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1. Understanding your current capacity by phase (initiation, requirements, dev, etc) by Role is critical. if you don't have this you are screwed from the start.
2. before you launch each project have you done discovery to understand business and IS hours needed to complete the project? Costs, ROI, CBA, etc. Basically do you understand the full costs (as best as you can at this point) vs. what you are getting?
3. Do you constantly go back to #2 as you complete each phase? If not you might be doing projects that no longer bring value.
4. Do you understand your strategies to help pick the projects regardless of their cost/benefits? For example if your goals are to win market share but all your projects focus on operational improvements you might have a problem?
5. Building off of #4 do you know all your strategies and what percentage you are focused on for each one? 50% operational improvement, 25% win the market, 10% shake up the market, etc.
6. Do you revisit all of the above as market changes? This should be done quarterly at least.
7. Do you understand how bringing in contractors helps your capacity model? It doesn't matter if you bring in 50 java developers but your bottle neck to testing. 8. Does leadership understand all of the above? are they educated and given data to show the above?
That would at least help your discussions.
Fun (sad) fact: We ran a pilot that offered free health insurance to a pilot group if people if they went to see a nutritionist once a month and went to the gym few times a month. The calculated effort on the members part was around 10 hours a month. Everyone in the pilot who already took care of themselves did what was asked. Those who didn't already take care of themselves none of them did it or stuck with it. Even for free insurance. Program is being tweaked to see if we can make it better but those initial results were not encouraging.
As for the Hippocratic oath we'll have to agree to disagree. My view is a doctor should use his time on patients willing to make changes to get better. THis leads to better outcomes, more time for the doctor to see more patients, and less overall medical costs. We have data that shows that. I just don't see what a doctor can do if their patient refuses to make the needed changes (quit smoking, better eating, etc).
If my doctor believes in X and I believe in !X it would seem to be a better move for me to find a doctor who thinks like I do vs. wasting people's time and energy. Why would I, as a patient, want to waste my time if every time I talk to them it's the doctor's way or the high way (and vice versa).
But my experience in the healthcare field (backed by a lot of data) is that there is a growing minority that just don't follow what there doctors ask of them. I'm not even talking about controversial things, simple things like you have type 2 don't drink soda and work out and people will just not do it. So why should we bother wasting time on them if they won't help themselves.
A big medical expense savings could be care/disease management. Preventing people for getting type 2 if they show the pre-stage symptoms or how to manage it better if they get it. Do you know why most of these programs fail or fail to achieve the savings? The patient won't put in the effort even when financial compensation is offered.
Given the shortage of nurses, doctors, etc. At some point firings makes 100% sense.
it's understandable i think. I'm sure they are a lot of new patients who would love to get on a doctor's schedule sooner than later. And a few doctor friends of mind complain about the waste of time and energy on patients (especially those who are obese or have type 2) who just refuse to do anything to better themselves.
Managing your health requires that you actively participate in bettering yourself. I don't care if you are working with an MD, Chiro, new age healer, etc. If you won't do anything to take care of yourself why should you expect people to waste their time on you?
But on the other hand the unemployment rate for those with college degrees is about 4.5% which beats the national average ~10%.
On the flip side I also consider physical activities not a sport. I don't think power lifting is a sport (sorry to all the power lifters). Is it easy? No. Does it require training? Yep? Does it require an ounce of brain power? No, if I go by all the power lifters I've ever meet at the gym, school, etc.
Does that mean things like poker, games, darts, whatever are easy? Not at all especially at high levels of play. But, for me, I don't consider them a sport. Yes you can make a gob of money in them so I don't look down on anyone with the time to be good in their area and bring home the bacon.However that level of play is an exception.
Just my 2 cents...