Why Won't They?
A traditional and still popular theory of employee motivation holds that managers must find a secret button for each employee that, when pushed, brings forth unusual performance. This theory is endorsed by athletic coaches, military commanders, and others who need and often get short-term, heroic performances from basically mediocre people. But should orthodontists rely on such exhortation to produce first-rate employees in their offices? Considerable evidence now suggests that this kind of motivational strategy is at cross-purposes with the process of sound team building for the long haul.
Those who believe in the magic button theory feel that people who are underperforming simply aren't trying, and could really do better if they only wanted to. Sometimes this may be true, but in most cases the causes of subpar performance are quite specific, although they vary from person to person. As distasteful as it may be for us to admit, most causes of orthodontic staff failures reside in the orthodontists' selection and training programs, rather than in individual flaws of character or dexterity.
One of the best explanations of employee behavior I've come across is a thin book entitled Why Employees Don't Do What They're Supposed to Do and What to Do About It by Ferdinand F. Fournies (107 pages, $14.95, Liberty Hall Press, 1988). When I review my own failures in personnel training, his suggestions seem on target, and I have an idea they will ring a bell with you, too. Although it isn't possible to present more than fragments of Fournies's thesis in an editorial, here are a few highlights.
They don't know why they should do it. What may be obvious to management is often unclear to employees. For instance, staff members may think the orthodontist unreasonable in insisting that the phone be answered right away, unless they are told how it presents an image of effective service to customers. It is management's duty to explain the problems, goals, solutions, benefits, and penalties of failure to employees. Expecting them to understand the overall office strategy without a detailed explanation is unreasonable and presumptuous. They don't know how to do it. If telling were the same as teaching, everyone would be a genius. Unfortunately, the only way most people learn anything is by doing it correctly, time after time. Practice makes permanence, not perfection, so permitting employees to groove themselves by repeating errors may make it impossible for them to master tasks properly. New employees need close supervision. And keep in mind that mistakes made while practicing on patients are always more costly than mistakes made on a typodont. They don't know what they are supposed to do. If managers don't thoroughly explain employees' responsibilities, misunderstandings are bound to occur. For example, being at work at 8 a.m. may mean being ready to serve patients at that time to the orthodontist, whereas to an employee it may mean reaching the parking lot by that time. Asking staff members to describe what they understand their tasks to be and how and when they are to perform them will give you a good idea of how well they really understand. They think your way won't work. Orthodontists don't ordinarily have this problem unless they hire people who were trained under a different system and are highly opinionated. Remember, people don't mind changing as much as they mind being changed. Selling an idea involves convincing others to accept your concept. Once an employee buys into your idea, cooperation becomes much more likely.They think their way is better. When management values innovation, workers occasionally comeup with ideas they feel are superior to the ones their bosses insist they use. This requires managers either to evaluate and accept the employees' suggestions or convincingly explain the advantages of the preferred techniques. Otherwise, they will appear insincere about their desire for innovation.They think something else is more important. Most of the time employees are working. But they may not be working on what the boss would like. A good example is the office manager who arranges files, pays accounts, calls about invoice disputes, etc., all to the neglect of calling about delinquent accounts--a job few people enjoy. Sometimes the difference between successful and unsuccessful practices is that employees of successful practices work on the important things at the appropriate times. Managers can achieve this by establishing priorities, but not by giving everything a No. 1 priority or by changing priorities without notifying staff members about the changes.There is no positive consequence of doing it. B.F. Skinner summed this up correctly when he said, "People don't come to work to get paid, they come to work so the pay doesn't stop." The basic tenet of behaviorism is that consequences dictate behavior. Performances that are rewarded are repeated. And those rewards are most effective when they occur immediately following the specific behavior. Since people perform their tasks correctly a good part of the time, it's easy to catch them doing something right and reward them with a compliment, promotion, commendation, or bonus. Those who object to rewarding people for something they are already being paid to do should look upon such additional rewards as maintenance intervention, or an insurance policy that simply helps you get what you are paying for.They think they are doing it. This almost always happens because employees haven't received immediate, accurate, and specific feedback about their behavior. Simply telling someone, "You're not cutting the mustard", isn't specific enough to get improvement. Nor is the accolade, "You're getting your act together now", enough to let an employee know exactly what is pleasing you. Productivity increases dramatically with no other change than instituting appropriate and frequent feedback, and it costs nothing to deliver it. Costs accumulate only when managers avoid it.They are rewarded for not doing it. I once had an employee who I found was secretly telling others, "If you don't want to do a job, mess it up and he'll give it to someone else or do it himself." Rewarding performance, whether good or bad, increases its frequency. So in retrospect, I now understand why delinquent accounts weren't called, time-consuming archwire changes were delayed until I could do them, and some employees never learned how to trace cephalograms, do occlusograms, trim models, or make retainers. I was rewarding non-performance.They are punished for doing what they are supposed to do. Behavior that is punished occurs less frequently. Managers often punish unintentionally, such as by assigning more difficult work to an employee who does the tasks well without complaining, or by giving a loud, public rebuke to an innovative employee who hakes an uncharacteristic error. Orthodontists who berate staff members for delivering unfavorable reports shouldn't be surprised when announcements of bad tidings don't reach them until it is too late to remedy the situation. They anticipate a negative consequence for doing it. This is different from actual punishment, although the mindset that produces such behavioral paralysis may have been created by previous punishments. It could also result simply from natural timidity. The manager's task is to assure people that there are no stupid questions, that it's OK to question the boss, and that employees will not be punished for failure as long as they are trying to help the enterprise succeed. There is no negative consequence of poor performance. Unfortunately, we encourage too many underachievers to stay in their jobs because we can't or won't hold their feet to the fire until they either get good or get gone. This doesn't mean we should scream and badger and carry a big stick, but unless we make it matter whether people perform or not, many employees will be happy to do the minimum necessary to keep their jobs. There are obstacles beyond their control. Faulty equipment and tools or badly written training manuals are usually not the fault of the staff. It is management's duty to remove such obstacles by finding a new supplier, getting the manual rewritten, or taking whatever action is necessary. Their personal limits prevent them from performing. Some people do fail because of a lack of intelligence--or in dentistry, a lack of dexterity--but fewer than 25 percent fail for these reasons. Most people fail because they haven't been adequately taught or haven't had enough practice. Orthodontists need to be realistic and recognize that they don't need Mensa members on their staffs. Ordinary people with decent values and average dexterity and intelligence will do quite nicely--if we develop the required patience and adopt a reasonable training schedule. After all, good management is little more than doing the things necessary to help people succeed in their work. We owe all our employees that much.
