In many practices and especially in academia, important but burdensome tasks are either treated like hot potatoes or flow downhill to the most junior faculty. There are several strategies for distributing important but non-measurable or non-promotable tasks:
- random assignment
- rotating schedules
- clear benefits like compensatory time off
- automatic cycling/off periods (e.g., do a task for one year, then off for four years)
Avoid asking for volunteers in some situations, particularly for tasks that have little upward mobility, little chance to shine, and where performance is perhaps less important or easy to measure. Otherwise, you get the same people-pleasers doing everything and burning out. Even if they’re not burning out, their time is taken up (perhaps by doing the wrong activities as acts of service).
Alternatively, if a task is important enough to get done, consider ways in which it can be part of someone’s job description. This may be more practical when something undesirable is paired with something desirable, like remote schedules with a more challenging case mix.
Another possibility is putting your money where your mouth is. My practice has a small component of bonus compensation tied to accumulating enough brownie points for doing various tasks like tumor boards, recruiting activities, etc. The reality in our group is that we are large enough and the tasks varied enough that the minimum threshold to qualify is laughably small, and there aren’t measurable benefits to accumulating more than you need. It ensures a floor, probably relying more on the principle loss aversion than the actual money at stake.
You can give people effort RVUs for doing those tasks, but in this market, anything that gives you credit towards a full day’s work that detracts from reading cases can also contribute to overall staffing problems. In other clinical fields, it just pushes more work into the evening/weekends (and eats up precious academic/admin time if in the mix). In small groups where such activities may be distributed evenly, nothing may need to happen. In larger practices where most members will do nothing except interpret scans, stipends are an option, particularly for larger tasks like division directorship.
Bean counting is fine to an extent, and some activities like multidisciplinary conferences are easy to count. But many important tasks are challenging to quantify and may even backfire when attempted. The classic daycare fine experiment added a financial penalty when parents arrived late to pick up their infants, which replaced a powerful social norm with a market norm (swapping guilt for a few dollars). Sometimes, something people would do for free is devalued when a sticker price is put on it that is laughably small.
Consider preventing excess accumulation/consolidation: if someone is going to do something more, the default should be for that person to do something less as well. It’s not just for their benefit. Our institutions are fragile when they rely on individuals too much for any reason.
(On a related note, documentation is key for onboarding and transferring. Truly useful internal documents that are up to date are exceedingly rare.)
Distinguish between areas where someone is specifically important—where the specific representation matters—versus when someone is a warm body. Not all extra work is the same, and not all additional roles are interchangeable or easy to replace. The ones that leave a real hole need to be valued more, even if that comes mostly in the form of consistent gratitude.
If you think someone special knows just how much they are respected and appreciated, they don’t. I promise.
