Jan 27 2014, 4:35am CST | by Forbes
The brilliant Ira Glass managed the impossible in the penultimate This American Life episode of 2013 – humanizing car salespeople to the point where you begin to empathize with them, even if you continue to dread (perhaps even more so) your next visit to a showroom.
Glass takes us through a month in the life of the Town and Country Jeep dealership in Levittown, Long Island, introducing us to an eclectic group of men and one woman who are trying to hit their target of 129 cars, and earn a handsome bonus from Chrysler. There are individual bonuses available as well. Glass explains how the system works:
“So there actually is a place at Town & Country where they keep score of who has sold what. It’s in Freddie’s office, the general manager’s office. It’s a white board with each person’s sales for the month to date on it.
Every car or truck that they’ve sold is represented by a little magnetic rectangle that’s roughly the size of a nine volt battery. Everybody calls these chips. And the different colors of the chips stand for different models of cars and trucks.
And throughout the day, salesmen come and they hover around whiteboard, seeing where everybody stands. And generally, everybody is shooting for at least 15 sales a month. At 15 sales, your commission for the next month jumps from 20% to 30%.”
The easy availability of data has armed and empowered customers, meaning that dealerships now anticipate making less money on each transaction, and hope to make up the difference in volume, further ratcheting up the pressure.
You listen to the experiences of the salespeople – the divorces, the missed opportunities to watch a son’s football game, the weight gain, the rituals — and are overwhelmed by the intense pressures of the job, and by the extent to which it evokes the poignant desperation of Death of Salesman, and the violent urgency of Glengarry Glen Ross. The manager actually reminds his staff to, “Always Be Closing,” and the modern equivalent of the magical Glengarry leads seem to be customers drawn from the internet. By any measure, it seems like a brutal way to make a living.
In the month or so since the episode aired, I’ve been struck by the unflattering parallels between the experience of Glass’s car salespeople and the reports I’ve heard from physicians in a range of practice settings.
I’ve heard from physicians employed by for-profit companies that their productivity – in terms of patient encounters – is monitored using a nearly identical communal chart to the one the Long Island dealership uses to track Jeep sales. Providers are explicitly urged to increase their productivity, receiving bonuses if they hit a pre-specified number of patient encounters, and warnings about their future career prospects if they fall short.
I’ve heard from doctors at leading academic medical centers that their lives are increasingly revolving around RVUs, a billing metric (see this piece and this piece by Uwe Reinhardt, and this one by my Forbes colleague Dan Munro). An academic surgeon tells me “every meeting we have is about RVU goals.” Providers who fall short of their target may be docked a portion of their salary, while high-performing providers may have an easier time being promoted.
Perhaps some of the unhappiest physicians I’ve encountered (admittedly a highly competitive category) may be those working at Kaiser, who complain that it feels increasingly like “a patient mill” focused on throughput. Most Kaiser physicians I know invoked some kind of factory analogy when describing their job – and they’re not thrilled by the comparison.
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