Employee Motivation Part III

Thomas E. Cavanaugh, DC, MBA

In Part I and II of our series of  “employee motivation’ I discussed the lack of having the proper resources, training materials and lack of appreciation as a few reasons for an unmotivated staff. This week I will discuss the lack of reward as another factor that can cause staff to be unmotivated, resulting in a slow death to the practice.

Battle Wounds

If you have been in practice for more than a few months, you already know that the most challenging responsibility you have in your office is managing staff.  Working with employees is the most difficult part of your job because each has their own unique personality, attitude, habits and perceptions.  

Don´t feel alone in having lost a few on the battle field and wounded a few others.  It is an unfortunate but common occurrence for those of us who have never been trained in the area of human resources and effective staff management.  

I experienced a real taste of staff management when I was a contracted consultant in an Orthopedic Clinic. There were three doctors, three physicians´ assistants, three medical assistants, three insurance billers, a surgery scheduler, three medical files clerks, and three front desk receptionists, and some other part-timers. It was the first time in my working career as an adult that I was not the boss. I was “middle management’. To me that meant I was in the middle of the employees and the bosses, who were the doctors.

It was quite a challenge for me to learn how to get things done without being the boss, the person writing the checks.  Since I had not worked at the front desk in medicine, or as a physician´s assistant, a surgery scheduler, a medical insurance biller nor a records clerk, getting the staff to look at me for the answers and listen to me for the tasks to be accomplished was no easy feat.    

In that orthopedic office it took firing a couple of individuals who were bringing the other staff members down, hiring others to fill those empty spots and hiring additional employees to ease some of the work over-load.   By putting the right people in the right job and learning some key things about people and their needs, I was able to gain the staff´s respect.  This is what each owner doctor must do… earn respect by showing respect.  One way to show respect for employees´ accomplishments is through the use of rewards or bonuses.

Remember Who Is Helping You to Succeed

Establishing goals and using your statistics to evaluate how well your practice is progressing is an easy way to measure practice success.   If you do not recognize staff for their part in reaching goals and helping your practice grow, you create an office ambience in which your employees might believe that you simply don´t care about others and their efforts.

Goal setting is the doctor´s responsibility, but achieving them is a team effort.  Doctors who go to seminars and pat themselves on the back during the announcement of having reached higher goals, need to remember who worked with them to make it possible.  It is impossible for doctors to accomplish any greatness in their practice without the loyalty and diligence of their staff.  Unfortunately, there are many doctors who learn this the hard way by losing great staff for lack of recognizing and rewarding their good work.    

Experienced doctors or doctors who have been professionally advised, understand that the positive effects on the growth of their practice far outweigh the cost of performance rewards for employees.  These doctors use a healthy paycheck or bonus system, they don´t miss an opportunity to give employees positive feedback and are generous with their expressions of appreciation for all their staff´s efforts.  When their staff is asked about work, they seem to always say how wonderful it is to work for their doctor, and you would seriously doubt that even a 25% increase in pay could lure them away to another office.

It is a basic human need to be acknowledged for “a job well done’ when a job is well done!

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Set Up a System

Many small offices wait until the end of the year and the holiday season to give out bonuses as rewards for employees´ efforts.  Bonuses or rewards should be for “peak performance,’ not for a holiday.  Replace holiday bonuses with another type of gift in order to maintain the special integrity of your bonus and reward system.  

Doctors should establish in their policy manual what kind of levels or statistics represent peak performance for each department. If each department has their own specific goals to reach, there will be no jealousy when one department receives a reward and another does not.

Group rewards also go a long way with unifying your staff.  Determine rewards for the office as a whole, when particular goals are achieved. This might mean a great night out with the staff and their spouses to a great restaurant, a play, a professional sports game or opera. Whatever you choose, establish the parameters for the goals to be reached and the rewards that will follow.

Of great importance, you need to know what would constitute a nice bonus or reward in your employees´ minds. To some it might mean a cash bonus. To others it might mean an extra day off or a weekend getaway.   The bonuses or rewards must motivate employees to want to achieve more, but doctors must also understand that rewards are more symbolic than representative of the value for which they are presented.  In other words, doctors should not try to match the reward to the value of the performance for which it was earned – this mentality has financially crippled many good practices.   

If you´re not sure what bonuses would best motivate your staff, make a suggested list and have your staff decide.  As not all goals merit the same level of achievement reward, your list should include specific goals and suggested corresponding rewards.  If you do not tailor rewards and bonuses to your particular staff, they will do little to motivate staff and pretty much render your reward system ineffective.

Think Big!

Obviously you can´t send everyone on a cruise. But, maybe after a few years of consistently accomplishing goals with your loyal staff that might be something you can do.  Doing things in a positive way for your staff will bring you tremendous rewards of peace on a daily basis, and growth to you in the future of your practice.

Be Fair

Everyone wants the approval and respect of their boss or supervisor.  But, doctors must be careful not to show any favoritism towards one staff member over another.    

Rewards for each person or department must be equal in their challenge.  If one department continuously falls short after a lot of effort you should reevaluate the goals you´ve set for them and determine what needs to be done – are they too high, does the department have what they need to accomplish them, etc?  Unreachable goals are de-motivating, demoralizing and defeating.

Stay true to your reward and bonus system.  Give what has been promised, when it has been promised, and never give in and reward individuals who have not earned them.  Being a nice guy by going back on your word is not good for you or your practice even if it is a “positive deposit’ with the receiver.


My conclusion is very simple. Just remember how you got to where you are and reward accordingly!  If you don´t, you just might end up back to where you started!

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