transparency, communication, and faculty motivation rebecca m. minter, md vice chair, clinical...

Transparency, Communication, and Faculty Motivation

Rebecca M. Minter, MDVice Chair, Clinical Operations and FinanceAASA New Administrators WorkshopOctober 4, 2015

Department of Surgery

DisclosuresI am a faculty member

I am new to my role in Clinical

Operations

I am not new to managing teams

I believe effective communication is

critical and transparency is a

natural result

I have no financial disclosuresDepartment of Surgery

Goals for this talkDevelop an understanding for how to

effectively communicate with faculty

Explore the pros and cons of

transparency

Broaden one’s understanding of

what truly motivates high performing

individuals

Communication Basics

Miscommunication

Email is not a good medium for complicated or

unpopular communications!

Effective communicationis very time consuming!

Communication Basics

No communication

No Communication

Purposeful (not usually)

Path of least resistance

No time

“I emailed so and so and I never got a response.”

No communication

Finance Speak

Watch your crowd

Elements of Personal Communication• 7% spoken words• 38% voice, tone• 55% body language

Faculty PhenotypesBlissfully Ignorant

Just Want to Understand

Everyone is Trying to Screw Me

15% 80% 5%

Happy Goal Oriented

Happy Goal Oriented Often Focused in a

Particular Area

Particular Area Surprised when

they get a bonus

they get a “bonus”

Curious – “Explain to me how…..”

Want to feel in charge of their own destiny

Will respond to data

Will respond to data May prefer a more

scripted incentive plan

Suspicious - think you are trying to hide things

Suspicious – think you are trying to hide things

Often intimidating

Often intimidating Generally glass half

empty type of folks

empty type of folks No incentive plan is

fair – others are getting more than they are

Communication strategiesBlissfully Ignorant

empty type of folks No incentive plan is

fair – others are getting more than they are

Communication Landmines

The compensation

The incentive plan

A Tale of Two Comp Plans

Operating Margin by Division and DepartmentCollections Model

CT CRS GS TrB SO Vas TX Ped Pla Dept

Oper Margin +++ ++ + + +++ +++ + ++

Cardiac & Thoracic Surgery (blended)

$61.43

Colorectal Surgery

$47.83

General Surgery

$57.47

Trauma Surgery

$55.39

Surgical Oncology

$48.79

Vascular Surgery

$50.66

Transplant Surgery

$59.13

Plastic Surgery

$65.40

Pediatric Surgery

$81.18

Median AMGA Compensation to Work RVU Ratio 2011-2014

Operating Margin with Specialty Specific AMGA wRVU Payments

Oper Mar - Col +++ ++ + + +++ +++ + ++Oper Mar - wRVU ++++ ++ -- - +++ ++++ ++ ++

Cardiac & Thoracic Surgery (blended)

$61.43

Colorectal Surgery

$47.83

General Surgery

$57.47

Trauma Surgery

$55.39

Surgical Oncology

$48.79

Vascular Surgery

$50.66

Transplant Surgery

$59.13

Plastic Surgery

$65.40

Pediatric Surgery

$81.18

Median AMGA Compensation to Work RVU Ratio 2011-2014

Blended wRVU

payment of $65.00

Operating Margin with Specialty Specific AMGA wRVU Payments

Oper Mar - Col +++ ++ + + +++ +++ + ++Oper Mar - wRVU +++ ++½ + + ++ ½ ++ ½ ++ ++

So What Happened?Three years later……..

Annual Faculty Satisfaction Survey

Excerpted Questions 2012 2014

14. I am compensated fairly for my work 76% agree 54% agree

15. I am compensated fairly as compared to my peers at other institutions

65% agree 40% agree

In Debriefing…..Failure to adequately communicate

the process, logic, and modeling that

supported the decision for a blended

Failure to engage all stakeholders in

the planning and decision-making

What steps were undertaken to

address the problem?Department of Surgery

The second landmine

The incentive plan

The incentive planAssure understanding of the source

for incentive payments, and the

criteria for earning an incentive

Differentiate a bonus plan from an

incentive plan – which is it?

You must understand what motivates

an individual

What is the source of incentive payments?

Clinical revenue

–But at what level?

–Department?

–Division?

–Section?

“The department”

Criteria for earning an incentiveIs it an incentive or a bonus?

Prescriptive versus flexible

Are criteria pre-defined?

–At the level of the individual or the

group?

How was it communicated to the

faculty?Department of Surgery

Incentive plans

What motivates an individualfaculty member?

What are you trying to incent?

The surprising truth about what motivates us………

https://youtu.be/u6XAPnuFjJc

Motivation – Take-home pointsIf/then rewards work for simple tasks

–Do more cases, get an incentive payment

Principle of “Pay people enough to

take the issue of money off of the

table” is important

–Opens the door to set the bar high for an

incentive to be earned Department of Surgery

MotivationImportant to remember – “When the

profit motive becomes unmoored from

the purpose motive bad things

happen.”

–Unnecessary procedures

–Internal competition

–Failure to properly supervise

MotivationMake the task more complex and

empower the faculty to find a solution–Autonomy

–Mastery

–Purpose

Individuals are internally motivated – and

their motivation is hard-wired and unique –What makes them tick?

Downside to Transparency?Recognize there are pros and cons to

transparency–It can be a burden to young faculty

members and the “blissfully ignorant”

–It takes time and may create less

“flexibility”

The positive effects far outweigh the downsides which can be managed.

SummaryCommunication and Transparency–Tailor your message to the faculty

phenotype–Always respond – even if only to say you

need more time–Engage the faculty in decision-making

(autonomy)–Ensure there is understanding – explain

the reason why!–Try to predict the communication

landmines and be proactive!Department of Surgery

Summary - Motivation

Motivation is individual and unique

Carrots and sticks only work for

simple tasks

Try to pay individuals enough to take

the issue of money off the table

Set a high bar for the incentive –

motivate them to achieve the BHAG

Thank you

transparency, communication, and faculty motivation rebecca m. minter, md vice chair, clinical...

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