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Don’t Keep Telling Me About the Carrot


Words are less important than actions.

Sometime back around college or med school, I recall a friend expressing frustration with a flaw she encountered all-too-commonly amongst our young adult contemporaries. That being: Attempting to compensate for failing to get something done (in a timely fashion, or at all) by talking about one’s continued intention to complete said task. In her own words, “Don’t keep telling me about how you’re going to do it. Just do it.”

The sentiment has stuck with me over the subsequent decades, and is more-than-occasionally apropos when one is working as a professional in the health care field. We tend to hear a lot of promises from the Powers That Be about how they’re going to make our work easier and/or more efficient, impactful, rewarding, etc.

This often comes hand-in-hand with new impositions that get enacted far more rapidly (sometimes instantaneously) than the promised improvements do, if indeed the improvements ever materialize at all. The coerced implementation of not-really-ready-for-primetime EMRs leaps to mind. Carrots being dangled in front of us have a funny way of constantly remaining out of reach, no matter how persistently (or gullibly) we pursue them.

One can almost forgive, or at least understand, such machinations coming from politicos and administrators who have never walked a single step in our physician shoes. Getting things done with limited resources and making promises that can’t be kept is pretty much a requirement in their lines of work.

It stands out as more of a sore thumb when the mover of our cheese is one of our own. For instance, a couple of columns ago I addressed the not-uncommon problem of medical groups failing to come through with promises regarding partnership. One of the ploys used there is to tell the would-be partner that, gosh, things aren’t looking opportune to promote anyone at the moment, but fear not! We know you’re due. Maybe next year. Keep up that hard work in the meantime! (This also goes for potential pay-raises, improved benefits, upgrades to office equipment, more support staff, etc.)

Such nebulous “coming soon!” promises are dangerous things to make, or repeat. Even if the goalposts haven’t been moved (yet). If the positive development being hyped is truly a motivating interest to your audience, they won’t have forgotten that it’s supposed to be in the pipeline. Bringing it up is thus of limited potential rallying effect.

Rather, it might make them think, “Why am I being told about this again?” Or dwell on how, yes, there’s supposedly a carrot for them down the line, but in the meantime they’re carrotless. Maybe it introduces a smidge of doubt as to whether they will be receiving it, after all. Or snowballs some pessimism around a preexisting kernel of uncertainty. Especially if they’ve previously seen, or heard of, promised/earned carrots that failed to manifest.

It’s probably safe for someone with a flawless track record of carrot delivery to speak about their future plans for the distribution of root vegetables. (Although many with checkered pasts in this regard have significant blind spots of self-reflection, and might not realize how low their perceived reliability actually is-a proactive carrot-promiser might make a point of inquiring amongst anonymized subordinates for honest appraisals.) Certainly, at least an initial statement needs to be made; people can’t be motivated by rewards whose existence is unknown to them.

But beyond that, there’s a steep slope of diminishing returns: The more you talk about those carrots you might someday be handing out, the less help-and the more harm-it might do to morale. Save some of that talk for when you’re actually delivering.

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