Nicely done!

April 12, 2021
Eric Postal, MD

Positive acknowledgement can go a long way.

In the middle of my morning routine this past week, I had a standard interaction with the household pooch. She was sitting nearby, our eyes met, I said something, and she approached with tail wagging to receive some scratches from me. Both of us were gratified for our minimal efforts: Her approach and tail-wagging indicated her appreciation of me, and my verbalization/scratching did the same in reverse.

The thought stuck with me as my workday ensued: We humans don’t show our appreciation for one another all that much, outside of family and friends. Downright miserly with our positive feedback, when it comes to work environments.

It could be that, for most folks, work is a relatively joyless affair. If you’d prefer to be somewhere other than you are, doing something else, it might take all of your motivation just to attend to your responsibilities. There might be little psychic energy left to distribute positivity to those around you. Folks doing what they’re supposed to be? Well, that’s what they’re getting paid for; you’re not wasting your meager reserves to coddle them.

Immersed in a culture of non-appreciation, one adapts. If I find that, day in and day out, I’m getting my job done, and nobody ever says a positive “boo” to me, I’m probably going to return that indifference to everyone with whom I interact. Especially if I think I’ve gone above and beyond—getting more done or doing it with higher quality. If it seems to me I’ve been doing 110 percent and everyone else is in the 90 percent-to-100 percent range, I might go beyond indifference, to resentment.

I also think some folks are wary, consciously or otherwise, of expressing positivity about others in their work environment. Why risk praising a subordinate if you might have to take them down a peg or two later on? And, if you express approval of a peer or a superior, might they take it the wrong way? Who are you, to comment on their performance?

As understandable as all of this might be, it’s maladaptive. In a column of yesteryear, I wrote about the too-often-wrong focus of quality assurance (QA) programs: Detecting, tracking, and remediating errors, but rarely if ever focusing on work that was particularly well done. In psychological terms, business-as-usual QA is “aversive conditioning.” It’s been shown to shape behavior, but not as well as “positive reinforcement.” In other words, catching somebody being good works better than punishing them for being bad.

Being stingy with appreciation risks “negative reinforcement,” which is not the same as aversive conditioning. Negative reinforcement means taking away something desirable in response to unwanted behavior. For instance, withholding an end-of-year bonus from someone who previously got bonused. It shapes behavior most effectively if the reinforced individual knows why they’re no longer receiving something…but even if no such connection is spelled out to them, they might come to their own conclusions. (“I’ve busted my hump since day one, and nobody seems to notice. Think I’ll take it a bit easier from now on.”)

I’ll emphasize that positive reinforcement does not need to be a big deal: A financial bonus, a promotion, even an “Employee of the Month” certificate…such things can of course be strong motivators…but, much like with my doggo, simple words, even gestures go a long way.

Perfect example: One of the human resources folks in my current rad group takes the opportunity to say something positive in most interactions, even if sometimes in jest. I can’t speak for anybody else there, but to me she’s always a spot of sunshine. Small wonder that she’s usually the point-person for recruitment.

Changing the culture of a group to be freer with verbal encouragement is no small project; heck, even getting one person to alter their behavior can be tough. Leadership and other senior members of the team can make it happen more easily/naturally if they exemplify the proactive-positive approach.

Since I imagine more than a few readers aren’t in such lofty positions to enact change, and might remain relatively starved of positive regard in their workplaces for the visible future, allow me to tell you what you should probably already be hearing. Not all might apply to your particular circumstances…but, when in doubt, be generous to yourself:

  • Thanks for your part in clearing the worklist every day!
  • Good job fielding those calls from referrers/techs/patients, answering their questions, addressing their concerns! Always easy to get in touch with you.
  • Other members of the team really appreciate that you’ve made yourself available for consultations—both in and outside of your subspecialty.
  • Hey, those are some nice suggestions you’ve made to leadership! It’s great to see interest from members of the team.
  • Scheduling wants you to know: They really appreciate your flexibility and reliability. You pitch in when they need help with coverage, and never have unexpected absences for them to fill in a hurry.
  • Thanks for always being on top of your CME and other credentialing requirements!
  • Just wanted to acknowledge your timely responses to messages and attentiveness when following up on issues. Way too many people respond late or not at all…you could teach them a thing or two.
  • Great diagnostic catch on that case the other day! A lot of rads would have missed it.
  • You’ve got a broad comfort-zone with the types of studies you read. “Plug and play” rads like you who can fill just about any spot in the schedule are priceless!
  • It’s been great having you on the team for [X amount of time]; I hope we continue to make you feel welcome!

Follow Editorial Board member Eric Postal, M.D., on Twitter, @EricPostal_MD.