How one medical center returned millions to the bottom line by eliminating emotional waste

Decades ago when I was working as a clinical coordinator of several clinics associated with a large medical center, I was excited about launching the then-innovative electronic medical records system that would revolutionize and computerize the physician documentation process.

We thought this was a rational move based on a well-developed business plan intended to make doctors more efficient and give them more patient-focused time, I thought the doctors would be in agreement that the technology would lead to patients getting higher quality care with more consistency.

Except the physicians weren’t ready to have their world rocked. They were openly opposed to using the technology and skeptical about the expected time savings, believing it would actually slow them down. This small circle of skepticism rippled out into waves of resistance that echoed throughout the entire system. In response to physician opposition, we gathered data to see what reality said.

We created a time-study research project. Observers were assigned to watch the physicians as they worked and record time increments in one of two columns. The first column tracked the time physicians spent working directly with patients. The second column documented time they spent typing notes into the computer. The data collected would allow us to compare the findings with existing data on time spent documenting patient records. It wasn’t long before the observers called to tell me they needed a third column because something was showing up that we hadn’t factored in. I initially resisted adding a third bucket of data collection, but it turned out to provide the most startling revelation in the study. This third column revealed that physicians spent about two hours a day complaining about the new technology or about the patients.

Two hours per day of drama?
That time spent in emotional waste could have been an investment in developing their technology skills, strengthening their patient relationships, and adding value to the enterprise they had committed to serve.

Fast forward twenty years, I partnered with the Futures Company to redo this study with over 800 leaders from 100 different organizations. The biggest surprise that emerged since the original study was time lost in drama at work had increased! The data showed leaders were now spending almost 2.5 hours a day in drama that creates emotional waste at work.

The Drama and the Data
Sit with that number for a moment as you reflect on the productivity lost in 2.5 hours a day, 17 hours a week, 68 hours a month and 816 hours a year. Multiply that by the average salary in your organization. That’s a huge leak of hard dollars from the organization. These numbers likely reveal what you already have felt at work: the wasted time, energy drain, and the difficulty of balancing the right staffing levels.

Yet, 62 percent of leaders surveyed said they had participated in Human Resources provided learning and development programs to deal with these exact issues. It got our attention that in spite of having such programs, 2.5 hours a day continued to leak out of the productivity pipeline due to emotional waste. Why aren’t those programs, techniques and training working? Our expertise and experience is that the traditional tools and programs being taught and used over the last few decades simply don’t work for several reasons because:
• They hit the ego head on
• They focus on fostering engagement but without accountability, which leads to entitlement
• They coddle people’s preferences rather than helping them grow their business readiness
• They don’t help employees develop better mental processes through reflection and heightened self-awareness

Returning Millions to the Bottom Line
The Reality-Based Leadership philosophies help people develop the kind of healthy mental processes that plug the productivity leaks caused by emotional waste. Let me give you an example. Four months after using Reality-Based philosophies at a regional Midwestern healthcare system, leaders reported they had decreased the time spent dealing with employee drama by about an hour per day. Based on an average hourly salary of $48.00 for managers, multiplied by 275 managers, the organization estimated a cost savings of almost $3.5 million annually. Leaders were so excited about this initial savings that they baked it into their new annual budget. The organization’s leaders also projected an additional $13 million savings per year based on a 15-minute per day drama reduction among its 7,000 employees. Not only will this be a great monetary savings, leaders are equally excited about the redirection of that time into quality care, patient safety and process improvements. Many of these accomplishments were achieved using simple tools that bypass the ego, and asking great questions that promote self-reflection to cultivate accountability.

Questions that halt venting, bypass the ego and promote more productive behavior include:
• What do you know for sure? What are the facts?
• What did you do to help?
• What would great look like?
• What would provide more help right now, your action or your opinion?

One of the senior executives, also realized that Reality-Based tools could help him resolve a problem that has dogged national healthcare systems for years: nursing shortages. Assuming an average nurse salary of $68,000 per year, this leader estimates that the system’s nursing shortage (estimated at 300 nurses) evaporates if he can recapture two hours a day spent in drama. He told me his calculations were based on conservative numbers because they don’t factor in premium pay, overtime pay or the cost of traveler RNs. The leader also shared how these savings multiply in ways not reflected by the dollar amounts - things like fatigue, stress and all the other things that affect morale and patient care.

A New Approach for the Modern Leader
Many leaders have come to unconsciously accept a work experience so full of emotional waste that it’s seen as normal and a cost of doing business, an inevitable occurrence you must deal with because you work with complex human beings. When we can better understand the root cause of drama and emotional waste, the financial impact becomes clear and leaders can emerge as a modern leader who helps people recapture the time spent on fruitless drama and redirect it to added value and great results.

The cost of emotional waste is staggering. Ego-based resistance to change, employee disengagement, lack of alignment to strategic initiatives and the lack of buy-in is costing healthcare organizations millions of dollars per year. And while there is no lack of training, tools and techniques available, it hasn’t dealt with the root causes of emotional waste. You can find practical tools leaders can actually use in my new book, No Ego, to help you cut the cost of workplace drama, cultivate accountability and end entitlement to deliver big results.

Cy Wakeman is a dynamic international keynote speaker, leadership expert and New York Times bestselling author who has spent over 20 years cultivating a revolutionary approach to leadership and work that reveals the truth, interrupts thinking and settles the mind. Her Reality-Based Philosophy helps leaders and their teams ditch the drama, turn excuses into results, and find opportunities in every challenge they face. Contact her at, or visit

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