September 1, 2011

'Pay for performance' works only in certain jobs

Recent attempts at using a "pay for performance" model to improve job performance and contain costs in many endeavors including education, management, healthcare, government and Maine Department of Health and Human Services seem at first glance to be a no-brainer.

Pay workers to do A instead of B, and they will do A.

However, things are not always as they seem.

Recall that long ago people believed that the sun revolved around the Earth since they could see it rise in the east and set in the west daily.

All agreed, until Copernicus did some research and found that this prevailing belief was pure illusion and that the Earth revolves around the Sun while also rotating on its axis, giving us day and night.

One of our contemporary illusions is that pay for performance will work as intended. Sometimes it does. When? When the work is very linear, step by step repeated, like an assembly line.

However, research repeatedly demonstrates that when the work becomes complex and requires thinking and decision-making (as in medicine, education, government, management, psychotherapy, etc.) more money for better production actually decreases performance. Seems bizarre, doesn't it?

Moreover, attempts to use pay for performance to improve treatment of hypertension failed, according to a research project published in BMJ, formerly the British Medical Journal.

We can keep trying to squeeze square pegs into round holes just because we think it should work and we are attached to our own ideas being right, or we can look for truly better ideas that really do improve performance.

Keith Cook, psychologist

Waterville

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