Managing the medical mindshift: employee motivation

Data, facts and instruments on the German health system

What it’s all about

„My staff are lucky to work here“, or: „The salary is motivation enough“ are mindsets that many practice owners still have internalised today. However, in view of the limited availability of staff and the changed requirements of medical assistants, GPs and specialists urgently need to correct this attitude.

What the right motivation does

Staff motivation, defined as the willingness and drive to work towards the goals of the practice, is a central theme of practice management. Motivated staff – as practice management comparisons show time and again – are much more productive than less committed colleagues, work much more independently, carefully and with foresight, create a more positive working atmosphere and have a more sympathetic effect on patients. In addition, many small problems are solved independently before conflicts or escalation occur. The overall service quality of a practice thus benefits from motivated staff, and there is also a noticeable reduction in the workload for the practice owner.

Low employee satisfaction

But only about 40% of doctors in private practice make use of the advantages described. Our company comparisons show an average Job Satisfaction Score (JSS, job satisfaction in relation to requirements) of 58% (optimum: 100%). At this value, labour productivity is about one third lower than in an optimised state. In concrete terms, the dissatisfied female employees complain above all about

  • too little recognition of their work
  • too little freedom to work in a self-determined way,
  • unfair treatment,
  • lack of opportunities to help shape the work in the practice (suggestions for improvement are ignored) and
  • unfair or inappropriate criticism, e.g. in the form of reprimands in the presence of patients.

The list already shows the first approaches to creating motivated female staff.

The Motivational Mindset

But if you as a practice owner want to motivate in the long term, you should first consider some basic aspects of staff motivation:

Money is only a short-term motivational tool.

„My female staff always want more money, but as soon as they have received a raise, the next demand follows!“ This aspect of motivation is cited again and again in analyses of the management system of medical practices. The situation is symptomatic for practices where no or only few motivational measures are used. Thus, for the staff, the question of motivation is reduced to the amount of salary or additional benefits and bonuses. Basically, however, it should be noted that monetary payments always have only a temporary motivating effect. People quickly get used to the new income level, and the effect of the „first moment of joy“ quickly fades. This also makes it clear that cash payments must be supplemented by other motivational measures in order to achieve long-term activation.

Motivation is multi-layered

Employee motivation is made up of three components:

  • First, the extent of basic or inner motivation, one could also speak of life motivation. This is the essential drive that a person displays and which determines the way in which he or she acts.
  • The second component is work motivation, which results from the workplace and the associated area of responsibility.
  • The third influencing factor is group motivation, which arises from the cooperation with the team at the workplace.

If practice staff are to be motivated, all three areas must be taken into account. If problems exist in one area, e.g. in the form of team conflicts, the most positive orientation in the other two sectors will not lead to an optimal overall constellation.

Motivation only works if the „right“ employee is employed in the „right“ place

If motivational measures do not lead to the desired results, the cause is often wrong staff selection or inadequate task assignment. The best activation concepts do not help if the requirements resulting from the tasks to be done over- or under-challenge the individual employee or do not (or no longer) correspond to the profile agreed upon at the time of recruitment. In these cases, motivation cannot activate, but at best prevent worse.

Motivation is based on mutual trust

Staff motivation is only possible if the practice owner and the staff value each other. This means that on the management side, it should be assumed without bias that all employees want to achieve the best possible for the practice. Without such a basic attitude, motivation is only half-hearted. Similarly, staff must trust the practice management.

Motivation is a process

Specialist articles on the subject repeatedly speak of motivational measures. However, staff motivation is to be understood as a process in which measures are combined and used sequentially over time to ensure the permanence of the motivational state. Moreover, similar to the use of marketing instruments, motivational measures only have a synergistic effect in combination, i.e. the effect of the individual measure is greater in combination than when used in isolation.Motivation is not additional work: With regard to staff motivation, doctors often have the opinion that these are additional activities to their daily work. Rather, it is correct that it is part of the daily cooperation: a brief praise in passing or thanks for the quick completion of a task have a motivating effect without any significant additional effort.

Motivation lives from orientation

Without perspectives and goals, motivation is not possible, because commitment needs direction and a way of judging success. Clear and comprehensible practical and work goals are therefore indispensable for sustainable employee motivation.

Motivation relates to both the individual and the team

The multi-layered nature of motivation already mentioned makes it clear that two directions of motivation – each individual employee and the group – must always be taken into account. Although group motivation results from individual motivation, it is always possible to further individual motivation via team motivation (so-called pull strategy). Team motivation also aims to bind the staff as closely as possible to the practice through team spirit (minimising fluctuation).

What instruments and measures are suitable for motivating practice staff and teams?

Top performance in a medical practice is mainly achieved through a motivating work culture, which can be easily created with the help of the following selected building blocks:

Professional induction of new employees

Especially the first days at a new workplace are decisive for the basic motivational attitude. Friendliness and helpfulness, but also organisation and professionalism during the induction phase have a decisive influence on attitude and commitment.

During onboarding, personal conversations between the practice owner and the new employee to be hired play a very special role. In contrast to earlier times, when owners thought they did not need to bother much after the recruitment interview, professional recruitment management today is structured in several stages to follow the development of the employee and to align mutual expectations:

  • Phase 1: Applicant interview and selection
  • Phase 2: Interview between confirmation of employment and start of work
  • Phase 3: First working day
  • Phase 4: End of the first week
  • Phase 5: End of first month
  • Phase 6: Monthly during the probationary period
  • Phase 7: End of probationary period
  • Phase 8: Regularly as with all female employees

In addition, anniversaries should not be forgotten.

Concrete target agreements

The practice and work goals to be achieved should be set out in writing and linked to success criteria and review dates.

Regular praise and criticism meetings

The basis of long-term motivation is regular communication in order to praise and criticise in such a way that the matters of complaint are eliminated and motivation is nevertheless maintained. The best instrument for this is regularly conducted one-on-one meetings.“Three-second recognition“: Motivation is part of daily cooperation. If an employee has done something excellently, this should also be noted positively in a short and timely manner. The appreciation can be brief („You did a good job!“, „Great!“) and in passing.

Consistent delegation

An important motivational tool is the delegation of tasks for independent completion. Freedom of action and decision-making offer the opportunity for self-realisation in one’s own area of responsibility and represent a strong positive incentive to get involved. It is important here not to practice „sham delegation“, i.e. to monitor the completion of tasks by constantly asking questions and, if necessary, even to change the task definition during the completion process.

Winning participation

Nothing is more motivating than the awareness that one has not only actively contributed to the success of one’s own practice, but also participates in it, e.g. in the form of profit sharing. It supports the staff’s identification with and loyalty to the practice in the long term. At the same time, it has a positive effect on the practice’s finances, as this form of participation is due depending on the profit actually generated and is financed from it.

Practice meetings

By means of practice meetings, the skills and knowledge of the employees from everyday work can be used in a targeted manner to solve problems that arise or to further develop the quality of the practice work. If the contributions made by the staff are actually implemented, this has a strong motivating effect, as the staff feel that they are being taken seriously and that they are making a significant contribution to the work of the practice. The same applies to the suggestion system.

Common activities

On special occasions, it is beneficial for motivation to organise communal experiences. This could be a company outing, a meal together or a visit to the theatre. Such semi-private gatherings strengthen the sense of unity within the practice team.


All in all, staff motivation is a highly efficient instrument of practice management that, when applied consistently, offers comprehensive benefits and ensures economic success.