The Cost of Worshiping the God of Efficiency

Making things more efficient sometimes comes with a high price

I had an interesting morning today. From going to my doctor’s appointment at my HMO, to the post office, to the gym, and finally home to hide from everything and everybody.

The doctor’s appointment. They have instituted an online check-in program to make things more efficient. So I checked in online, proud of myself for navigating yet another tech process, given that I did not grow up with all this technology. I arrived at the reception area to the office, and sat down, happy that I was already checked in. 

A staff member came up to me asking if I had registered already. I responded that yes, I had registered online. Thinking that she probably didn’t think that I would be doing that, being an older woman. Ha, I thought. We can learn! Don’t make assumptions about us. 

I was then immediately informed that I needed to check in at the front desk anyway, as the system did not always work correctly. Seriously? So much for bypassing that part. I checked in. 

I was called into my appointment.

 I tend to accumulate significant wax in my ears, and more so in the ear that I recently got a hearing aid for. So, I was there to get the wax cleaned out. The staff person came in, way too cheery and energetic for my comfort zone at that hour of the morning (but that is for another story) and showed me this new device that they would use to clean my ears with, using water pressure. I have had my ears cleaned out before with water, and prefer the staff to use the manual technique. Water tends to get stuck in my ears. They let me know that this device is what they would now be using for ear cleaning, and that it would help make things more efficient for the staff, as then some of the line staff could use this device rather than having a doctor, nurse practitioner, or other licensed staff, have to use their time for this. 

I realize that my reason for this appointment was not any kind of emergency or life altering situation, and yet, I felt a bit put off that this didn’t warrant any attention of the doctors or nurse practitioners. I can already begin to feel that way by simply being an elder. 

The staff are still in the process of learning to use this device and seeing how it works, I realize. But today it took three times as long, several visits from the licensed staff to come and check how it had worked, and several tries with the new machine. And I still feel like I have water in my ear. 

Next, I went to the post office to mail something that I wanted to send via Priority Express. Getting to the postal clerk’s window after standing in line, I was told where the Priority Express envelopes were. I grabbed one and filled it out, and then went back and again waited in line. Once again getting to the postal clerk’s window, she then informed me that I needed to fill out another form and she handed me that form. Back to the table I went, filled out the form, and got back in line. 

I was finally able to get the item mailed off. I know that it is efficient to have all the forms filled out in advance, and I am glad to do so. I do think, however, that when the clerk pointed out the proper envelope for me to fill out, she could have at that time mentioned the additional form required. I am glad to be more efficient, but also ask that others be more clear and efficient in their communication. Just saying. 

I thought that I would then go to the gym to work off some of the tension that I had built up in the morning. That didn’t work today, however. I simply needed to be alone and do things at my own pace. Even if that was nothing. I didn’t feel like being on an elliptical machine going nowhere, even though that was an efficient way to get some steps in. I didn’t feel like being efficient. I’d had enough of that for the day. 

I am paying most of my bills online these days. I like the idea of not using paper when possible. But, sometimes, I really would like to speak to a live human being if I have questions. But, once again, it is more efficient to have things dealt with online. Live chats are sometimes available online, but not always. It can be kind of like trying to get a representative when making a phone call and getting lost in the menu hell of all the choices, only to end up back to the original main menu. And screaming representative at the top of my lungs into the phone, to no one there. 

I used to work at a nursing facility before I retired. And I was amazed at how administration was continually trying to make things more efficient. Which often translated to less time with the doctor, so that their time could be used in the most productive manner possible. I am not sure who determines what is productive, but I do sense that the bottom line is all too often monetary. Of course, businesses have to watch the bottom line and pay attention to expenses, but in the medical field, there is more to business than that. 

I understand how crazy busy the doctors are, and how they are pushed beyond what is reasonable. But, I also see that efficiency seems to have a strong correlation with patients not feeling really seen or heard or paid attention to by their doctors. Patients who are often scared, overwhelmed by the system, and trying to get answers to what is going on with them. I did my best as a social worker to get them answers, but I was not their doctor. I was just better at (and less nervous about) chasing their doctor down and being annoying to them. And I would tread carefully when talking with the patients so as not to overstep what would be my place to answer and what would really be a doctor’s place to answer.

I felt that the younger social workers, who were clearly told to focus on discharging patients as quickly as possible, saw me as old fashioned when I spent more time with patients, listened to their stories, and advocated for them to have a bit more time in the facility while we found the best place possible for them. Not very efficient, I know. 

I would, at times, have patients’ families crying in my office, because of how they felt treated by their doctor. Doctors who can be so pushed and rushed that they can forget the kind of trauma that each family is feeling at that moment. They can forget how much impact their words and tone and feelings can have on families and patients. Forget that they have many patients, but these patients have only them as their doctor. All in the name of efficiency and getting a higher number of patients seen. Well, maybe not really seen.

I also begin to feel some of this demon of efficiency creeping into how I feel treated as an elder. Brushed aside more quickly, I think. Sometimes already seen as on the way out and not warranting as much time or energy or attention as those younger than I. I wonder if my doctors see me this way. 

I have to be vigilant if my own attitude turns toward this. It’s easy to internalize these messages of insignificance, not wanting to be a bother, not being a burden. 

Is it more efficient to not spend as much time with elders, since they are closer to leaving this planet anyway? Is it more cost efficient to spend time with those younger, who still are what is seen as productive members of society? As if we elders are no longer productive if we are not in the work force, no longer part of that statistic. 

Is it a waste of time to spend time listening, really hearing, paying attention to each other? 

Quite the opposite, I feel. 

Suffice it to say that you will not see the word efficient on any tombstone or memorial of mine. Thank God.