The art of motivation

Many readers will no doubt remember the colourful figure of Derrick Evans, better known as Mr Motivator, who shot to fame in the early 1990s by virtue of his numerous TV appearances promoting health and fitness as a way of life.

Use of the stage name ‘Mr Motivator’ struck a chord with the public as it infers the gentle persuasion of people to do something that they intrinsically don’t really want, or feel inclined, to do. In other words, people by and large lack self-motivation and must be pushed, cajoled and exhorted to get off their backsides to exercise.

Stephen Covey, the author of The 7 habits of highly effective people, observed that such attempts at externally applied motivation are usually doomed to failure: ‘Motivation is a fire from within. If someone else tries to light that fire under you, the chances are that it will burn very briefly.’

There is a fine line to be drawn between motivation and manipulation. People aren’t stupid and they know when they are being cynically manipulated with the sole aim of improving business performance. Ultimately we cannot motivate anyone – people motivate themselves – and the longest lasting teams are those to which members choose to belong. Yet we are often encouraged to keep our staff ‘motivated’, presumably so that they might perform their jobs well and remain positive, enthusiastic and proactive members of the team.

Perhaps former US President Dwight D Eisenhower had it just about right when he said that:  ‘Motivation is the art of getting people to do what you want them to do because they want to do it.’

How can this be achieved? A key management task is to try to create the conditions in which motivation and team development is not only possible but actually inevitable.

Demotivation

Before we look at motivation, let’s flip the coin and examine the concept of demotivation. We have discussed the work of Abraham Maslow and his hierarchy of human needs before in this series of articles. In a simple form these can be broken down into three levels of need:
1. Lower-level needs – food, clothing, shelter
2. Middle-level needs – a secure job, reasonable working conditions, reasonable pay
3. Higher-level needs – the need to belong, to be in control, self-fulfilment, pride, etc.

Demotivating situations might arise when team members’ mid-level needs are compromised, for example if they are asked to take a pay cut, move to part-time work against their wishes, or asked to undertake duties for which they haven’t been trained.

In the dental practice environment, most staff members are greatly influenced by higher-level needs and a reduction in these will likely lead to a demotivated team – for example, when promised further training does not materialise. The behaviour of the dentist is critical here and lack of enthusiasm, poor delegation, the inability to praise, lack of clarity and so on are all strong demotivators.

Remember that the practice principal’s behaviour will be taken as a guide, so if the boss is always late then don’t be surprised if the staff start turning up late too. Staff like the boss to be ‘in charge’ and don’t respect weak, indecisive leadership, so don’t be afraid to be demanding.

Once a downward cycle has begun it can spread quickly among staff members. The term ‘attitude virus’ was coined to explain how demotivation is highly contagious, to the extent that staff members start suffering from a condition known as ‘presentism’. In other words, they have turned up for work but the ‘lights are out.’ Once this has set in, it can very difficult to turn the clock back and remotivate staff.

Motivation

Employers and their employees are usually quite different in their outlook when it comes to the workplace. These differences show up most starkly when it comes to motivation. Very often, the things that motivate owners and managers are quite different from the drivers that motivate staff members. For example, dental practice principals consider the business to be their career, and as such they demonstrate significant levels of commitment. Employees, on the other hand, don’t always consider their jobs to be a part of their careers. It might be a stop on the way, but that’s about all it is – a pit stop. This is clearly related to the fact that the principal owns the business and this ownership creates a different level of dedication and desire. With most jobs, workers get their weekly or monthly salary and that’s it. Business owners have more job security than staff members, which means that employees will be less willing to try new things for fear of making a mistake. They would rather remain ‘under the radar’.

So, does this mean that it is impossible to motivate employees and get them to take the initiative? Not at all. The key is to understand how members of your staff think and then use this knowledge to your advantage. The first thing to realise is that one size does not fit all. Different employees have different personalities, skill sets, goals and needs. Your job is to work out what works for each one and tap into that. This is time consuming and not necessarily easy, but it is key to getting results.

Monetary incentives

The pioneering work of Hertzberg in the 1950s showed that pay rises, in themselves, are not necessarily enough to motivate employees since other, higher-level needs also need to be met. That said, it would be foolish to underestimate the importance of money since everyone needs it to maintain a comfortable lifestyle and, as we have already noted, any pay reduction will almost certainly demotivate staff members As with patients’ fees, an individual’s basic salary is a balance – in this case between what the practice is happy to pay and the employee is willing to accept, and should be seen as compensation commensurate with contribution. This implies a considerable degree of mutual respect between both parties, something that forms the basis for a balanced transaction between the two.

We were careful earlier to use the term ‘basic salary’, since there is always scope for giving performance-related incentive bonuses over and above the basic salary. This makes considerable sense, because staff will often ask how they are to benefit from the increased profits brought about by everyone’s hard work and enthusiasm.

Some people recommend regular production-based monthly bonuses. Here are some pointers on how to structure bonuses based on increased production numbers:

• Collection percentage should be above 95%. There is little point in giving team members a bonus based on production if a large proportion of the fees have not been collected. Collection ratios should remain above this level for at least three months before you go ahead with any type of incentive plan. Doing so will encourage staff members to be vigilant in collecting practice revenues

• Your monthly production goal should be attainable and realistic

• Before increasing your production goal, the previous goal should be met for at
least two to four months in order to ensure that you can, in fact, remain at this level
of production

• Monetary rewards should be exactly the same for each full-time employee irrespective of whether they are a direct revenue ‘producer’. Everyone contributes to the success of a dental practice and therefore the rewards for all should be the same

• If the monthly goal is not reached then there should be no bonus. If bonuses are given out regardless of whether a goal has been reached, it will be taken for granted and expected every time. This is neither motivating nor productive

• Don’t make bonuses and subsequent increases too high and do set a maximum amount, otherwise you could end up struggling to hand out bonus cheques. Also, let staff know that you will review the scheme after a set period of time to determine if it remains feasible.

It can be argued that such production-based bonus systems quickly become the norm and are soon taken for granted. Some people therefore recommend occasional ‘surprise’ bonuses to be given when least expected as your way of saying thank you for doing such a great job.

Non-financial incentives

Improved business culture
Every dental practice has a culture, in essence the way you do things. Some are by design but most happen accidentally. Typically, the culture is based upon the personality and values of the practice owner. Do you make an effort to share your vision with your staff? What is your culture? If it is not to inspire motivation or to be enjoyable and comprised of hard-working, fun and dedicated people then you have work to do.

The book Fish! by Stephen Lundin, Harry Paul and John Christensen explains how to turn a drab workplace, and its corresponding business culture, into a productive, fun environment.

They state: ‘People are dying to bring their passionate, authentic selves to their jobs. Unfortunately, their jobs often won’t let them.’

The book explains that, by allowing people more freedom to express their joy and talents at work, they will be more motivated and a company’s culture can accordingly be transformed. The authors suggest the following:
1. You can choose the attitude you take to work. While there may not be any control over what you do and where, you always have the choice of how you do it – with a smile or a grimace. Life is too short and we spend too much time at work to take a bad attitude in as, generally, you get back what you put in
2. Play and have fun. You can be serious about doing great work without taking yourself seriously. Look for ways to have fun. Happy people treat others better, time passes more quickly and work becomes something to enjoy rather than to dread
3. Make their day. Create great memories for your customers by finding ways to include them in the fun. Develop a service personality committed to customer satisfaction. By serving others well and caring about their problems, it will take our attention from our own difficulties
4. Be there. Focus on the person in front of you; listen and look for opportunities to help. Put your customer first.

Orchestrate systems for everything
Paddi Lund says that you should never blame a person but rather a system. This is sometimes easier said than done but the principle is a good one. For this reason it is vital to start building an office manual that covers a wide range of employment issues and working practices, including but not limited to:
• Office hours
• Staff appearance
• Job descriptions
• Probationary periods
• Salary reviews
• Sick leave
• Lateness
• Outside employment
• Lunch and dinner breaks
• Smoking policy
• Personal phone calls
• Team meetings.

The entire team should be involved in drafting the office policy manual, although you, as principal, have the final say in setting all policies. Indeed, you should set certain policies without the involvement of the team, for example those on: staff evaluation and reviews; termination, tardiness and absenteeism; staff benefits; and staff holidays, personal days and staff dental days. The more detail and the more certainty you can incorporate, the better.

Michael Gerber, writing in The E-Myth, says that you should aim to orchestrate, organise and standardise as much as possible, down to the smallest detail, as the only certainty in business is that your staff will act unpredictably.

Training
One thing employees want, especially younger employees, is the ability to sharpen or add to their skills. Offering training and continuing education programmes as a perk for a job well done can be mutually beneficial. It makes employees happy because they will be more employable down the road and it makes you happy because they can offer you more skills. You can either offer in-house training or send your employees off-site. Alternatively, you can offer video and/or internet-based training.

What matters is that you tie the training to some job-related performance and attainment of practice goals such as an increase in new patient numbers, reducing no-shows or increasing case acceptance for various forms of treatment such as aesthetic dentistry.

Let each team member decide, perhaps on a yearly basis, the programmes they would like to attend, subject to your approval.

Conferences and exhibitions are particularly attractive options, especially if it is in a different city, or even country, and if all the team members get to go together.

Recognition
Positive recognition is one of the mightiest motivators at work. Sincere appreciation of a job well done goes far. Too many employees feel that their knowledge goes unheard and unappreciated. A culture that fosters feedback makes people feel wanted and understood. However, listening is not enough; you also have to act on their suggestions and feedback if you are going to make your employees feel more motivated. It has been said that praise is a gift we love to receive but find hard to give.

Make sure praise is genuine, heartfelt and done publicly. Negative feedback should be given in private – never in front of other staff members. To do so is extremely demotivating to all members of staff, not just the individual being criticised.

Creative rewards such as gift certificates, an afternoon off, a special parking spot, a massage or facial, a round of golf, a new title, or being mentioned in the practice newsletter are relatively simple, low-cost ways to recognise employees.

Creative policies
It may be possible to arrange paid time off, especially during the summer months. On all long weekends you might consider giving your team the extra Friday or Monday off so that they can have a four-day weekend instead of a three-day one. They should be paid for this day, as it is a bonus. A similar alternative is to arrange shorter working hours in the summer with the same pay. For example, instead of finishing at 5pm on a Friday, leave at 3.30pm or 4pm and pay your staff for this time anyway.

Let go of lost causes
As hard as it is emotionally, legally and often financially, at some stage you have to consider letting go of people who simply don’t share your vision and infect other staff members with their negativity. You simply cannot afford for such people to represent you.

Conclusion

You cannot build the practice of your dreams on your own. Dentistry is a team effort and you will get out of your team as much as you are prepared to invest in them. As far as motivation is concerned, you first have to look to yourself – examine your own levels of drive and enthusiasm, and ensure you believe in, and care about, what you are doing 100%. Only then can you seriously address the inspiration of your support staff.

References
Covey SR (1989) The 7 habits of highly effective people. Simon and Schuster, New York

Gerber M (2001) The E-Myth explained. Harper Collins, New York

Herzberg F (1959) The motivation to work. John Wiley and Sons, New York

Lund P (1994) Building the happiness-centred business. Solutions Press, Brisbane

Lundin SC, Paul H, Christensen J (2000) Fish! A remarkable way to boost morale and improve results. Hyperion, New York

Maslow A (1943) A theory of human motivation. Psychological Review 50: 370-96

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