Engaged employees: Which intrinsic rewards keep dental staff members feeling valued?

Feb. 17, 2016
By Dorothy Garlough: Which intrinsic rewards keep dental staff members feeling valued?

Dorothy Garlough

The sinking feeling hits her as she drives to the office. In fact, she is practicing a yoga mantra to calm her mind so that she can deal with the day. Not that today will be any different than any other day; it just takes all she's got to show up for work. For a long time now, she hasn't felt a part of the office and feels ostracized by the "people in power." She has been shut out so many times that she is shutting down. The exclusive office environment has changed her. The enthusiasm she once felt as a contributing member of a team has evaporated and been replaced by detachment. These days, she arrives at the dental office, serves her patients in a conscientious and professional manner, and leaves as soon as possible. She knows she is no longer an engaged employee and this bothers her. She often asks herself why she stays, but knows the answer. She needs the job.

According to Wikipedia, "an 'engaged employee' is defined as one who is fully absorbed by and enthusiastic about [his or her work], and so takes positive action to further the organization's reputation and interests."1 A 2014 Gallup poll says that 51% of employees are not engaged at their workplace, with 17.5% of workers actively disengaged. These disengaged workers can actually be doing harm to the organization. Less than a third (31.5%) of workers are engaged in their work and of those, 42.2% are from the traditionalists generation with the millennials being the least engaged at 28.9%. The youngest group of workers say they have less opportunity to do what they do best. This frustration creates apathy toward their careers.

Research by the Dale Carnegie Institute says that everything about the business improves when staff is engaged. Happiness is not only increased but so is loyalty, productivity, quality of work, and profits. When dental staff are engaged, they are giving their best, and of course, this results in better work and more engaged patients. It is said in public speaking that the audience will not remember what you say, but they will remember how they feel. In the dental office, the infection of enthusiasm (or apathy) is contagious. Having engaged staff is good for business.

The stick or the carrot?

Dental offices, like all businesses, need to be proactive in eliciting engagement of their staff. Research shows that the "command and control" style of management no longer works to motivate employees.2 In earlier eras, when work was generally more routine and bureaucratic, there was a need for employees to comply to rules and procedures. Today, most workers are self managed and the "stick" method of beating staff into submission results in disgruntled workers who are at the office in body only. These workers live to leave and even though the work may be adequately done, they aren't happy. No one produces their best work in this state, and this translates into a negative for the employee and the business.

We now know that control leads to compliance, while autonomy leads to engagement. Today, we recognize that the "carrot" management style works in raising engagement. The carrot is a reward system that brings staff on board willingly, thus increasing satisfaction. There are two types of rewards: extrinsic and intrinsic.

Extrinsic rewards, which are usually financial, are tangible and given through raises, bonuses, or benefits. They are external to the work itself and are reliant on another person or persons to grant you the reward. Although this reward system does have its benefits, Professor Edward Deci in 1969 concluded in his research that "when money is used as an external reward for some activity, the subjects lose intrinsic interest for the activity." He felt that once the effect of a large bonus wears off, money alone could reduce a person's long-term interest for the activity. Although being paid fairly for work is vital to job satisfaction, money above the fair wage does not offer the day-to-day motivation for ongoing enlistment and performance.

Intrinsic rewards, on the other hand, are motivators with long-term effects. Enjoying the work itself, genuine achievement, and personal growth are carrots that keep workers engaged. These internal desires boost satisfaction and performance. When we look at today's dental staff, we see that the staff self-manages to a significant degree. Dental office personnel use their own intelligence and experience to direct their work activities. They are continually innovating, problem solving, and improvising to meet the needs of the office and the patients.

The path to self-management

The self-management process involves four steps:3

  • Believing and committing to a meaningful vision or purpose
  • Choosing how to fulfill the purpose
  • Making sure that you are performing your work competently
  • Making sure that you are progressing toward the vision

These four factors are important for dental staff in assessing the value and effectiveness of their efforts. Examining why they are there (vision) and the degree of autonomy they have in performing their work are linked to positive engagement. In addition, judgment of their own performance and the progress being made to fulfill the purpose are key to job satisfaction. Workers need to feel that their work is of value, that they are competent and are making a meaningful contribution.

When positive, each of these judgments is accompanied by a positive emotional charge. These positive charges are the intrinsic rewards employees get from work.3 They are the reinforcements that keep employees actively self-managing and engaged.

The hygienist showcased in the opening paragraph identifies that there is a disconnection between the work she does and feeling a part of the team. Although she is competently performing her work, she is not satisfied and does not feel a part of or may not even know what the vision of the office is. In next month's column, we will examine the level of intrinsic rewards as well as how to build a culture of engagement. The upside to creating such a culture is two-fold: success for the dental office and fulfilling careers for employees! RDH

Keys to engagement

  • Meaningfulness: The sense that you are accomplishing something of real value in your work-something larger than yourself. This feeling gives you a strong sense of direction and purpose.
  • Choice: You feel autonomous in your work, choosing how you will accomplish the work and having ownership of your work.
  • Competence: You believe that the performance of your duties meets or exceeds your personal standards. You feel that you are doing high quality work and take pride and satisfaction from that.
  • Progress: You feel that things are going in the right direction and are encouraged. You have a strong sense of accomplishment.


1. Employee engagement. Wikipedia. https://en.wikipedia.org/wiki/Employee_engagement. Accessed December 22, 2015.
2. Pink DH. Drive. New York, NY: Riverhead Books; 2009.
3. Thomas K. The Four Intrinsic Rewards that Drive Employee Engagement. The Ivey Business Journal. Published November 2009. http://iveybusinessjournal.com/publication/the-four-intrinsic-rewards-that-drive-employee-engagement/. Accessed December 22, 2015.

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change in both the dental and corporate worlds. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected].