may not produce the best thinking.

In How We Learn, Benedict Carey argues that periodically stepping away from tasks actually produces better results than staying on task. Research demonstrates that leaving workplace environments to walk, visit a gym or coffee shop, or take a short nap all recharge the brain and trigger more creative and high-quality thinking.

Zoom meetings have actually introduced new disorders into our lexicon: “Zoom fatigue,” “Zoom dysmorphia” (people stressing out about how they look on Zoom screens or how background noise and images in residential settings will be perceived) as well as insecurities from interacting with individuals who have mastered the art of “performative work” (work that looks impressive, but accomplishes nothing). 

Attendees must allocate specific time blocks to meetings. This “synchronous work,” may not be best at inducing productive work. In-person meetings bias us toward synchronous work, but allowing people to respond asynchronously may be better for them and their organizations.

Employers often require monitoring devices that track time employees spend logged on to screens. They appear to believe that, unless monitored and coerced, employees will not do necessary work. In any employee population, some workers are highly engaged and others are not. Leaders should identify the disengaged and either find a way to motivate them or replace them. Assuming that the default behavior of every employee is disengagement is destructive of morale, and does not enable employers to source the best talent.

It is unhealthy for individuals and organizations to encourage late night emails and text messages that deprive employees of needed sleep. Sleep is healthy, and conducive to better decision making. Some employees are so addicted to responding quickly to emails or text messages that they exhibit “email apnea,” a condition in which their breathing stops or becomes irregular when scanning through emails. Employers can track and control aberrant late-night work activity. 

Smartphone Protocols

We all know individuals who nervously check smartphones because they literally cannot avoid responding to notifications, alerts, likes, text messages or emails. Reporter Max Fisher, in The Chaos Machine, traces the design of these social media platform features back to adaptations of how gambling casinos made slot machines addictive by creating small, intermittent noisy rewards.

Dr. Carl Marci, the co-founder and Medical Director of Predictably Human, recently published Rewired, which presents a substantial body of research about the addictive effects of these features, which are built into most smartphone applications and Internet browsers. He particularly notes that “digital natives,” people under 30, are interrupted so often that their task attention spans are less than one minute. Moreover, they are uncomfortable when unable to access their smartphones for even a few seconds.

Leaders need strategies to wean populations away from dependence on the stimuli to which smartphones have driven them to respond. 

Beware Micromanaging

My wife and I walk to Starbucks every morning. Loud, intrusive music plays. Starbucks employees have no discretion whatsoever on whether to play it, what to play, and its decibel levels, even in response to customer complaints. Starbucks employees moreover have virtually no ability to adjust thermostats, even on unusually chilly mornings.

Employees and front-line managers understand better what is needed for the health and wellbeing of their employees. If a front-line manager fails to make the right decisions, that manager needs to be replaced, not subject to high-level micromanagement. 

This period of “quiet quitting” or “the great resignation” should be a wake-up call for leadership to focus on details that have a significantly positive impact on employee health and wellbeing. One of those details is the empowerment of properly trained front-line managers.

Thoughtful Workforce Reductions

The Elon Musk Twitter saga is a case study in how not to carry out a workforce reduction. Individual employees who are losing their jobs need to be treated with dignity. The communication process should minimize their anxiety and insecurity.

The one good aspect of Musk’s process is that he did not let the uncertainty of workforce reductions hang over the organization. The only thing worse than an insensitive rapid-fire mass termination process is a process months in the making that makes an entire workforce insecure. 

Taking time to do a workforce reduction right is critical. Taking too much time wipes out the benefit of the careful thought process that precedes it. 

Adequate Coaching and Training

Recently, I spoke with a personal services provider who told me about the devastating psychological effects of Covid-induced isolation on one of her sons. Before Covid, he was an attorney and a rising star at a large global firm. When his firm abruptly eliminated in-person work, the firm’s well-developed supervisory coaching and training processes disintegrated and never returned.

He and many colleagues experienced serious emotional anxieties and insecurities from the absence of this supervisory interaction. Emails, text messages and even Zoom conversations cannot substitute adequately for in-person coaching meetings.

Final Observations

COVID-19 uncovered and amplified structural and emerging issues at American companies of all sizes. These span employee-employer and peer-to-peer relationships. 

Addressing these new and ongoing problems requires simple, useful, and practical ideas plus experiments. A balance between employee well-being and employer profits under cultural norms and extreme change is key.