Work – Balance Your Week For a More Meaningful Life

Dear Work Professional

How many hours a week are you willing to work to seem valued by your employer: 60…80…100+?

Unfortunately, for many, long hours at work is worn as a badge of honor. It’s a rite of passage. Long hours demonstrate the highest level of commitment. It is used as a tool to compare employees. It is one of the most treasured of unspoken corporate awards: The Long Hours Award. My career has benefitted from the Long Hours Award and I’ve been a victim of others winning the Long Hours Award. I have had many bosses that mistakenly held “hours work” as the benchmark for performance. I have had many that haven’t.

This is what I have learned.

Long hours equals long hours.

Nothing else. 

Long hours does not mean hard work. Long hours does not mean high value. 

Not Hard Work

There are countless examples from my past about people who were “on the clock” but were effectively useless for many hours of the day. They were there to show they were there; they weren’t working hard; and they took long breaks, long lunches, and long desk chats. They got less done in 60 hours than I did in 40. But when the weekly overtime report came out, they were champions. 

Not High Value Work

Ok, you’re burning the midnight oil. Every night. You’ve built in the expectations to your employer that your job is 1 FTE when it clearly isn’t. You can’t back down now. You agreed to the role. The thing is, when those hours tick by, you become less and less effective at your work. Every hour on the clock become mere minutes of productive effort if any. You aren’t fooling those who work under you, even if your work is still impressing those above you.

Loss of Life Balance

We aren’t built to work the hours we do. Our relationships weren’t either. Unless we’re married to our job and our best friend is someone at the water cooler. Here’s what you lose when you put too many hours in–personal health, family relations, volunteerism and personal breadth.

“But,” you say, “If I stop, I’ll lose.”

Who are you competing against? Where is the finish line?

You’ve already lost. Your company won.

Your Health

Long hours in the office can wreak havoc on your health. The minimal amount of cardio exercise recommended is 2 1/2 hours every week. Include prep and clean up and that number can balloon to double that. And that’s the minimum. Your heart and health can hold for a while. You certainly can pack weight on through your 20s and 30s without really feeling it. At some point, it starts to catch up with you. Your blood pressure is suddenly high. You become diabetic. Your joints are aching all the time. You can’t catch your breath. Maybe it becomes a major medical event. Perhaps your quality of life suffers. 

Maybe you are squeezing in workouts, at the expense of your family.

Work Family or Real Family

Do you think your spouse cares about your career as much as you do? Even if you think they do, how long will they think that before they change their mind? It’ll be sooner than you think. You’ll drift. Unofficially two separate lives until it becomes officially two. Your kids certainly don’t understand it. Eventually, they will become teens, teens you are or aren’t connected with. Those teens will make decisions that impact them as they enter adulthood. But I had to provide for them, for college. Then it’s too late for your to get off of the hamster wheel. You’ll get back what little time you invested.

Volunteer Work

So the school/church/neighborhood needs help. They know they can’t ask you. You’re too busy. Your spouse/child/friend is always embarrassed by the suggestion they ask you to help. You’ve already made your decision. Your career. Your work. You. YOU. All of those teachers, parents, coaches, helpers, and the army of people that helped you grow up, learn and become who you are today…

So you write a check instead. Bravo!

Work Breadth

If narcissism is the trend from long hours, then here is where you lose. You gain tremendous expertise in one, infinitesimally-small slice of the professional world. Your expertise is limited to one industry, one company, one series of roles. If that company folds or downsizes or offshores your role, you may be looking at relocation or unemployment.

You running under the misassumption that all of your time is for your personal consumption.

Choosing to play the game of long hours at work will always catch up to you. Always. You may seem invincible. It may seem like you have everything under control. You may think people don’t know what’s percolating behind the scenes. Spoiler alert: you can’t win. I’m trying to head off your regrets before it’s too late for you.

Win the Award that Matters: Your Legacy

Start with working forty hours, not fifty, not eighty.

  1. Do a great, focused job while you’re working 
  2. Give a little extra time on occasion when needed
  3. Balance the rest of your life and give time for others

It’s worth it.

Never Fail

There is a phrase that is being misinterpreted. “Fail fast and fail often” should never be the mantra of a development team with regards to projects.

Not a project badge of honor

“We want to fail fast, fail often.” I hear clients say all the time. This is no doubt repeating what they have interpreted from popular innovation books, when discussing their product pipeline. 

I disagree completely. 

Every product idea requires development team effort. Teams consume more resources as they go through the development process. Development resources are among the most precious of all corporate resources. They are extremely finite, have a long gestation for their work and create the soul source of future revenue for the company. One bad bet could sink the company. A project failure means you have wasted time. There is certainly no room for failing often. 

Instead, your mantra should be “Never Fail” with the tagline: “…with projects, but fail regularly with options.” Approach every project with the mentality to succeed. However, this assumes that the team will not pursue a singular solution option from the start 

Fail on Options

At every decision point on a project, consider a minimum of three options. In addition to this, the team should never jump ahead more than one critical decision at a time. Teams can’t focus on a singular solution or jump ahead to a defined solution. Doing so increases the likelihood that a product will eventually fail.

It is the options at every decision point that fail fast and fail often. Therefore, the amount of failure should exponentially increase in proportion to the number of people working on the project. Every designer should be studying a myriad of options for all of the solutions they are responsible for at every decision point. 

Let’s take buying a house as an example. One of the first decisions you’re going to make when buying a house is where you want it. Unless somebody gave you some property or you have your mind set on an exact lot, there are a myriad of options for exactly where your next house could be. Multiple factors impact the location: proximity to work, distance to amenities, closeness of relatives and so on. For every home location option, each one of those factors have a better “rating.” Over time, you will narrow down to the city and  neighborhoods that are options. 

The process will proceed when one chooses a location. Every other location “failed,” but the home buying project did not. However, if you blindly chose the house without regards to location and then discover after closing that it was too far from many destinations, the project failed. You are regretfully stuck in a home would rather not be in. 

Shoot for success with EVERY project
Your Project House

Every decision about the project should have multiple options that are studied, feasibility conducted and alternative solutions partially developed. Only one option makes it to the next step of project maturity. The next decision should also have multiple options. 

If a project fails, it usually means that due diligence was not done on a previous decision or that the development team took to long to introduce the product to the market. Never take the approach that you want to project to fail. You certainly don’t want to fail often. Instead, you want to kill a near infinite number of options on your way to project success. 

Healthcare Fix Despite Government-Media Vitriol

Healthcare Targeted

Like our nation at large, I live in a politically divided state. We are equally Republicans and Democrats. This was demonstrated in the ‘16 election and evident by our two Senators being in separate parties. Everyone is hotly debating healthcare. In the lead up to the BRCA vote after the AHCA passed the House, I emailed both of them. Eventually, I received carefully crafted responses, likely sent by a staffer. Neither were focused on the real issues, instead they were filled with the same partisan lines we’ve seen in the news.

The healthcare debate is dividing our nation for no reason.
I thank my senators for their responses but neither had a true grasp on the real problems occurring within healthcare. We should not have acted like either
ACA or BRCA is better for the country. There are pros and cons to each bill. It would behoove lawmakers and citizens alike to investigate the facts before offering a canned assessment of healthcare. However, I believe we can unite and fix healthcare despite the circus in Washington.

I See Something Different

Virtually every week of my life I am helping healthcare organizations transform themselves through the IHI Triple Aim–better outcomes, lower cost and patient satisfaction through innovation practices. I have helped many of these organizations make enormous progress toward this goal, despite regulatory constraints. We could easily improve Triple Aim metrics by a factor of two through the adoption of a fraction of the best practices I have seen. With or without ACA, if we don’t act, insurance premiums will continue to increase. The trend is staggering. Premiums will not begin to match inflation until four things are done:

Healthcare providers must: streamline their operations, maximize licensure usage, apply the most effective technology,  and focus on treating the person, not the disease.

Addressing the Four

Operations

Healthcare operations are among the most clunky of any industry. Streamlining through the use of operational excellence principles is critical. Every person in America could be meaningfully insured and treated without a government mandate or a single payer system; however, we have to lower the cost to deliver care. It’s actually easier than the industry would like you to believe. I have audited thousands of appointments across multiple healthcare systems: many do not require an actual office/hospital visit, a large percentage do not require a physician, and many are not required by evidence based practices. These appointments fill the schedules, restricting access for higher acuity patients.

In addition, there is excessive waste in clinical and administrative processes. These add zero value yet are repeated constantly. I have seen major waste removed time and time again by expert practitioners working with health systems to modernize their operations to these best practices.

Licensure

Staffing in healthcare is not unlimited. It takes half a generation to train many of them. We need to take advantage of every level of licensure. For example, in many states Advanced Practice Clinicians (APCs – Physician Assistants and Nurse Practitioners) can see many of the cases that currently go to a physician. In primary care, there needs to be an about face. High acuity, complex patients are the ones who should be using physician’s time the most. There is a perception that the patient only wants to see their doctor.

In the thousands of patients I have surveyed and interviewed, I have found this to be the case only about one third of the time when the patient is facing an appointment delay. Doctors need to see only the patients and cases that other clinicians cannot handle. APCs, RNs, LPNs and others can all focus more of their daily activity to match what their state allows them to do.

Technology

Next is technology. I’ve seen repeated installations of technology for technology’s sake. Only a handful of healthcare delivery organizations have the capability to determine the needs for a technology from both the clinician and patient viewpoint, research options and make purchase decisions. What I typically see is a radiography department leader being courted by an imaging firm or an EMR vendor singing praises of the latest module to a CIO. You can’t fix a broken process with a shiny new object.

This recipe is simple: fix the process and then add technology to advance the process toward the Triple Aim. Don’t let the medical device companies push what they think is best for clinicians and the patient. They’re not close enough to really know. The best innovations are ones created in the hospital or clinic, not the R&D center of a multinational conglomerate.

Treating The Patient

Finally, we have to treat the person. Unfortunately, many people who need care are not entering the system until it’s too late for an optimal outcome. A variety of social determinants impact a person’s health and their ability to get appropriate care. Areas that desperately need attention are behavioral health and patient education. The break-fix treatment model doesn’t work anymore. We can’t afford it so it’s time to be proactive. There aren’t enough physicians entering the workforce or enough dollars allocated to treat the future issues as we are now. We have to address poor health choices sooner in life.

Take Type 2 Diabetes Mellitus (DM) as an example. Diabetes plagues almost 10% of our population. This condition skews toward impoverished, minority communities. It is the 7th leading cause of death yet understanding and adherence to best practice care by patients remains elusive.2 Untreated, DM leads to vascular damage which then leads to more serious issues like nerve damage, amputations, blindness and eventually death, significantly raising the cost of care for that patient while simultaneously having a profound negative impact on their life. Patients following a proper treatment protocol significantly reduce or eliminate those expensive, life-altering exacerbations. This is true many conditions including congestive heart failure, hypertension or asthma.

Escape the Noise

I attended multiple, so-called healthcare innovation conferences last year. I listened to dozens of speakers. There were zero presentations on reducing cost. Instead, every organization, whether it was a payer, a medical device maker, software provider or provider, was looking to get a bigger chunk of the existing insurance premium dollar from another company for their own organization. This doesn’t save money, it merely shifts it around.

If lawmakers truly cared about health, we would ban smoking, the number one contributor to health issues and costs. Close to smoking is obesity. We have allowed our restaurants and grocery shelves to be full of low-cost, high-sugar and high-fat foods, practically begging for obesity. A myriad of health issues arise later in life due to obesity. These issues are expensive to treat, significantly more than the healthier, lean population.

Focusing on the number of insured won’t fix healthcare nor will it break it. Patients are empowered to cooperate when we focus on getting the proper treatment to them using a method they prefer. Reimbursements must reward outcomes achieved, not actions taken. Healthcare providers that continue to force patients to high-cost facilities (hospitals) by overqualified medical staff (MD/DOs) with a protocol that doesn’t follow the latest evidence based medicine (EBM) can no longer be tolerated. Patient behavior must be guided by insurers, including Medicaid, by pushing EBM practices. Allowing these things to continue is kicking the proverbial can down the road until we hit a healthcare version of the 2008 subprime market collapse.

Leading the Charge

Institutions like Jefferson Health, UPMC and Kaiser Permanente are leading the way in true healthcare reform with thought leadership practices like population health, innovation centers and vertical integration.

We cannot allow partisan politics continue to slow true transformation of our healthcare system for those it impacts most, patients. We don’t need regulations to deliver the right care. I’ve seen it. However, I’ve more frequently seen the opposite.

Worse, the division, angst and spectacle Congress has created and the media has fueled has paralyzed and misled those inside and outside healthcare. Regardless of government direction, hospital administration must take the reigns. We need strong leadership cooperating and developing a real solution; our country’s and citizens’ health depend on it.

Adam Ward is an Innovation Consultant for Simpler, an IBM Company. Initially trained as an engineer, he designed cars for 12 years before switching to improving processes, products and services in healthcare, where he has worked as a consultant for several large healthcare systems, public and private in the 10 years since. His passion is radical performance improvement while delighting the customer–patients and clinicians. He started his personal health transformation in 2009 and has finished multiple Ironman triathlons.