Trust often begins when someone dares to go against the flow–someone who’s initially seen as unrealistic, even naive. In the next part of this book, I want to introduce you to several such individuals. Managers who have total faith in their staff. Teachers who give kids free rein to play. And elected officials who treat their constituents as creative, engaged citizens.
These are people fuelled by what William James called ‘The Will to Believe’. People who recreate the world in their own image.
13
The Power of Intrinsic Motivation
1
I’d been eager to meet Jos de Blok for some time. Having read about the success of his home healthcare organisation Buurtzorg, I had a hunch he was one of those exponents of a new realism. Of a new view of human nature.
But to be honest, the first time I talked to him he didn’t strike me as a great thinker. In one sweeping statement he dismissed the whole management profession: ‘Managing is bullshit. Just let people do their job.’
Sure, Jos, you think. Have another. But then you realise: this isn’t some crackpot talking. This is a guy who’s built a hugely successful organisation employing over fourteen thousand people. Who’s been voted Employer of the Year in the Netherlands five times. Professors from New York to Tokyo travel all the way to the town of Almelo to witness his wisdom first-hand.
I went back to have a look at the interviews Jos de Blok has given. They soon had me grinning:
Interviewer: Is there anything you do to motivate yourself? Steve Jobs reportedly asked himself in the mirror each morning: What would I do if this were my last day?
Jos: I read his book too, and I don’t believe a word of it.1
Interviewer: Do you ever attend networking sessions?
Jos: At most of those things, nothing happens aside from everybody reaffirming everybody else’s opinions. That’s not for me.2
Interviewer: How do you motivate your employees?
Jos: I don’t. Seems patronizing.3
Interviewer: What’s your speck on the horizon, Jos–that distant goal that inspires you and your team?
Jos: I don’t have distant goals. Not all that inspired by specks.4
Unlikely as it may sound, this is also a man who’s received the prestigious Albert Medal from the Royal Society of Arts in London, ranking him with the likes of Tim Berners-Lee, brain behind the World Wide Web; Francis Crick, who unravelled the structure of DNA; and the brilliant physicist Stephen Hawking. In November 2014, it was Jos de Blok from small-town Holland who received the honour and the cream of British academia turned out to attend his keynote speech. In broken English, De Blok confessed that at first he thought it was a joke.
But it was no joke.
It was high time.
2
To understand what makes de Blok’s ideas so revolutionary–and on par with cracking DNA–we have to go back to the beginning of the twentieth century. That’s when business administration made its debut. This new field of science had its roots planted firmly in the Hobbesian view that human beings are greedy by nature. We needed managers to keep us on the straight and narrow. Managers–the thinking went–had to provide us with the right ‘incentives’. Bankers get bonuses because it makes them work harder. Unemployment benefits are conditional to force people off the couch. Kids get F grades to make them put in a better effort next term.
What’s fascinating is that the two major ideologies of the twentieth century–capitalism and communism–both shared this view of humanity. Both the capitalist and the communist would tell you that there are only two ways to propel people into action: carrots and sticks. The capitalists relied on carrots (read: money), whereas the communists were mainly about sticks (read: punishment). For all their differences, there was one basic premise on which both sides could agree: People don’t motivate themselves.
Now you may be thinking: Oh, it’s not as bad as that. I, for one, am plenty motivated.
I’m not going to argue. In fact, I’m sure you’re right. My point is that we tend to think those other people lack motivation. Professor Chip Heath of Stanford University refers to this as our extrinsic incentives bias. That is, we go around assuming other people can be motivated solely by money. In a survey among law students, for instance, Heath discovered that 64 per cent said they were studying law because it was a long-time dream or because it interested them. Only 12 per cent believed the same held true for their peers. All those other students? They were in it for the money.5
It’s this cynical view of humankind that laid the foundations for capitalism. ‘What workers want most from their employers, beyond anything else, is high wages,’ asserted one of the world’s first business consultants, Frederick Taylor, some hundred years ago.6 Taylor made his name as the inventor of scientific management, a method premised on the notion that performance must be measured with the greatest possible precision in order to make factories as efficient as possible. Managers had to be stationed at every production line, stopwatch at the ready, to record how long it took to tighten a screw or pack a box. Taylor himself likened the ideal employee to a brainless robot: ‘so stupid and so phlegmatic that he more nearly resembles an ox.’7
With this cheery message, Frederick Taylor grew to become one of the most renowned management scientists ever. In the early twentieth century, the whole world was giddy with his ideas–communists, fascists and capitalists alike. From Lenin to Mussolini, from Renault to Siemens–Taylor’s management philosophy continued to spread. In the words of his biographer, Taylorism ‘adapts the way a virus does, fitting in almost everywhere’.8
Of course, a lot has changed since Taylor’s day. You’ll now find plenty of start-ups where you can show up at the office wearing flip flops. And many workers these days have the flexibility to set their own hours. But Taylor’s view of humanity, and the conviction that only carrots and sticks get people moving, is as pervasive as ever. Taylorism lives on in timesheets, billable hours and KPIs, in doctor pay-for-performance programmes and in warehouse staff whose every move is monitored by CCTV.
3
The first murmurs of dissent came in the summer of 1969.
Edward Deci was a young psychologist working on his Ph.D. at a time when the field was in a thrall to behaviourism. This theory held–like Frederick Taylor’s–that people are shiftless creatures. The only thing powerful enough to spur us to action is the promise of a reward or the fear of punishment.
Yet Deci had a nagging sense that this theory didn’t stack up. After all, people go around doing all kinds of nutty things that don’t fit the behaviourist view. Like climbing mountains (hard!), volunteering (free!) and having babies (intense!). In fact, we’re continually engaging in activities–of our own free will–that don’t earn us a penny and are downright exhausting. Why?
That summer Deci stumbled across a strange anomaly: in some cases, carrots and sticks can cause performance to slack off. When he paid student volunteers a dollar to solve a puzzle, they lost interest in the task. ‘Money may work’, Deci later explained, ‘to buy off one’s intrinsic motivation for an activity.’9
This hypothesis was so revolutionary that economists rejected it out of hand. Financial incentives only served to increase motivation, they steadfastly maintained, so if a student enjoyed doing a puzzle, a reward would make her even more enthusiastic. Fellow psychologists were equally contemptuous of Edward Deci and his ideas. ‘We were out of the mainstream,’ recalled his co-researcher and closest friend Richard Ryan. ‘The idea that rewards would sometimes undermine motivation was anathema to behaviorists.’10
But then a steady stream of studies began corroborating Deci’s suspicions. Take the one done in Haifa, Israel, in the late 1990s, where a chain of day care centres found itself in a predicament. A quarter of the parents picked their kids up late, arriving past closing time. The result was fussy children and staff forced to work overtime. And so the organisation decided to impose a late fee: three dollars every time a parent showed up late.
Sou
nds like a good plan, right? Now parents had not one but two incentives–both a moral and a financial one–to arrive on time.
The new policy was announced, and the number of parents who arrived late… went up. Before long, one-third was arriving after closing time, and in a matter of weeks, 40 per cent. The reason was straightforward: parents interpreted the late fee not as a fine but as a surcharge, which now released them from their obligation to pick up their kids on time.11
Many other studies have since validated this finding. It turns out that, under some conditions, the reasons people do things can’t all be added up together. Sometimes, they’ll cancel each other out.
A few years ago, researchers at the University of Massachusetts analysed fifty-one studies on the effects of economic incentives in the workplace. They found ‘overwhelming evidence’ that bonuses can blunt the intrinsic motivation and moral compass of employees.12 And as if that wasn’t bad enough, they also discovered that bonuses and targets can erode creativity. Extrinsic incentives will generally pay out in kind. Pay by the hour and you get more hours. Pay by the publication and you get more publications. Pay by the surgical procedure and you get more surgical procedures.
Here again, the parallels between the western capitalist economy and that of the former Soviet Union are striking. Soviet-era managers worked with targets. When targets went up–say, at a furniture factory–the quality of the furniture plummeted. Next when it was decided tables and chairs would be priced by weight, suddenly the factory would produce pieces too heavy to move.
This may sound amusing, but the sad truth is that it’s still happening in many organisations today. Surgeons paid on a per-treatment basis are more inclined to sharpen their scalpels than to deliver better care. A big law firm that requires its staff to bill a minimum number of hours (say 1,500 a year) isn’t stimulating its lawyers to work better, only longer. Communist or capitalist, in both systems the tyranny of numbers drowns out our intrinsic motivation.
So are bonuses a complete waste of money? Not entirely. Research by behavioural economist Dan Ariely has shown they can be effective when the tasks are simple and routine, like those Frederick Taylor timed on his stopwatch on production lines.13 Precisely the kinds of tasks, in other words, that modern economies increasingly get robots to do, and robots have no need for intrinsic motivation.
But we humans can’t do without.
Sadly, the lessons of Edward Deci haven’t made it into daily practice nearly enough. Too often people are still treated like robots. At the office. At school. In hospital. At social services.
Time and again, we assume that others care only about themselves. That, unless there’s a reward in the offing, people much prefer to lounge around. A British study recently found that a vast majority of the population (74 per cent) identify more closely with values such as helpfulness, honesty and justice than with wealth, status and power. But just about as large a share (78 per cent) think others are more self-interested than they really are.14
Some economists think this skewed take on human nature isn’t a problem. Nobel Prize-winning economist Milton Friedman, for instance, argued that incorrect assumptions about people don’t matter so long as your predictions prove right.15 But Friedman forgot to factor in the nocebo effect: simply believing in something can make it come true.
How you get paid for what you do can turn you into an entirely different person. Two American psychologists demonstrated a few years ago that lawyers and consultants who are paid by the hour put a price on all their time, even outside the office. The upshot? Lawyers who meticulously log their hours are also less inclined to do pro bono work.16
It’s mind-boggling to see how we get tripped up by targets, bonuses and the prospect of penalties:
• Think about CEOs who focus solely on quarterly results, and wind up driving their companies into the ground.
• Academics who are evaluated on their published output, and then tempted to put forward bogus research.
• Schools that are assessed on their standardised test results, and so skip teaching those skills that can’t be quantified.
• Psychologists who are paid to continue to treat patients, and thus keep patients in treatment longer than necessary.
• Bankers who earn bonuses by selling subprime mortgages, and end up bringing the global economy to the brink of ruin.
The list continues. A hundred years after Frederick Taylor, we’re still busy undermining one another’s intrinsic motivation on a massive scale. A major study among 230,000 people across 142 countries revealed that a mere 13 per cent actually feel ‘engaged’ at work.17 Thirteen per cent. When you wrap your brain around these kinds of figures, you realise how much ambition and energy are going to waste.
And how much room there is to do things differently.
4
Which brings us back to Jos de Blok. Up until early 2006, he sat on the board of directors at a large Dutch healthcare organisation. He floated one idea after another for ‘self-directed teams’ and ‘hands-off management’ until he had his fellow managers seeing red. De Blok himself had no business training or degree. He’d started studying economics years before only to drop out and become a nurse.
‘The gap between the people at the top and the folks doing the actual work–in healthcare, in education, you name it–is enormous,’ De Blok tells me when I visit his office in Almelo. ‘Managers tend to band together. They set up all kinds of courses and conferences where they tell each other they’re doing things right.’
That cuts them off from the real world. ‘There’s this notion that doers can’t think strategically,’ De Blok continues. ‘That they lack vision. But the people out doing the work are brimming with ideas. They come up with a thousand things, but don’t get heard, because managers think they have to go on some corporate retreat to dream up plans to present to the worker bees.’
De Blok has a very different take on things. He sees his employees as intrinsically motivated professionals and experts on how their jobs ought to be done. ‘In my experience, managers tend to have very few ideas. They get their jobs because they fit into a system, because they follow orders. Not because they’re big visionaries. They take some “high-performance leadership” courses and suddenly think they’re a game changer, an innovator.’
When I point out to de Blok that ‘healthcare manager’ was the fastest-growing occupational group in the Netherlands in the years 1996–2014, he heaves a sigh.18
‘What you get with all these MBA programmes is people convinced they’ve learned a convenient way to order the world. You have HR, finance, IT. Eventually, you start believing that a lot of what your organisation is accomplishing is down to you. You see it with loads of managers. But subtract management and the work continues as before–or even better.’
As statements like this testify, de Blok tends to swim against the tide.
He’s a manager who prefers not to manage. A CEO with hands-on experience. An anarchist at the top of the ladder. So as care became a product and patients became customers, De Blok decided to give up his management job and start something new. He dreamed of an oasis in this vast bureaucratic wasteland, a place fuelled not by market forces and growth, but by small teams and trust.
Buurtzorg started out with one team of four nurses in Enschede, a Dutch city of 150,000 on the country’s eastern fringes. Today, it numbers more than eight hundred teams active nationwide. However, it’s not what the organisation is, but what it is not, that sets Buurtzorg apart. It has no managers, no call centre and no planners. There are no targets or bonuses. Overheads are negligible and so is time spent in meetings. Buurtzorg doesn’t have a flashy HQ in the capital, but occupies an uninspiring block in an ugly business park in outlying Almelo.
Each team of twelve has maximum autonomy. Teams plan their own schedules and employ their own co-workers. And, unlike the rest of the country’s infinitely scripted care industry, the teams don’t supply code H126 (‘Personal Care’), code H127 (�
��Additional Personal Care’), code H120 (‘Special Personal Care’), or code H136 (‘Supplemental Remote Personal Care’). No, Buurtzorg supplies just one thing: care. In the exhaustive ‘Product Book’ of ‘Care Products’ defined by insurers, Buurtzorg now has its very own code: R002–‘Buurtzorg’.
For the rest, the organisation has an intranet site where colleagues can pool their knowledge and experience. Each team has its own training budget, and each group of fifty teams has a coach they can call in if they get stuck. Finally, there’s the main office which takes care of the financial side of things.
And that’s it. With this simple formula, Buurtzorg has been proclaimed the country’s ‘Best Employer’ five times, despite having no HR team, and won an award for ‘Best Marketing in the Care Sector’, despite having no marketing department. ‘Employee and client satisfaction is phenomenally high,’ concluded one consultant at KPMG. ‘Though costing only slightly less than the average, their quality of care clearly exceeds the average.’19
That’s right, Buurtzorg is better for patients, nicer for employees and cheaper for taxpayers. A win-win-win situation. Meanwhile, the organisation continues to grow. Every month, dozens of nurses leave other jobs to sign on with Buurtzorg. And no wonder: it gives them more freedom and more pay. When Buurtzorg recently acquired part of a bankrupt counterpart, de Blok announced: ‘The first thing we’re going to do is raise staff salaries.’20
Don’t get me wrong: Buurtzorg isn’t perfect. There are disagreements, things go awry–really, they’re almost human. And the organisational structure is, if anything, old-fashioned, with de Blok’s aim always having been a return to Holland’s uncomplicated domestic healthcare services of the 1980s.
But the bottom line is that what Jos de Blok started back in 2006 is nothing short of extraordinary. You might say his organisation combines the best of left and right, spending taxpayer money on the delivery of small-scale care by independent practitioners.
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