Dan Pink provides a great 10 minute animated review of the literature describing the motivating factors for success in the workplace: http://www.youtube.com/watch?v=u6XAPnuFjJc.
To grossly paraphrase, cash can be a motivator for rote, very basic tasks. But once a work activity becomes at all intellectually challenging, cash rewards can actually decrease performance. The conclusion of the research is that the role of money is paying people enough so they have their basic needs met. From there forward, motivation is based on autonomy, mastery, and purpose.
Many if not most healthcare employees likely have a strong sense of purpose. To get a job as as a clinician-scientist, the doctor or nurse must have some form of mastery already. I wonder if we can tweak the traditional approach to autonomy to bolster innovation within a healthcare institution.
The current incentive paradigm is at least in part tied to the extent to which a researcher gets published. When a researcher get's published, it is easier for them to receive more grants, hence get paid more. For clinicians that explore innovation through research, then their autonomy may be fully actualized because the publish-and-get-paid paradigm is aligned with their core interest. But what about the clinicians that aren't interested in basic research and publication? What about the clinician that wants to explore building a service or product that will provide social value? How can we incentivize them to innovate autonomously?
I propose that we protect some of the clinician's time to do creative work of their choosing (without having to do clinical work or worry about submitting publications to make ends meet). If a clinician knew that they had 10% of their time protected and paid for, perhaps we could free them to think outside the box and allow them to explore alternative ideas that may be equally or more innovative than their day to day work.
Would love to hear if anyone out there has examples of this type of incentive structure that prioritizes and protects a clinicians autonomy for the sake of exploring innovation.