Most people believe putting profits over patients’ care is wrong, but systems such as Michigan Medicine are pushing staff to reach increasingly harsh productivity metrics. 

Michigan Medicine once prioritized quality patient care over financial surplus, but this focus has shifted in recent years. Staff are being pressured to see more patients per day and spend less time with each one individually in order to increase surplus, with productivity metrics exemplifying this shift.

What are productivity metrics?

Productivity metrics are a very simplistic way of measuring a healthcare worker’s output and affect Dietitians, Social Workers, Physical Therapists and other healthcare workers.  They can lead to less safe patient care and poor employee retention, health and well-being.

Metrics Doesn’t = Comprehensive Patient Care

Productivity metrics are directly associated with various forms of harm. Healthcare professionals can fear punishment or job loss, leading to poor coping strategies like cutting corners, delaying tasks, not reporting near misses, and taking increased risks. We can find ourselves focusing more on meeting employer imposed goals than performing the full-spectrum of care our patients need and deserve. 

Over time, a gradual erosion of acceptable safety practices and standards becomes “normalized” because no accidents have occurred. As these standards become normalized, it could negatively impact comprehensive patient care. There could be medication errors, inappropriate care, and increased patient mortality.

Metrics are unsustainable

The economic-focused environment and reliance on productivity metrics also contribute to the physical and mental distress of employees. Studies of performance metrics show they are linked to burnout, job dissatisfaction, stress, detachment from work, sleep deprivation, and chronic fatigue. 

The focus on increased productivity metrics has become a vicious cycle that is unsustainable at Michigan Medicine, leading to critical staffing shortages. There are many of our co-workers who would rather leave than treat patients as a number on a ledger. At some point, some staff feel it is better to provide quality care elsewhere than to stay at Michigan Medicine and provide care that they sometimes feel is inadequate.

Our work is already mentally and physically taxing. As healthcare workers, we face:

• A burnout rate of more than 50%, leading to a variety of negative health outcomes.
• Rising mental health issues, with 49% of healthcare workers diagnosed with PTSD, 40% with anxiety, and 37% with depression.
• Increased suicide rates, which went from 3.8 million to 6.6 million between 2008 and 2021, and are continuing to rise due to the stress from the COVID pandemic. 
• Increased musculoskeletal, cardiac, endocrine, and other serious health issues, leading to higher rates of premature death. 

We experience moral injury due to increased productivity standards. In order to reach our metrics, we feel we cannot provide the care patients deserve while meeting these impossible goals set by the administration. We feel our jobs are reduced to a number or dollar amount, which is dehumanizing and demoralizing. It devalues the essential work we perform. Adding to these issues, unnecessary production pressures lead to increased absenteeism, lower productivity, reduced effort, and a negative attitude towards the workplace.

The Real Bottom Line

If our employer’s concern is the bottom line, they should remove productivity standards while increasing autonomy to providers. This approach ensures that those on the frontline can deliver the best care possible while maintaining better overall personal health. It also ensures that Michigan Medicine lives up to its message of exceptional patient care and being one of the top healthcare employers in the nation. We can be the leaders and best, but prioritizing productivity over top-notch healthcare makes that goal impossible.

In Solidarity

Kate Robins (UMMAP Treasurer and Michigan Medicine Physical Therapist)