Study Hacks Blog

On Screens and Surgeons

Atul Gawande has a fascinating article in the most recent issue of the New Yorker about the negative consequences of the electronic medical records revolution. There are many points in this piece that are relevant to the topics we discuss here, but there was one observation in particular that I found particularly alarming.

Gawande introduces the Berkeley psychologist Christina Maslach, who is one of the leading experts on occupational burnout: her Maslach Burnout Inventory has been used for almost four decades to track worker well-being.

One of the striking findings from Maslach’s research is that the burnout rate among physicians has been rapidly rising over the last decade. Interestingly, this rate differs between different specialities — sometimes in unexpected ways.

Neurosurgeons, for example, report lower levels of burnout than emergency physicians, even though the surgeons work longer hours and experience poorer work-life balance than ER doctors.

As Gawande reports, this puzzle was partly solved when a research team from the Mayo Clinic looked closer at the causes of physician burnout. Their discovery: one of the strongest predictors of burnout was how much time the doctor spent staring at a computer screen.

Surgeons spend most of their clinical time performing surgeries. Emergency physicians, by contrast, spend an increasing amount of this time wrangling information into electronic medical systems. Gawande cites a 2016 study that finds the average physician now spends two hours at a computer screen for every hour they spend working with patients.

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The CAA Way

I’m currently reading Michael Ovitz’s engaging new memoir. Even if you don’t know Ovitz, you definitely know his clients’ work. He’s the super-agent who co-founded the domineering CAA talent agency, and during the 1980s and 90’s become one of the most powerful figures in Hollywood.

In his memoir, Ovitz emphasizes the importance of communication in the talent business. For a talent agent, he notes, your time is one of the primary resources you have to offer, so to succeed in this field, you have to constantly talk to clients, potential clients, ex-clients you might want back, and all the assorted figures in the entertainment world orbit who might have information helpful to your clients.

One of the cardinal rules during the early years of CAA was that you always returned every call the same day. Ovitz personally exemplified this rule. He would start making calls as soon as he woke up and continue making calls until right before he went to bed. He would make hundreds of calls every day.

The importance of these touches were so important that he had a small sign that read “communicate” placed on every phone in the I. M. Pei-designed CAA headquarters.

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A Social Media Icon

Seth Godin recently noted the following on his always insightful blog:

“The Mona Lisa has a huge social media presence. Her picture is everywhere. But she doesn’t tweet. She’s big on social media because she’s an icon, but she’s not an icon because she’s big on social media.”

This perfectly sums up a point I often find myself trying to make when arguing that people don’t need to engage social media to advance their career.

In my experience, if you push people — especially young people — about why they think social media is crucial for their professional life, you’ll eventually uncover a belief that an important factor holding them back is that people in power simply haven’t noticed their specialness.

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A Stark Survey

A couple months ago, Adobe released the results of its fourth annual Consumer Email Survey. Drawing from data gathered earlier in the summer from over 1000 panel participants, the survey provides a snapshot of current consumer email habits.

Among other results, it reveals that self-reported time spent checking work email has decreased slightly to 3.1 hours per weekday on average. By contrast, the average time spent checking personal email has increased by almost 20% to 2.5 hours per weekday.

Combined: the average daily time spent checking email is now 5.6 hours — up almost a half hour since 2017.

These numbers are self-reported and therefore should not be taken too literally, and if you look at the histogram provided by Adobe, it’s clear that the variance is significant. The survey still captures, however, the stark reality that the average professional is now dedicating a substantial fraction of their waking hours to sending and receiving digital messages.

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On Productive Technology and its Discontents

Recently, I’ve been dipping in and out of Edward Tenner’s provocative 1996 book, When Things Bites Back. In following one of Tenner’s footnotes I came across a fascinating 1992 academic study from the National Review of Productivity, authored by the Georgia Tech economist Peter G. Sassone. 

The paper has an innocuous title, “Survey Finds Low Office Productivity Linked to Staffing Imbalances,” but its findings are profoundly relevant to our recent discussion of attention capital theory, and the value of deep work more generally.

Beginning in 1985, Sassone began a series of twenty office productivity case studies spread over different departments in five major U.S. corporations. His initial goal was to measure the bottomline benefits of the front office computer systems that were new at the time, but as he notes, this soon changed:

“[I]t became apparent that [my] data collection and analysis techniques were yielding important productivity insights beyond the cost justification of office computer systems.”

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An Idea Revisited

Last week, I wrote an article exploring the idea of using human APIs to optimize value production in knowledge work organizations. It generated fascinating discussion both in my email inbox and the post comment thread.

To help prod this discussion forward, I thought it might be useful if I try (not necessarily successfully) to respond to a few of the more common concerns I heard about the hAPI concept…

Concern #1: Human APIs would induce stultifying bureaucracy.

The idea of implementing strict routines for professional interaction conjures hellish images of TPS reports and forms filled out in triplicate.

This is a reasonable fear. To create a bureaucracy, however, requires more than just a commitment to systems, but also an obsession with these systems that becomes divorced from the actual objectives of the organization. This requires special circumstances, such as an organization becoming large and slow enough, with sparse enough competition, that it can support ranks of career bureaucrats without promptly going out of business.

It’s perfectly consistent to imagine a firm that embraces the structure of hAPIs, but also maintains an obsessive focus on producing value, dynamically adjusting these protocols as needed whenever they notice undue friction or discover a more effective alternative.

Keep in mind, for example, that the original Ford assembly line was incredibly systematic and rigid as compared to their older method for building cars, but this structure yielded, at least at first, a much more profitable and dynamic company.

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The Bezos Mandate

In 2002, Amazon founder and CEO Jeff Bezos sent a mandate to his employees that has since become legendary in IT circles. It reads as follows:

1. All teams will henceforth expose their data and functionality through service interfaces.
2. Teams must communicate with each other through these interfaces.
3. There will be no other form of interprocess communication allowed: no direct linking, no direct reads of another team’s data store, no shared-memory model, no back-doors whatsoever. The only communication allowed is via service interface calls over the network.
4. It doesn’t matter what technology they use. HTTP, Corba, Pubsub, custom protocols — doesn’t matter.
5. All service interfaces, without exception, must be designed from the ground up to be externalizable. That is to say, the team must plan and design to be able to expose the interface to developers in the outside world. No exceptions.
6. Anyone who doesn’t do this will be fired.
7. Thank you; have a nice day!

This directive, which some informally call Bezos’s “API Manifesto,” transformed Amazon.

To be sure, transitioning to these formal APIs made life harder in the short term for its engineers. It was also expensive, both in terms of the money spent to develop the new interfaces, and the time lost that could have been dedicated to projects producing immediate revenue.

But once the company embraced Bezos’s mandate, it was able to operate its systems much more efficiently. It also enabled the launch of the public-facing Amazon Web Services, which now produces a much needed influx of profit, and allowed Amazon’s web store to easily expand to encompass outside merchants, a key piece in their retail strategy.

The impact of the API Manifesto has since expanded to the IT industry as a whole. From start-ups to massive organizations, the idea that information systems are more valuable when interacting through clearly specified and well supported API’s has become common.

Last week, for example, the cofounder of an IT firm told me the story of how he helped a large financial services firm implement an API for a set of services that were previously accessed in an ad hoc manner  (think: batched FTP).

It cost the firm a little over a million dollars to make this transition. He estimates it now helps them earn an additional $100 million in revenue each year through a combination of cost savings and the new customer acquisition applications enabled by providing a clearly specified and accessible interface for these services.

On Attention Capital

When I heard about the API manifesto, a provocative thought popped into my head: could these same underlying ideas apply to communication between people?

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Productive Pondering

As I transition from the slow freedom of summer to the constrained energy of fall, my thoughts have been gravitating back towards nuts and bolts productivity issues. One topic that keeps catching my attention is the distinction between habits and workflows.

When most people talk about personal productivity, they tend to focus on improving the habits they deploy to wrangle their work. For example, batching email, or deploying time blocking to control the flow of their day (which, as longtime readers know, I highly recommend).

There is, however, another relevant layer: the underlying workflows that dictate what you work on and how this work is executed. For example, if you’re a project manager at a consulting firm, and you spend much of your day emailing back and forth with your team members to get answers to questions from your clients, this behavior is an implicit workflow that dictates that asynchronous, unstructured messaging is your preferred method for extracting relevant information from your team.

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