Do incentives work?

This is the question that I am consistently asked. I have seen many different incentive strategies with little to no positive outcome. It is disheartening when dentists tell me they gave their team money, gifts, or trips and didn’t receive even a simple thank you. Yet when I talk to the team, they say they are very appreciative and yet confused. They are not sure if it is a reward or an incentive with expectations to change something. An open conversation will go a long way in creating clarity as well as creating an opportunity to express appreciation.  

There is a vast difference between an incentive and a reward.

Incentives have attached expectations to motivate and improve behavior or performance. An incentive is (in essence) an enticement to change something.

A reward is simply a thank you for past performance without any strings attached. Incentives have future expectations attached to them and rewards do not.

I have had the privilege of working with dental teams since the early ‘80s, first as a manager and now as a culture coach. I have yet to see where incentives have created any long-term change. The sad truth is that incentives don’t generate sustained motivation or changes in behavior. Any expectation of an incentive increasing and sustaining motivation and performance will disappoint.  

The assumption that incentives work is prevalent, but growing evidence supports the opposite. According to numerous studies in workplaces, classrooms, and other settings, rewards typically undermine the very processes they are intended to enhance. 

So back to the question… do incentives work? The answer depends on what we mean by “work.” Research suggests that incentives succeed at only temporary compliance. When it comes to producing lasting change in attitudes and behavior, however, incentives, like punishment, are ineffective.

Incentives are like throwing sticky balls at a wall and hoping they will stick.

Here are three reasons why incentives don’t work.  

The first time you give something it is a surprise and greatly appreciated. However, it is human nature that once we receive something we expect it again.  

1. Incentives can feel like manipulation similar to punishment. “Do this and you get that! or do this or this will happen!”  In the case of incentives, the gift may be highly desired; but by making it conditional on certain behaviors, the team will feel manipulated. That experience of being manipulated is likely to feel very similar to punishment.  
2. Many of us have received conditional love. Conditional meaning that another person’s love for you is contingent on certain actions, or things. Do you remember how you felt? It can feel manipulative, controlling and at times even abusive.    
3.  Incentives can cause people to focus on the numbers instead of what’s best for the patient. It could even lead to unethical behavior such as unnecessary treatment.  

We will be disappointed if we expect incentives to fix problems. Money, gifts, and trips don’t fix problems. It is important to understand the underlying causes and address the specific concerns.  

So, what does work? Cultivate a happy, healthy, and high performing culture. Where the number one core value is that the entire team (including doctors) treat each other as well as they treat the patients.

A happy, healthy, and high performing culture empowers: 

• Clear core values and consistent leadership 
• Opportunity to grow and learn 
• Value and appreciation towards each other 
• Trust and respect with coworkers and patients 
• Open communication and feedback
• Recognition and respect for teamwork 
• Positive attitudes 
• Ongoing team building strategies 
• A consistent structured training program
• A competitive compensation package

It will take commitment from the leadership team to maintain the culture. They are the ones who determine who will be a part of the culture. Anyone whose attitude and behavior does not support the culture values will not be invited to continue to be a part of the culture.  

Implement the core value standards to cultivate a happy, healthy, and high performing culture. You will nurture meaningful relationships and positive lasting change. You won’t need incentives. The money, gifts, or trips you give will truly be a thank you reward with no strings attached!