...Performance Pay for Massachusetts General Orthopaedic Association Spring 2014 Christopher J. Tukiendorf March 17, 2014 Performance Pay for MGOA Physicians Key Problems Faced by MGOA I believe that there are three key problems that the Massachusetts General Orthopaedic Associated (MGOA) faced when Dr. Harry Rubash and Dr. James Herndon arrived to help remedy the association’s financial situation. The first of the three issues was the financial problem that MGOA was faced with. Over time MGOA had not addressed the issues of receiving fewer monies from private and governmental insurers and that amount had now grown to a staggering $1 million dollars that the orthopaedic association had borrowed from the hospital. The second issue was the number of practicing physician’s that bought in less revenue than the expenses that they accrued by using the hospital’s facilities. The third and final issue was the apparent lack of administrative organization and communication. The lack of leadership really gave way to the financial issues and poor performing physicians that now plagued MGOA. The Massachusetts General Hospital realized these three issues were becoming major problems and decided to bring Rubash and Herndon on board to help turn the association around. The Solution and Roll Out Rubash and Herndon realized they needed to act fast and the first order of business was to communicate the problems to the staff. Rubash held meetings that allowed the staff to express their...
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...The primary objectives of the proposed MGOA pay for performance was to return MGOA back to financial stability by motivating the doctors to increase their clinical productivity, ensuring repeated performance, allocating all departmental cost to the doctors and eliminating the salary protection presently provided for low performance. The compensation plan attempted to reward the doctors for number of surgeries they could perform (clinical productivity) in any given period. The new MGOA pay for performance was tied to clinical activities and this, in a way, underestimated the relevance and contribution of teaching and medical research. While Rubash's argument that "financial security will allow MGOA to achieve its mission" was true, he failed to realize the negative effect of possible misalignment of his proposed pay strategy with the organization mission on the motivation of the physicians. Without a strong medical research activities, MGOA would lose its medical research reputation and this would had a long term effect on the output and number of patients, which could in turn led to decline in revenue. Expectancy Theory: Rubash goal was to drive productivity in order to increase MGOA revenue, and he figured out he could achieved this by motivating the doctors to increase their clinical productivity and making each one of them take full responsibility for his cost. However, the Expectancy theory reveals that employee motivation is an outcome of how much an individual wants...
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