Fire Up Your Staff

Understanding some basics about motivation is an important first step in creating an environment in which employees thrive and produce consistent, high quality work. Here are some basics about motivation and some specific ideas for improving the output of your workers.

People Do Things for Their Reasons, Not Yours

Employees work to get something they want and value--income, for starters. To the extent they get what they want in the process of giving you what you want, both you and they remain content.

But the need for money is not the only motivator. Amateur athletes are a great example that the desire for personal accomplishment and recognition can stimulate performance beyond normal expectations and with no money involved. Similarly, opportunities to learn on the job, be promoted or given added responsibilities are motivating. That's because they offer a sense of personal growth and accomplishment while building confidence and providing recognition.

It's the manager's job to establish a rewarding environment. That means knowing what motivates each employee on your staff. You might think it's the salary and benefits that motivate workers most. It's true, most won't come to work without competitive compensation and inadequate pay or benefits will be a distraction. Workers may accept your job offer but be continually unhappy with the insecurity or personal devaluation that taking low wages and poor benefits means. They certainly won't be motivated to be high achievers.

But the volunteers at the hospital are an example that many people are motivated through accomplishment and recognition. So, once a satisfactory compensation package is in place, getting more from your employees will require catering for this higher order need. The sense of satisfaction derived by helping people--employer, coworker and patient alike--can often be the best motivator.

It's important, though, that good work be acknowledged. While some employees are able to give themselves praise and don't require it from others, the receptionist who is acknowledged as having provided valuable work and doing it well is more likely to be motivated to higher levels of achievement. Good managers do this and get the doctors to do it, too.

When a doctor comes up to the front desk and congratulates a receptionist on handling a difficult patient with finesse and tact, she's much more likely to come in tomorrow with a renewed sense of enthusiasm. Creating an atmosphere where each employee has his or her special needs met as a result of performing the work efficiently and effectively, are the responsibility of the owners of the business and the specific job of the manager.

On the other hand, regardless of their other needs, most employees are likely to suffer a decline in job satisfaction and performance when recognition for a job well done is lacking. Employees should not have to assume that since they haven't been fired their work is satisfactory. But that's the way many physicians work. Praise and thanks can be powerful motivators, especially after a long, hard day.

Knowing What Success Looks Like

Some otherwise well-motivated employees don't perform well because nobody ever told them specifically what was expected. If your worker is unclear about what you expect, inferior performance should come as no surprise.

But we hear unenlightened managers say naive things like, "We're all adults here and they should know what to do." Maybe they should, but why not tell them anyway? Goal setting is essential to goal attainment. Employees should have clear goals set for each aspect of their jobs. Of course, that implies a clear job description for every position that is unambiguous, and that means it needs to be in writing.

Goals maintain a focus and provide a sense of accomplishment when met. Reasonable goals should be high but achievable. If they're too high, they tend to demoralize the worker because she cannot experience success and the joy it brings. If you expect your billing clerk to process more bills per hour than is reasonable, or your nurses to see more patients or return more phone calls than they can handle with quality, the result may be low morale and even resignations.

On the other hand, goals that are too low fail to offer a challenge or sense of accomplishment when met. Employees who are doing work below their level of training and experience are likely to become dissatisfied with the routine nature of the work. They may also come to feel overcompensated for the work, and that creates a sense of insecurity. Workers who know they're being paid more than they're worth often worry about when they'll be found out and discarded in favor of somebody better.

Keep Feedback Coming

Once the standards for the job have been set, employees need frequent feedback and reinforcement to keep motivated. Let people know when they're doing well early and often. It's best when it comes from physicians because they are the ones who sign the checks and whose approval carries the most weight. Managers and supervisors are also important in the praise process.

But praise isn't the only feedback people need. They need to know when they're missing the mark. If doing the job well and being noticed for it is a motivator, then the physician or manager who withholds feedback on how to do better is a de-motivator.

You Get What You Reward

Unfortunately, in lots of practices, the reward structure is counterproductive. Practices that want a harmonious environment often reward those who complain the most. Managers who want employees to take initiative may take punitive measures when employees make mistakes. You may want meetings to start on time, but you delay beginning the meeting until everyone is present, rewarding latecomers. Or some practices say they encourage teamwork, but they continually compare one person against the other, playing favorites. Or they reward individual achievement more than team success.

Every undergraduate learns in Psych 101 that behavior that is rewarded tends to be repeated, and that the best rewards are those that come closest to approximations of the desired behavior. Giving people a bonus at the end of the year may make you feel good, but it's not much of a motivator. But thanking people on the way out of the office after a particularly stressful day is.

While some employees can give their own rewards (silently taking pride in the self-satisfaction of knowing they've done a good job, for example), most need outside feedback. Nurses and physicians get lots of feedback from patients who are grateful for their services. But office employees like billers, receptionists, file clerks and even managers usually get negative feedback from both patients and physicians. They need positive feedback to balance it.

Validate Your Workers

It's natural for most people to want to feel cared about, and it's not exclusive to personal relationships. People spend a lot of their lives at work. To the extent that they feel that coworkers and bosses care about them, the quality of work life is improved.

You can show concern for how employees feel by occasionally asking how their work is going and listening for the answer. If you simply ask but don't pay attention to the response, you appear insincere and it's a de-motivator. Genuinely listening to employees not only demonstrates your concern for them, but it may provide valuable information about managing your office. Since your employees know how busy you are, it's that much more meaningful when you have a personal dialogue with them.

People work harder when they feel others are counting on them. A recent client was complaining about his employees' insistence on taking breaks mid-morning and mid-afternoon, no matter how busy the practice is. Their slavish insistence on adhering to the letter of the state law was confounding to the doctor, who felt they should be more sensitive to the needs of the patients in the practice.

Morale in the practice was low because the physician continually communicated dissatisfaction with the employees and management was no help in the process. It seemed there was never a positive or kind word, and this attitude rubbed off on the staff who treated each other with similar insensitivity.

These were workers who didn't care about doing a better job. They weren't interested in helping a doctor, manager or co-worker that they didn't like. They didn't much care that going on a break puts extra stress on the workers who have to cover the job during the absence. Tardiness and abuse of the sick leave policy were also widespread in the practice.

Turning these people around will require a huge management effort and it's a lot easier to prevent this situation than to recover from it. These workers will need to want to work at their desks instead of sitting in the lounge for 15 minutes on their break. That means they'll have to find the work more rewarding than whatever they find in the kitchen. It's management's job to make that happen.

The same is true for showing up for work even though the sick leave policy will pay a worker to stay home. Some employees come to work every day because they care about imposing on their coworkers. But employees who abuse the sick leave policy don't care what problems their absence causes. Motivated workers don't want to let down the team, especially when that team works well together and creates a quality service. Employees can feel like team players by ensuring that each one understands how her role contributes to the practice's success.

Publish More 'Inside' Information

Failure to keep employees adequately informed generates a host of motivational problems, too. When employees feel that information is being withheld, they may jump to conclusions: that they're not important enough to be told, that the information is negative, or that their input is not valued. These are all demoralizing and demeaning conclusions.

Further, when information is missing, employees often 'fill in the blanks' and in so doing may circulate damaging or unproductive rumors that have very little relationship to the truth. Try not being so secretive. Even though people don't need to know everything that goes on, they want to know because they're on the team. If it's not highly sensitive, fill everybody in.

Here are some other techniques for letting employees know they're valued and important to your team, the practice and the patients.

• Celebrate birthdays and special occasions. Little fiestas are fun and the kind of thing teams do.
• Give titles that reflect the importance of the position. 'File Clerk' is traditional, but 'Medical Records Coordinator' is really what this person does and it conveys more respect for this valuable work.
• Reward outstanding accomplishments. Try thinking up new ways to let employees know you notice their achievement, such as special parking spaces, employee of the month luncheons, spontaneous merit bonuses or modest gifts and so forth.
• Be supportive when employees have ideas and suggestions--even if they're goofy. If you want employees to continue contributing ideas, don't roll your eyes when they come up with losers. Stay noncommittal: "What an interesting idea. You must have thought about that a long time!"
• Give plaques or awards for excellence, longevity and other accomplishments. Business cards, memo pads with employees' names on them, and other symbolic representations of being 'on the team' can help, too.
• Keep employees informed. Telling them what's going on reduces their insecurity and lets them know you have confidence in them as team members. The more 'inside' the information, the more motivating effect it will have when shared with employees.