The prevalence of remote work has come with a rise in worker productivity trackers—intended to make sure employees are actually working rather than, say, making balloon animals with their surgical gloves—and healthcare is no exception. Scoreboards that track various metrics tied to productivity are commonplace in healthcare. In radiology, scoreboards are commonly used to make sure radiologists are keeping up with a slew of metrics, like financial performance, customer satisfaction, and regulatory compliance.

Worker productivity trackers across industries have proven to be controversial, with some employers arguing they help ensure workers are getting their jobs done and that a business is meeting its goals, while others argue trackers hurt morale and are a way for companies to overly micromanage employees. Within the radiology world, there are also differing views on whether scoreboards are helpful or harmful.

Tracking productivity: Eric Rubin, a radiologist in Pennsylvania and chair of the Human Resources Commission for the American College of Radiology—a trade group that represents tens of thousands of radiologists—said he hasn’t heard industry-wide complaints about the use of the scoreboards. But his group, Southeast Radiology, made the decision not to use them, he said, because they have the potential to slow down workers and negatively affect morale.

Raking in the cash? Dawn Harris-McClain, president of consulting firm Accountable Physician Advisors, said that monitoring efficiency and effectiveness can improve medical practices’ profit margins, make sure they’re holding themselves accountable, and benchmark against industry standards. Keep reading here.—MA

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The Centers for Medicare and Medicaid Services (CMS) added a new designation to identify which hospitals are “Birthing-Friendly”—a label it will begin adding to qualifying hospitals in fall 2023.

“It’s a starting point,” said Missy Danforth, vice president of healthcare ratings at The Leapfrog Group, a nonprofit that collects and publishes hospital and outpatient surgery center safety and quality data. “Maternal mortality is one of the biggest problems in patient safety in this country right now. It’s encouraging that CMS is moving in the direction of establishing the infrastructure for a ‘birthing-friendly’ hospital designation.”

CMS’s designation—at least in its initial form—isn’t tied to outcomes, Danforth emphasized. However, medical professionals said there are a variety of measures and outcomes that have been shown to make a hospital truly birthing-friendly.

Why C-sections matter: When it comes to measuring maternal-care quality, one metric comes up over and over again: a hospital’s C-section rate, said Holly Loudon, chair of obstetrics, gynecology, and reproductive science at Mount Sinai West and Mount Sinai Morningside in New York City.

Eyeing other metrics: Cynthia Gyamfi-Bannerman, chair of the department of obstetrics, gynecology, and reproductive sciences at UC San Diego Health, said physicians should not induce a pregnancy before 39 weeks without a medical reason.

Ob-gyns are increasingly emphasizing a less-is-more approach to labor and delivery. That involves taking a cautious, judicious approach to interventions, while still monitoring closely and providing supportive care during and after birth. Keep reading here.—MS

Chime in: What other areas of improvement should hospitals focus on to create better maternal health outcomes? Reply to this email with your thoughts.

Hearing aids walk a fine line: They must amplify sound, but in a way that doesn’t further damage a person’s hearing. It’s not an exact science, either, as the FDA’s recent change on output limits for over-the-counter (OTC) hearing aids shows. The FDA initially proposed last fall setting the decibel limit at 115 decibels, or 120 dBs for devices equipped to compress the loudest sounds.

That’s “like a jackhammer right next to your ear,” said Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association (ASHA).

After some pushback—including from ASHA—the FDA revised its final rule in August that created a category for OTC hearing aids to put the output max at about 111 dBs, or 117 dBs for hearing aids with compression.

“It’s a 50% reduction in sound,” Creed said. “That’s a big reduction.”

Although sounds in the natural world can reach up to 120 dBs (and louder), Creed argued that hearing-aid users might not be able to remove the devices quickly enough or move away from the loud sound to protect their hearing. The FDA ultimately agreed the potential exposure to loud noise was outside of acceptable safety limits and, as ASHA also requested, required all OTC hearing devices to have a volume control users could adjust.—MS

Do you work in health care or have information about the industry that we should know? Email [email protected] or DM @MikeSchroederIN on Twitter. For completely confidential conversations, ask Michael for his number on Signal.

Today’s top healthcare reads.

Stat: Harvard Medical School researchers have found that gun violence is costing America $557 billion a year, or 2.6% of GDP. (Bloomberg)

Quote: “We need to re-evaluate almost everything we know about cancer through the lens of the tumor microbiome.”—Ravid Straussman, a cancer biologist at the Weizmann Institute of Science in Israel, on the discovery that cancer could be better treated by measuring the microbial DNA of a tumor (the New York Times)

Read: Health experts are not confident in the US’s ability to stop infectious diseases from spreading after witnessing the American response to Covid-19 and monkeypox. (the New York Times)