The Economy You're Investing In (But Don't Even Realize It)
The parking garage at work makes me homicidal. With the recent trend of parking by backing your car into spots (why?!), people who lose control of their kids and let them run directly into the lanes (honestly?!), and the rise of extended-cab-F-1-blah, blah, blah taking up way more room than allocated (seriously?!), I was flying into a rage nearly every time I came into or left work. And I’m at work more days than I’m not, so that was a lot of rage.
Having been burned out for the past month, things went further off the rails last week when I got sick. I caught whatever virus is going around and ended up coughing so hard that one night I thought my lingering chest pain was a heart attack. (I got checked out in the ED. EKG, NSR w/ low voltages. POCUS WNL, no pericardial effusion. Troponin undetectably low. CXR w/ a microscopic ditsel in the RUL, “clinical correlation recommended.”) Needless to say, I hit my limit with our parking garage shortly thereafter.
The parking pass that allowed staff to park on the lowest levels of the garage was an expensive, unnecessary perk when I started here over a decade ago. The pass I had was $60/mo and allowed parking on levels 5 and up. The pass allowing parking on levels 1 - 3 was $180/mo. Was I willing to spend an additional $120/mo just to avoid the first four levels of the parking garage? Especially when that fifth level is usually full (even on service days when I get to work maximally early), so I’m usually on the sixth or seventh? Now, raging, burned out, and sick, my answer was a resounding “Yes.” An extra $120/mo to not have to dodge people paying attention to nothing other than their rear-view cameras when parking? To save myself from the angst of imagining running over an errant child? To make my inner narrative about the people who buy extended-cab-F-1-blah, blah, blahs vastly less frequent? Yes. 100%. Sign. Me. Up.
Friends: only four days into the new parking pass, I cannot sing its praises highly enough. I’m not even beating myself up for not getting it sooner because I’m just so stinking happy I just got it when I did. Sure, I know hedonic adaptation will kick in at some point. But the reason that extra $120/mo will remain a good investment is not what it’s giving me; it’s what it’s taking away.
“Annoyance economy” is a term I’ve seen floating around recently. In the world of business, it’s made up of “robocalls, hidden fees, and customer service chatbots that can’t solve most problems.” But another explanation takes the concept much more broadly: “the everyday interactions that should be simple but often turn into fraught ordeals.” Some drivers of the annoyance economy are intentional, like making it nearly impossible to cancel a subscription or membership. Overwhelmed by the idea of figuring out how to cancel the thing you no longer use, navigating webpages or phone trees, imagining a customer retention specialist guilting you into keeping the thing in one form or another is enough to make anybody with a bit of disposable income just keep paying $20/mo for the thing. Other drivers of the annoyance economy aren’t intentional, but are due to life changing without the systems in which life takes place adapting or evolving concurrently. Our parking garage is an example of this. When it was built, reversing into parking spots wasn’t something people frequently took the time or effort to do, and huge, extended-cab vehicles weren't a thing. (Children were still not to be trusted; they were feral creatures back then, too.)
The “annoyance economy” in patient care is managed with workarounds such as dot phrases in EMRs and office managers handling patient billing and insurance claims. And as physicians, we are highly adaptable problem-solvers, so often the annoying things don’t even register. Or if they do, they’re fleeting. A peer-to-peer that shouldn’t be necessary, given how obviously indicated the course of action is, becomes a quick curse with an eye roll while reaching for the phone to call whoever the alleged “peer” is and just fix the problem. We recognize, either consciously or unconsciously, that annoyances in medicine will usually require massive systemic change, and, without the time, energy, or agency to bring about that change, we do the best we can with what we have and get on with it. It becomes normal. So normal that we spend hours of our day with annoyances that could be mitigated, if not completely resolved, with relatively little time and effort.
Disposable income helps, for sure. Money may not buy happiness, but it sure fixes problems. A new parking pass, grocery delivery, or a virtual assistant to manage household schedules is an additional budget item, but could free up enough time and mental space to make it wholly worth it. And even if there is no disposable income, reserving an hour to brainstorm how to solve an annoyance for free could yield some outside-the-box thinking that isn’t available when you’re quick-curse-and-eye-rolling your way through a typical day.
So, what’s your most frequent annoyance? Not your biggest one, but one you experience basically every day? First, respond to this email and let me know; I’m very curious to find out what we've just accepted as the price of doing business. Then find some solutions (that don't involve telling yourself to “just be better”) and try one out. If the first solution works, great! If not, experiment with another possible solution until you find one that works. Rinse and repeat until you reduce your participation in the annoyance economy. Just like that, you may find you have the mental bandwidth to calmly spot the parents losing control of their kids in parking garages a mile away.