I had a conversation recently with another pediatrician who had been employed by a large hospital system owned practice, but who had recently been let go. It seemed that her approach to patient care didn’t align with the organization’s financial goals anymore. She was willing to manage complex chronic patients (who require more time), and she was devoted to her late teenage and early college-aged patients whom she had seen since birth, but whom also admittedly generate fewer office visits at their ages (compared to an infant who comes in every 2 months). Recently, she was also starting to get push-back from the newer/younger physicians who had joined the group, because they saw her patients as “time sucks” that hurt their bottom line. She’d been with this practice for almost three decades. She had a loyal, if not fiercely devoted following of families. And yet, the hospital system saw no value, not only in her as a skillful and compassionate physician, but also in her patients, whom they clearly viewed as replaceable and a liability to their revenue column.
If this sounds familiar, read on.
Since these stories no longer trigger shock in me anymore, she and I didn’t waste much time lamenting the sadness of it all, but rather we jumped right into a discussion about the irony and paradox of a system that is filled with so many brilliant minds, yet has such little insight into the business of taking care of people. Years ago, I was introduced to the book Drive, by Daniel Pink. It changed the way I think about life, relationships, and the physics of human behavior. The premise is simple. Pink reviews the science of what makes people do the things they do, and more specifically, what works to motivate people…and what doesn’t. He discusses a study, financed by the Federal Reserve Bank and conducted by economists from MIT, The University of Chicago, and Carnegie Melon, in which graduate students at MIT were asked to do a series of tasks, ranging from memorizing a sequence of numbers, to word puzzles, to simple physical tasks like shooting a ball in a hoop. They then told the students that if their performance of these tasks was meager, they would get a small monetary reward, those whose performance was somewhere in the middle would get a medium-sized monetary reward, and those who performed the best, would get the largest monetary award. What they found, was that when it came to tasks that involved even rudimentary cognitive work, bigger rewards did not equate to better performance. In fact, the group who initially performed the best and who received the highest monetary reward? Their performance actually began to tank, and they essentially became worse than the other two groups. The researchers were baffled by these results, and thinking that maybe their sample (MIT students) were possibly just not sufficiently motivated by the dollar amount they were offering, they decided to take the variable of affluence out of the equation, and they took their study to a location on the globe, where money is in short supply…rural India. And guess what? They got the same results. Even in one of the poorest areas of the world, the dangling carrot of more money, did not equate to better performance.
I’m guessing that most of you are smiling a little bit, by now, as I did when I first read about these mind-baffling results. “Yes! We’re not puppets, for God’s sake!” I found myself thinking. And yet, that’s exactly the approach most organizations take with their employees, and most certainly the approach that many healthcare corporations take to the cogs in their wheels…the physicians and nurses caring for their patients.
What Daniel Pink goes on to say, is that what really motivates human beings, actually has nothing to do with money at all. It boils down to three things: autonomy, mastery, and purpose. That’s right folks. Science proves time and time again, that if you 1) get out of people’s way 2) allow them to work at becoming better at something and 3) demonstrate how they are contributing to a greater purpose outside of themselves and even outside of the organization…you’ll not only have better performing companies…you’ll have happier, better performing employees.
So, you can see why, after being introduced to this concept, and after watching it play out time and time again, in my own life, and in the lives of my colleagues, I’ve made a commitment to go PINK. It’s not only made all the difference in my life and in the lives of my team, but it’s changing the way parents and families are experiencing healthcare. And that, gets me out of bed every single morning. I’d love to hear your thoughts.