[ReallyAnonymous]

I work for a >10,000 employee health care system as a physician. What I have seen is that the front line workers are considered disposable, and should be grateful for a job. The superstars ( always nice, compassionate, and excellent at their jobs) are not recognized by management and so when raises are given, everyone gets them, including the lazy ones. This disappoints the worker bees, and leads to incredible turnover and more frustration for us physicians. Unfortunately, a lot of the attributes of a great employee cannot be quantified on a spreadsheet so the MBAs running my organization have no clue how to compensate people. Instead, they just lump everyone in the same pile so the workers get frustrated bc they work twice as hard as the lazies, but make the same amount.

I've tried to talk to executives about this, but I think it's essentially to deaf ears - bottom line is the most important, so they can get their bonuses.

It leads to disenchantment and then, over many years, inability to get hardworking / intelligent people to enter front line professions.

Smart people will recognize that their hard work will never be acknowledged, so they switch careers. Others, who cannot get jobs elsewhere, or pivot, are stuck working there.

Not sure what the solution is, but it's just an observation.

[Balgair]

This is called the Peter Principle [0]. Unfortunately, the system is kinda unfixable. If we promote based on achievement in your last job, then at some point you can become unpromotable in your current job as you just aren't suited to it or some other reason. If we want to get rid of the Peter Principle, an inherent 'bug' in a merit based system, then you have to radically change how promotion is decided. Your front-line workers are victims of management that is affected by the sclerosis of the Peter Principle, and they themselves are as well as they are unpromotable and have 'failed' at the merit based system (namely, the internal politics of the Hospital).

Still, it sounds like management just wants to hire/fire at a whim, as it keeps wages down and there tends to be a glut of nurses out there that can be replaced. Again, this is a feature of supply/demand and the job market. Also, if you did raise wages based on 'merit', then you would get the front-line people trying to snipe each other over the money and promotion would become based on internal politics and 'he-said-she-said' stuff. It all comes down to the money.

[0] https://en.wikipedia.org/wiki/Peter_principle

[caminante]

> Not sure what the solution is, but it's just an observation.

You're constrained (enabled) by the competitive strategy your HCS employs: cost leadership (e.g. Wal-Mart), differentiation (e.g. Apple), or focus (e.g. Southwest Airlines). [0] Strategic focus allows companies to better align their incentives with culture, and it seems to work better.

If your HCS doesn't fall in one of these categories, compensation's even more difficult to solve. On HN, you'll hear a lot of large tech companies (targetting differentiation) claim to have solved ranking and performance compensation when a simple look at Glassdoor and critiques of the trade-off call these claims into question.

The bottom line is that executives have a set budget to allocate and never enough data, yet they also have to make a decision. Thus, you can only get a good (bad) solution and never a perfect solution.

[0] https://en.wikipedia.org/wiki/Porter%27s_generic_strategies

[smitherfield]

What about Amazon? It seems like they're pursuing both the differentiation and cost leadership strategies.

Of course, they're the world's largest retailer by market cap, so they can afford to do both. And usually I don't even look elsewhere for a product, because I figure that they have either the lowest price or close to the lowest, and will deliver it the fastest. So I guess more differentiation?

[caminante]

If I had to pick one, I'd say cost leadership. Amazon grew through cost leadership, and that's still the company at its core as it a) achieves high asset utilization b) keeps costs low, and c) controls most of its supply chain. What might seem like AMZN using a differentiation strategy is actually just focused cost leadership in mid-up market segments.

[zigzigzag]

Is the issue unionisation? It sounds like the answer is no.

The solution is probably to switch to a competitor that does set pay levels individually. In the event that there are none, perhaps take a leap and set up a competitor that does? If it's as big a problem as you say, presumably lots of talented physicians would beat a path to your door.

[jacalata]

> This disappoints the worker bees, and leads to incredible turnover and more frustration for us physicians.

I think they are talking about treatment of non-physician employees.

[astazangasta]

I really don't give a shit if I'm being paid more than my fellows, hard-working or no. The only thing I care about in my pay level is: am I making enough to support my family in a decent lifestyle? This means I'm comparing against the cost of living, NOT what my coworkers make - I only care about my relative wage insofar as it indicates how most people are getting by.

What I'm more interested in, as a smart person, is that my work is recognized as valuable, given the resources it needs to succeed, encouraged, improved upon, aided.

[xfitm3]

Merit raises are an effect of recognition. The fact everyone got the same raise meant there was no recognition for hard work. It's the wrong job for someone who wants to do better than bare minimum. I'll speculate and suggest that the department is doing good enough and they're not paying attention to performance metrics.

[jdale27]

That may be a great attitude to have, but unfortunately it's not the attitude that most humans have.

[Thriptic]

Your pay level relative to everyone else is the principle way the company acknowledges the value of your work. If I am making the same amount as a total underachiever, it signals that the company either doesn't care about my work or thinks I am also an underachiever.

[naveen99]

So go start a "nonprofit" hospital or other business, and poach the star front liners yourself.

[B1FF_PSUVM]

> so the MBAs running my organization have no clue

There, you said it.