Staff Management

Unintended Consequences of Paying ODs Performance Bonuses

By Cheryl G. Murphy, OD

July 31, 2019

Bonus strategies are frequently used by employers to motivate staff and increase the prosperity of their businesses.

However, these strategies may be viewed negatively by some employees, especially doctors. You may want to think twice before using them to replace the traditional monetary reward system of salary increases.

Should Doctors Be Incentivized By Money?
If you have ever gotten your courage up to ask for a raise only to be denied, then you know how bad it feels. What if instead of giving you a raise your employer offered incentives or profit-sharing? Should you be happy or hurt by this? Is that method of performance-based bonus (which is meant to motivate and drive profits) harmful or helpful to morale, and should there even be that type of monetary reward in medicine?

Shouldn’t we be more concerned with our patients and the quality of care and kindness we provide than the number of patients we see per shift, how many procedures we bill for in a given day and how much we make in profits? Optometry is a business, and we all want financial success, but are these types of incentives more insulting than inspiring to employed doctors when used as a substitute for a regular raise?

I have been practicing optometry as an employed OD for about 16 years, and I have worked in many settings: corporate, private practice within corporate, private optometric practice and private ophthalmology practice. I try to stay a “low maintenance”employee as much as possible. By this, I mean I follow the rules. I do what is expected of me. I rarely complain. I keep up with my continuing education. I am a perpetual learner and am passionate about my profession and about patient education.

I connect with patients. I get to know their families. I put 110 percent of myself into providing my patients with topnotch, thorough and friendly eyecare experiences. Should I be rewarded for extending myself beyond what I feel is an appropriate work pace or level of billing? Should I be told I can have incentives, but not a raise?

Performance Pay Can Backfire
An article in Harvard Business Review states that sometimes “methods of performance pay can backfire, causing contentious behaviors among employees, complaints about unfair pay distribution, or overwork and stress.” It goes on to say that, “contrary to what many employers believe, organization-wide incentives, such as profit-related pay and share-ownership, may not generate [such] positive effects, as they were found to have negative relationships with employee well-being.” These incentive methods can influence job satisfaction, organizational commitment and trust in management, and not always for the better.

Isn’t there a happy medium between being fast and being caring? Should slower doctors get penalized for not raking in as many billable patient visits as faster doctors? Being faster and more profitable doesn’t make me a better or more honest and trustworthy doctor.

Good Doctor Doesn’t Necessarily Mean Rich Doctor
At the end of the day, I will rest my head on the pillow knowing that I am a good doctor even if I’m not a rich one. I did my best for both my patients and my employer whether they rewarded me for it or not. I do a good job of balancing patient care while being profit-conscious. I protect my license and avoid making mistakes or missing diagnoses.

I wish employers would recognize that losing good doctors for faster ones may not be the best way to ensure the continued success and longevity of their practices, and it may not always be what’s best for the profession.

 

Have you used performance-related pay, profit-related pay or share-ownership incentives in your practice? How have they influenced profits? Work performance? Employee morale? Have you had them offered to you as an employed doctor? How did you feel about being paid with that kind of bonus instead of a more traditional raise per hour or increase in salary?

 

Cheryl G. Murphy, OD, practices in Glen Cove, Syosset and Lake Ronkonkoma, N.Y. You can like her on Facebook or follow her on Twitter @murphyod. To contact her: murphyc2020@gmail.com.

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