The very first time you hire someone to be a part of your health care team, you have become a manager. Many doctors enter this arena blindly, without training, experience, communications, and without any sense of employment law or its bureaucratic cousins. Making a bigger impact on your community, being able to help as many people as possible, and generally being more effective demands that you become a great manager in addition to your diagnostic and treatment skills. This series will address basic concepts that can apply to an office of any size.
Rewards
Current thought in workplace satisfaction revolves around the idea of having engaged, productive and enrolled employees. Sounds great, but how do we get there? If your employees seem, disinterested, seeking time off, clock-watching, more interested in office politics than in patient service, you know you have some work to do. A common pitfall is to take the role of “motivating” your employees to really get in the game. Another is how you handle money.
Money
Daniel Pink has argued persuasively that rewards in the form of financial bonuses do not motivate higher performance, especially when the tasks are complex and cognitive in nature. The research he cites shows that the performance factors go down when the pay is in the form of bonuses, which is a startling paradox. So, what factors can be used in this arena?
- Be sure you are paying in the right percentile for the job, the demands and the experience present in your employee. If you pay in the decile above average, that employee will not be tempted to seek greener grass solely based on salary. You can find this information out at a compensation comparison website such as payscale.com.
- High performance employees seek three basic features of the workplace, and it’s your job as the manager to develop these. They are Autonomy, Mastery and Purpose, abbreviated as AMP.
- Autonomy comes from understanding what the job entails and being able to take responsibility for the entire process. Its opposite is micromanagement or division of labor that separates the start of a process from the conclusion.
- Mastery comes from practice, guidelines and training.
- Purpose comes from the top down. A purpose driven organization has a clear understanding and clear messaging in place that defines why the organization exists in the first place. This is easier said than done, but is crucial in giving employees a context for all tasks and procedures.
Motivation
Fredrick Herzberg makes several important distinctions in the area of employee motivation. The common confusion is between action and true motivation. Employees can be caused to act through negative methods (threats, demotions, censures, etc.) or through positive methods (perks, bonuses, fancier job titles, etc. ) None of these are motivators in a complete and higher-order sense. They all cause action of some type, but the manager is the one supplying the energy. Motivation in this sense is where the employee wants to generate an excellent end product, and supplies her own energy towards this result. A few simple ideas in this regard:
- Increase end-result accountability by decreasing some managerial controls
- Make responsibility for tasks go wire to wire so the employee sees the results of her labor
- Make task related information directly available to the employee, without having to go through a managerial channel
- Enable employees to take on higher-level tasks to encourage expertise (mastery) in a specific area.
All of these examples can be thought of enriching a job or expanding it in a vertical sense. The thing to avoid is horizontal expansion, which is merely doing more of the existing job or doing it faster. This will usually involve a change of managerial style and/or culture, but can be accomplished in any office environment.
Herzberg ‘s writings and research point out several key factors relating to high job satisfaction and high job dissatisfaction, regardless of pay or position. This area is somewhat non-intuitive for most doctors, and has many factors that will allow a more productive and internally motivated employee. This will be the topic of the next blog post.