My deep sympathies. I work in law, rather than in medicine, but my experience has been that the people making strategic decisions (i.e., management) are not even trying to optimize for any plausible set of performance criteria. Rather, they are all, to the last (wo)man, hard-core satisficers.
The managers’ daily activity is directed toward making problems go away, with minimum risk, minimum change, minimum (managerial) effort, and minimum cost, in descending order of priority.
Otherwise smart and competent people who know me fairly well and who I have talked to about this vigorously insist that as soon as I have my business/mortgage/reputation/ass on the line, or, failing that, after the first time I get burned by an innovation that doesn’t work out, I will adopt the exact same stance. I find that hard to believe (in the sense of having a very low prior for it), but the evidence is all pointing in the same direction, and I can’t think of a good reason (other than the low prior) why it’s not credible.
I don’t know whether you and I are actually optimizers at any deep level, or if we just see the kind of inefficiency that spends $100 on a page worth of patient names as being, itself, a major problem.
Either way, I hope we both manage to find work environments that value efficiency.
My deep sympathies. I work in law, rather than in medicine, but my experience has been that the people making strategic decisions (i.e., management) are not even trying to optimize for any plausible set of performance criteria. Rather, they are all, to the last (wo)man, hard-core satisficers.
The managers’ daily activity is directed toward making problems go away, with minimum risk, minimum change, minimum (managerial) effort, and minimum cost, in descending order of priority.
Otherwise smart and competent people who know me fairly well and who I have talked to about this vigorously insist that as soon as I have my business/mortgage/reputation/ass on the line, or, failing that, after the first time I get burned by an innovation that doesn’t work out, I will adopt the exact same stance. I find that hard to believe (in the sense of having a very low prior for it), but the evidence is all pointing in the same direction, and I can’t think of a good reason (other than the low prior) why it’s not credible.
I don’t know whether you and I are actually optimizers at any deep level, or if we just see the kind of inefficiency that spends $100 on a page worth of patient names as being, itself, a major problem.
Either way, I hope we both manage to find work environments that value efficiency.