“What do they want from me!?!” an exasperated manager said to me referring to her direct reports. Let’s begin by agreeing that a manager’s job is to motivate and inspire people for performance and to achieve a common organizational or departmental goal, not to simply give them everything they want. 

Having said that, there are some distinct differences between what managers or doctors think our employees want and what they really do need in order to experience motivation in the work environment. What do you think employees want? More money? A nicer office?

The following study has been done several times over the last 60 years across all industries. It simply asks managers to rank (1-10) the following as to what they think employees want. 

• Tactful Coaching and Discipline
• Loyalty (to employee)
• Good Working Conditions
• Interesting Work
• Sympathetic Help on Problems
• Promotion/Growth in the Organization
• High Wages
• Feeling of Being in on Things
• Full Appreciation of Work Done
• Job Security

Separately it asks front line employees to rank the same list as to what they indeed want. The results for both groups have been consistent over the last 60 years.    The gross differences in the results of what managers assume employees want and what employees really do want are depicted on the table below:

There are a number of learning points from these results. 

1.      Notice the top three ranked by employees are precisely what managers rank as the three of least importance. Over the years the employees consistently say that they want: 1) Full Appreciation of Work Done; 2) Feeling of Being in on Things; and 3) Sympathetic Help on Problems.  Those same items are ranked 8, 10 and 9, respectively, by managers. For those of us who were promoted through the ranks over the years, somehow we have forgotten what was important to us when we were on the front line. 

2.      The top 3 employee motivators have something distinct in common – we can make them happen at no expense, other than our time and effort.  They are all within the control of the manager or physician. We can do this!  We don’t always have the funds to give raises or remodel the office but it is always within our capacity to actively engage in these three motivators.

Full Appreciation of Work Done is really the pinpointed positive feedback that was discussed in Managing People I in the November 2010 issue of Medical News of Arkansas. It is more than the occasional “thank you.” Full Appreciation of Work Done is noticing the details of accomplishments and voicing them. We can give employees the Feeling of Being in on Things through team building and delegating tasks (with an explanation of their importance).  And, we can be there when an employee comes to us with a problem, not necessarily as a confessor, but as someone who will demonstrate discretion and compassion.

3.      Managers rank High Wages as the assumed number one motivator for employees and employees themselves rank it as 5. Two considerations on this difference. Some physician practices pay rates below market. Be sure you are paying your employees at fair market rate.  Secondly, often when employees leave a practice, they will give the reason that they were offered more money at another practice. In the absence of significant position enhancement (they did not get their nursing degree or secure a supervisory position), industry change, or a geographical reason, the departing employee may tell you she is leaving for more money to avoid confrontation. If the employee is a high performer and seems to have been a good fit, the question that needs to be pondered is – why did she start looking for a different job? 

4.      Managers put Promotion/Growth within the Organization as number 3 but employees put it as 7.  As an administrator in a physician practice, I am relieved by this.  Often there really is not a lot of opportunity for promotion within a practice.  Still, excellence and striving for improvement and positive change are essential.  The ability to motivate employees without the incentive of promotion is particularly applicable to physician practices.

Please understand none of this is to suggest we should be softies. It is just as important to address underperformance and misconduct as it is to provide pinpointed feedback and employee development. When we do not address these, we lower the standards for all employees and the practice. Establishing a work environment that motivates employees to top performance and conduct while conveying compassion and support is the rare, delicate balance that makes for managerial excellence. 

While considering the results of this study is a helpful reminder, we have an added motivator in healthcare – helping people. Even roles that are not direct patient care can be tied to helping people, which is a great inspiration.  There is no better feeling than knowing that you have helped someone in need. Medical Records staff assist in the provision of accurate quality care by tending to the documentation. Collectors help give people peace of mind and allow them to concentrate on getting better, rather than worrying about the bills.  Appointment Schedulers help get patients to the doctor so they can get the care they need. These are a couple of examples of the way we can tie the inspirational aspect of healthcare to each and every position and task.

Jennifer A. O’Brien, MSOD , has been in practice management consulting for 24 years and is currently the executive director of Arkansas Specialty Orthopaedics in Little Rock, where fellowship trained orthopaedic subspecialists help Arkansas’ physicians help their patients. Visit us at arspecialty.com.

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