As a physician, I enjoy listening to non-physicians tell me how to motivate doctors.  I don’t mean this in a totally snarky way (well, maybe just a little).  These conversations often highlight the chasm that exists between physicians and administration.

What’s the most common motivator people throw out there? Money.  Certainly everyone wants to make more money, I don’t refute that.  What I take issue with is the notion that the only way hospitals can get docs to cooperate is to offer them financial incentives.  This asserts that the underlying reason we do what we do is a fat paycheck, not our patients’ well being.

If you look at Maslow’s hierarchy of needs, human motivation is stratified into five levels of a pyramid.  Security of employment, resources and property reside toward the bottom of the diagram, above only one level that includes things like breathing, food water and excretion.  High-level motivators like achievement, respect, morality and problem solving climb to the top of the pyramid, where I believe most physicians function (insert obvious surgeon joke here).  In fact, it has been shown that after a certain level of compensation, additional financial incentives have little if any effect on performance.

And anyway, if simply dangling a financial carrot in front of a “simple-minded doctor” was enough to get them to decrease readmission rates, use laboratory and imaging tests more responsibly, and decrease length of stay, wouldn’t that have worked by now?

My answer when people ask me how to motivate doctors: Give them the tools they need to make the changes that will benefit their patients.  Collaborate with them on coming up with solutions to your institution’s ailments.  Allow them to come up with solutions and have skin in the game, and get out of the way.

As hackneyed as it might sound, doctors want what is best for their patients.  They want good outcomes, they want to be respected and regarded highly by their peers and in their communities.  They don’t want to be the highest paid, most mediocre member of a failing hospital system.

How do we narrow the chasm between physicians and administration?  Appeal to the highest levels of physician motivation: the desire to solve problems, achieve goals and gain respect.  Ignoring your medical staff and all of the subject matter knowledge they possess in favor of just paying bonuses with no strategy for engagement is indeed how not to motivate physicians.

Alexandra S. Brown is associate director, Healthcare Delivery Institute, HORNE LLP.