Recently, I stumbled over an unusual word that I have now added to my vocabulary.
That word was “miswanting” –  a rather poignant word from the world of psychology.
It is a word used to describe the human tendency to desire things that make us unhappy, and to shun things that fulfill us.
Psychologists have observed that we’re not very good at anticipating how our choices will end up affecting the way we behave and feel.
And so, again and again, we eagerly set off in pursuit of disappointment.

Miswanting is a term applied to the area of job satisfaction and job disruptors (such as automation).
It explains a lot about our rush to hand off to computers tasks we used to do ourselves.
In our personal lives, we look to software to direct us from one place to the next, to recommend which movie to watch and which person to date.
At work, we’re quick to offload even very sophisticated skills to robots or algorithms, rendering our own jobs more routine and less challenging.
We expect that automation will free us up for more meaningful and satisfying activities, only to find it has the opposite effect.

A recent study into job satisfaction illustrated how miswanting distorts our sense of the value of work

The researchers were surprised by what they discovered.
When people were at work, they were happier and felt more fulfilled by what they were doing than during their leisure hours.
In their free time, they tended to feel bored and anxious.
And yet they didn’t like to be at work.
When they were on the job, they expressed a strong desire to be off the job, and when they were off the job, the last thing they wanted was to go back to work.

“We’re actually happiest when we’re absorbed in a difficult task, one that challenges us not only to exercise our talents but to stretch them.” said the researchers.

People work for many reasons – some are obvious (I am paid to work), some are not as obvious (work is where my friends are). 
Research evidence and case studies testify to the reality of that understanding- how people approach work and what they get from it is vital to learning how to achieve the best possible outcomes for individuals and organisations.
Few other avenues offer as much promise for accomplishing valued outcomes as creating meaning in work – both in terms of individual flourishing, citizenship, commitment, and engagement and in terms of long-term, sustainable innovation, culture maintenance, and performance in organizations.

I have personally experienced all of the above and would elaborate to the extent that in a structured work place such as a pharmacy, I have a better sense of identity and place.
I enjoy the social interaction between other pharmacy staff and the customer/patient mix that I converse with.
To deliver a service, a formal structure is required.
Yet I crave the peace and quiet of my home office when I have to meet an intellectual challenge in the form of writing up a medication review, inventing a new product, developing a system or mentally sorting out a more efficient workflow for an established procedure (such as the delivery of patient advice – its form structure and payment).

But if I spend too much time in my home office, I begin to crave social interaction.
It becomes too quiet and I then switch the television on in another room to create a bit of “noise”, or I guiltily watch some program that may be entertaining rather than educational.
And if I am not fully engaged in an intellectual challenge, my productivity suffers and deadlines are not met.
My wife is forever challenging my need to meet deadlines when writing for i2P (instead of following some other pursuit like taking a coffee at a local coffee shop), but that is my personal infrastructure to hold me together in my home office coupled with a fixed number of intellectual challenges in the form of opinion articles.

It is best described as being never satisfied and being unhappy if I am in one environment for too long (pharmacy or home office).
Meaningful work is a good predictor of desirable work attitudes like job satisfaction.
In addition, meaningful work is a better predictor of absenteeism from work than job satisfaction.
Meaningful work can come from the individual or the organisation. 
Some people bring a sense of meaning and mission with them to the workplace, and some organisations excel at creating meaningful workplaces where every employee becomes part of creating success, cohesiveness, and culture at work.
These environments will have a mentoring culture in place.

Being absorbed in a difficult challenge so as to be happy can be produced by all manner of effort, from singing in a choir to racing a dirt bike.
You don’t have to be earning a wage to enjoy the transports of flow.

And yet, given the opportunity, we’ll eagerly relieve ourselves of the rigors of labour.
We’ll sentence ourselves to idleness.
Relieved of challenge our discipline flags, and our minds wander.
We get lazy.
And then we get bored and fretful.
Disengaged from any outward focus, our attention turns inward, and we end up locked in what Ralph Waldo Emerson called the “jail of self-consciousness”.
All too often, automation frees us from that which makes us feel free.

Our bias for ease over effort makes us particularly susceptible to the seductions of automation. By offering to reduce the amount of work we have to do, by promising to imbue our lives with greater comfort and convenience, computers appeal to our eager but misguided desire for release from what we perceive as toil.
In the workplace, automation’s focus on enhancing speed and efficiency — a focus determined by the profit motive rather than by any concern for people’s well-being — and that often has the effect of removing complexity from jobs, diminishing the challenge they present and the engagement they promote.

Would you not agree that the paragraph above in italics is a reasonable representation of pharmacy as it is currently structured today?
Positioned on the downslide of its PBS tipping point, and needing a complete replacement, a totally new paradigm to bring everybody together again.

Unfortunately, the 6CPA will not achieve this reformation, but the new clinical services under its banner may buy time to enable sufficient research into that pathway.
It buys time for restructuring but that will not progress significantly until the PGA can demonstrate leadership, by disposing of its conflict of interest issues.

The deck is stacked, economically and emotionally, in automation’s favour.
Automation can narrow people’s responsibilities to the point that their jobs consist largely of monitoring a computer screen or entering data into templates. 
This essentially describes dispensing.

All professionals (doctors, investment bankers and other highly trained people) are seeing their work circumscribed by artificial-intelligence systems that turn the making of judgments into a data-processing routine.
There are some diagnostic programs now available that consistently return higher levels of correct diagnosis compared to the qualified human doctor equivalent.
Will this leave the GP in a position forever challenged?

The apps and other programs that we use in our private lives have similar effects. 
By taking over difficult or time-consuming tasks, or simply rendering those tasks less onerous, the software makes it even less likely that we’ll engage in efforts that test our skills and give us a sense of accomplishment and satisfaction. 

All too often, automation frees us from that which makes us feel free.
The point is not that automation is bad. 
Labour-saving technologies have been progressing for centuries, and by and large our circumstances have improved greatly as a result. 

Deployed wisely, automation can relieve us of drudge work and spur us on to more fulfilling endeavours.
The point is that we’re not very good at thinking rationally about automation or understanding its implications.
We don’t know when to say “enough” or even “hold on a second.”
The deck is stacked, economically and emotionally, in automation’s favour.

How then do you measure the expense of an erosion of effort and engagement, or a waning of agency and autonomy, or a subtle deterioration of skill?

The costs are harder to pin down.
In fact it’s impossible.
Those are the kinds of shadowy, intangible things that we rarely appreciate until after they’re gone, and even then we may have trouble expressing the losses in concrete terms.
But the losses are real, and as they mount, they begin to drain our lives not only of effort, but of meaning.
It’s the reason health professions try to shut the gate on each other through disparaging press releases and knee-jerk responses that are thought to protect “turf”.
The medical profession also sees itself as becoming disrupted and displaced and has not been able to face up to the fact as yet.

Automation is not an event but a process.
As technology advances, we are continually called on to renegotiate the division of labour between ourselves and our machines.
As a society and as individuals, we can make these decisions wisely and attentive to the sources of human flourishing — or we can make them rashly, thinking only about what computers can do for us.
The danger in taking the latter course is that we may end up creating a world in which we don’t want to live.