We've all had 'em, all dreaded 'em. Possibly the worst part of office life: the meeting.
But, turns out, maybe it's okay to hate them, because they can be a huge waste of resources like time and money.
"Our best estimates -- and these are pretty educated -- are there are 11 million formal meetings every day in the United States. That tallies up to about four billion a year," says Nancy Koehn, who teaches at the Harvard Business School. "Over half of the people surveyed say about half the meetings they attend are unproductive."
"So maybe a little more than two billion meetings a year that most people regard a very poor use of their time -- that seems like a real waste," she adds.
And yet despite the loss of productivity, we continue to have meetings.
Koehn says it's mostly out of routine and habit, and that email has contributed to more meetings because it makes it too easy to invite a whole list of people for a gathering, even if there's not a good reason for it.
"Whether you could accomplish a goal some other way," Koehn says, "We just hit send."
She recommends that if meetings begin and end on time, and if you limit them to a short amount of time to get a stated goal completed, the overall meeting will be more productive.
Instead of asking you to talk about the pain in your foot, or the ache in your chest, health care workers are starting to ask you about...your story.
There’s an emerging idea in health care that social and psychological conditions -- like poverty and chronic stress -- change how your body and brain work, and that can have damaging long-term effects on your health.
Doctors and nurses from northern California to Camden, N.J., are beginning to see that the first step in treating these patients is often treating the part of the illness that’s not on the surface. Patients like 30-year-old Elizabeth Philkill.
For years, she'd kept her past buried inside. “Some things you do not expose. It’s a judgmental world,” she said.
But in a quiet room with Renee Murray -- a nurse and a virtual stranger -- Philkill finally told the story that she'd shared with only two people in her life.
She told Murray, she'd been sexually abused for years as a child. And that one night a few months ago, she'd had a terrible dream that forced her back to those days. And that she wanted to forget. Fast.
So she made the call. "I called to get me some wet. I made it through it, bam,” she said.
Nurse Murray, who runs a program for underserved pregnant women in a Camden, knew what the drug could do.
“'Wet' is marijuana with PCP dipped in formaldehyde and you smoke it. You are not on our earth anymore when you are high on wet.”
Philkill was three months pregnant at the time.
Outwardly, Murray didn’t react to the fact that Philkill had endangered her baby, and herself. She wanted Philkill to feel safe, to keep talking.
Murray had recently been trained in what's known as ‘motivational interviewing,’ a way of getting patients to open up.
“I was thinking like, ‘yeah, this is crazy,'" she said. "Someone who is pregnant doing this drug that you hear all these horror stories about. But, as a nurse, that’s my job. My job is to sit here and to learn Elizabeth’s story. Because if I don’t learn her story, I can’t do my job.”
The approach worked. “She don’t know me from a can of paint, and she care about me then people that should care cares," said Philkill. "So it made me get out what I didn’t want to expose. You know what I am saying, it made me go deeper as to why did you smoke wet.”
In Camden and around the country, this listening technique -- a first step in changing behavior -- is catching on because it’s seen as a way to help treat patients who, like Philkill, are tough to reach.
But here’s the big idea; researchers are learning that the prolonged chronic stress that comes with worrying about food, safety and money can make people sick.
British epidemiologist Michael Marmot says people who suffer from chronic or "toxic" stress, are more susceptible to chronic disease like and early death.
“What’s only come to light over the last decade or so." Marmot said, "is if a child is exposed to a stressful environment, an abusive environment that affects brain structures, that can actually change the architecture of the central nervous system.”
And, Marmot says, this can happen to anyone -- young or old, poor or rich -- if they feel a sense of helplessness, or constant danger. "Where the threat is uncontrollable. You are threatened by a wild animal, you run away from the wild animal. You escape, then you recover. That’s what’s supposed to happen. But imagine you can’t get away from this wild animal, it never actually tears you apart, it’s just threatening you all the time,” he says.
Marmot is primarily concerned with the physiological effects from long-term threats.
Princeton psychologist Eldar Shafir, who co-wrote the book "Scarcity," is focused on more immediate stresses, particularly economic ones. He says money, trouble, and especially poverty, takes away your ability to think about anything other than what’s right in front of you.
“The rent this month is questionable, that dinner is not yet taken care of, those financial impositions take a load on your mind and leave less mind for other things to handle,” he says. Things like going to the doctor and taking your medicine.
This lack of bandwidth is particularly damaging to people with chronic conditions, like diabetes and heart disease, that demand constant attention.
That patients make up a small fraction of the sick, but they are responsible for the majority of health care spending.
Medicare thinks the connection between trauma and chronic illness is important enough that it has invested nearly $20 million, in a multi-state project. It's based on a model designed by Dr. Alan Glaseroff from Stanford.
“This work begins by asking the question, 'Why wouldn’t a person with a chronic condition do everything in their power to live long and feel well?'" he says. "And generally there is sort of a subtext, 'What is wrong with this person, they are not listening to me.'"
At his clinic, Glaseroff sees 160 privately insured patients, who racked up $58,000 a year, on average, in medical bills before he began treating them.
Glaseroff directs his team to focus first on what matters to a patient like dancing at his daughter’s wedding, for instance. Then they deal with the fact that the patient is diabetic and smokes three packs a day.
Glaseroff says his approach has helped shave 20 percent off his patient’s medical costs. He says if the model succeeds in other states, "It will be a huge step forward.”
It’s the kind of step nurse Renee Murray is trying to take with Elizabeth Philkill back in Camden.
“When you are dealing with people that have complex issues, if they are not ready to get the care they need or make a behavior change, it’s not going to happen. This approach gets them a little bit closer because now there is a healthcare provider who is showing a genuine interest in their life,” she says.
But Murray is a realist. She knows Philkill’s life is rocky -- she has no job and no permanent place to live.
Since her talk with Murray, Philkill has disappeared from her pre-natal class for weeks at a time. She has also had her phone turned off, and she continues to smoke cigarettes.
Even with all that, she did show up for class this week.
Surgery sounds like a quick cure for sleep apnea, but a review of the evidence by doctors found the operations can be risky and disappointing for many people. Masks and pumps that keep airways open at night are effective. And the equipment is more comfortable than it used to be.
Dilma Rousseff had already called off a high-profile visit to Washington. Speaking at the U.N., she accuses the U.S. of violating Brazil's sovereignty with its spying programs.
Punished after the Jerry Sandusky child sex scandal, the school has since made "progress toward ensuring athletics integrity," the NCAA says. So, a limit on how many scholarships it can give to football players is being eased.
An FAA advisory committee is considering relaxing rules on the use of electronics, such as Kindles and e-books, on flights.
Until now, the FAA banned the use of smartphones and other electronics during take-off and landing due to safety concerns, even if the phone or device wasn't transmitting data.
"For so long there were these safety fears, they weren't really proven, there was no evidence for many of the studies that had been done," says Farhad Manjoo, who covers technology for the Wall Street Journal.
''I used to think about the plane as a break from all the other stuff we have going on. I used to get a print newspaper before getting on a plane, because that was the only thing you were allowed to do," Manjoo says. "Now, I think of it as working time. Especially now that we have Internet on the plane, I can do a lot of work on there. I can't anymore kind of justify those 10 minutes that I have to sit there and not do anything."
"You could argue that it's making us more productive, I think you could also argue that it's eating into any leisure time that we used to have," Manjoo says. "I think some people looked forward to the plane, because that would be the time they wouldn't have to respond to furious emails from their bosses or colleagues, they could credibly claim an excuse for that. And now they can't."
1. Home health aides and personal care aides are the two fastest growing jobs in the United States. The number of these jobs is expected to grow 70% between 2010 and 2020, according to forecasts from the Department of Labor. The growth has a lot to do with aging Baby Boomers who will need more care-giving in coming years and don’t want to move into nursing homes. As the New York Times reports, “six million of the 40 million Americans older than 65 need some form of daily assistance to live outside a nursing home. Federal officials estimate that the number will double to 12 million by 2030.”
2. The median rate a home-care agency charges a family for a licensed home health aide is $19 an hour. The median rate charged for a licensed personal care aide is $18 an hour.
3. The median wage for home health and personal care aides was $9.70 an hour, and $20,170 a year in 2010, according to the Bureau of Labor Statistics. About 20 states exempt home care workers from their wage and hour laws. A national survey of domestic workers in 2012 found that 23% were paid below the state minimum wage. 70% were paid less than $13 an hour.
4. Nearly 40% of home care workers rely on public benefits such as Medicaid and food stamps, according to former Secretary of Labor Hilda Solis. In a national survey of domestic workers (including home care workers) 20 percent report that there were times in the previous month when there was no food to eat in their homes because there was no money to buy any.
5. Until last week, if you worked as a home health aide or personal care aide, you were not covered by federal minimum wage and overtime laws.* That’s because your job, which commonly includes things like changing bed-pans, bathing and preparing meals for an elderly or disabled person, had been classified in the same category as casual baby-sitting, and was thus exempt from the Fair Labor Standards Act. Last week, the Obama administration announced new rules that will, in most cases, reclassify home care work, and extend minimum wage laws and overtime coverage to those aiding elderly and disabled people in their homes. *The new rules go in to effect in 2015.
6. Minimum wage and overtime laws still won’t apply to you if you’re hired directly by a household, and provide mostly “fellowship and protection” to an elderly or disabled patient. The new rules the Obama administration set last week will apply to all home care aides hired through outside agencies. Most aides fall in to that category. But, if you are hired directly by a household, the rules will only apply if you provide mostly “care” as opposed to mostly “fellowship and protection.” Meaning, you’ll get overtime and minimum wage protection if you spend most of your time doing things like dressing, grooming, feeding and “toileting” a patient or assisting them with taking medications, preparing meals, and light housework. If most of your work for the patient involves things like playing cards with them, reading to them, and taking them out on walks, you won’t be covered under minimum wage or overtime laws.
7. Until 1974, federal minimum wage laws excluded an even wider range of domestic workers employed directly by a household—including housekeepers, cooks or gardeners. In 1974, Congress extended those laws to cover many domestic service workers, but certain kinds of work within that category were left out, including home care workers who tended to the elderly or disabled.
8. Domestic workers weren’t eligible for Social Security benefits until the 1950s, even though Congress passed the Social Security Act in 1935. In 1950, the law was extended to cover domestic workers regularly employed by a single employer. In 1954, domestic workers with jobs at multiple employers were also included. Farm work took a similar path.
The world's largest cruise line has experienced a series of problems aboard its ships, ranging from fires and power outages at sea to the wreck of the Costa Concordia.
The country is the crossroads of East Africa, it has strong ties to the West, and it sent troops into Somalia's endless war. For all these reasons, Kenya was vulnerable to attack from al-Shabab, the Somali militia tied to al-Qaida.
The country is the crossroads of East Africa, it has strong ties to the West and it sent troops into Somali's endless war. For all these reasons, Kenya was vulnerable to attack from al-Shabab, the Somali militia tied to al-Qaida.
Happy cows may come from California, but dairy farmers and cheese producers are at odds with each other over the state's decades-old pricing system. Hundreds of California dairies have gone out of business because of low milk prices.
Hank Van Exel grew up on a large dairy farm his father started in Lodi, California. Beneath a cap that reads Swinging Udders Veternarian Services, his face wears an easy smile. Except when he talks about the recent fortunes of almost a fifth of the state's dairy farms.
"It was devastating," he says, "to see how many of these people have lost everything that their parents have built up."
Van Exel leads me around his farm, where calves moo expectantly at feeding time. Van Exel says the state's pricing system has broken in recent years. "Our feed has jumped over 100 percent, and our milk is as low as it was in the 70's," he says.
On top of that, state and federal milk pricing systems don't treat all milk equally. When California's pricing was created, 60 percent of its milk ended up in cartons. Now drinking milk accounts for just 14 percent. Cheese is now the biggest slice of California's milk market. But under the historic pricing formula, milk used for cheese fetches the lowest price.
In the Depression, that pricing was an incentive to get rid of surplus milk. But now the main buyers of milk also get the lowest price.
Rob Vandenheuvel, with the Milk Producers Council, says the gap between California's cheese milk price and the federal guideline has grown significantly.
"At the end of the day," he says, "we're looking for, how do we get a fair price to our dairy farmers?"
Rachel Kaldor is with the Dairy Institute of California. She says cheese processors agree pricing needs to change. But they now sell throughout the world and have to stay competitive.
"Let us be able to value these products in the market," she says. "We need that milk and we will pay for that milk and we will pay for it in a way that keeps that dairyman in business."
California has an economist working on different milk pricing options right now. And dairy farmer Van Exel says that can't happen soon enough.
Airbus, the second-largest aircraft-maker, says that in 20 years China will overtake the U.S. as the world's top aviation market. The estimates are similar to projections issued by Airbus' bigger rival, Boeing, earlier this year.
It's been a week since a shooting at Washington, D.C.'s Navy Yard left 13 people dead, including the gunman. But is there a consensus forming on how to stop these attacks from happening again? Host Michel Martin speaks with former Congressman Asa Hutchinson; Ron Honberg of the National Alliance on Mental Illness; and the National Crime Prevention Council's Ann Harkins.
The online marketplace for health insurance is scheduled to open in one week. But people are still confused about what that means, and how the Affordable Care Act will affect them. Host Michel Martin runs through health care Q & A with Mary Agnes Cary of Kaiser Health News.
The online marketplace for health insurance is scheduled to open in one week. But people are still confused about what that means and how the Affordable Care Act will affect them. Host Michel Martin runs through a health care Q&A with Mary Agnes Cary of Kaiser Health News.
A college student will be able to shop for health insurance on one of the exchanges planned to open for business in October. But depending on the family's financial circumstances, he may be better off staying on his parents' plan or looking into Medicaid.
Four people have now been charged in connection with Thursday's shooting at Cornell Square Park on the city's South Side. Thirteen people were wounded in the incident, which police say is likely gang-related.
There have been more than 60 mass shootings in the U.S. since 1982; in only one instance was the shooter female. Researchers say that may be because men who want to harm people are more likely than women to use lethal weapons, like guns, and are more likely to blame others for their problems.
Nations will disagree about when and how to stop tyrants from committing mass murder, the president told the U.N. General Assembly. But he made the case that the international community must do more to prevent atrocities. Obama also used his address to say the U.S. is encouraged by signs of moderation from Iran.
A new bill passed in California aims to protect minors from having a permanent record of photos and phrases they might regret. The law signed this week will take effect starting in 2015. It requires website operators to erase posts by the minors who request it. It'll also deliver more restrictions for product advertisements that minors will see online. But the bill does not require websites to delete posts from their servers or delete re-posts by a third party.
Janell Burley Hofmann, a mother of five who also teaches technology workshops, joins Marketplace Tech host Ben Johnson to discuss.