HCS/325 Week 3: Motivation and Conflict Management, sample paper

Raises Did Not Fix It: Herzberg's Two-Factor Theory and the Thomas-Kilmann Conflict Modes Applied to a Patient Access Team

[Student Name]

University of Phoenix

HCS/325: Health Care Management

Week 3 Assignment

[Instructor Name]

[Date]

The clinic, team and figures are a composite written for a model paper.

A composite multispecialty clinic employs fourteen patient access representatives who schedule appointments, register patients, verify insurance and collect copayments. Last year, after exit interviews mentioned pay, leadership raised their hourly wage by 8%, bringing it above the local market. Over the following year, five of the fourteen still left. At the same time, two senior representatives were locked in a dispute over the schedule for the busy Monday morning shift, and the team had divided into camps. Leadership had treated turnover as a pay problem and the dispute as a personality clash; both diagnoses were too simple. This paper applies Herzberg's two-factor theory to the motivation problem and the Thomas-Kilmann conflict modes to the dispute.

Herzberg's Two-Factor Theory

Herzberg (1968) proposed that the factors producing job satisfaction are different from those producing dissatisfaction. Hygiene factors, including pay, company policy, supervision, working conditions and relationships with coworkers, cause dissatisfaction when they are poor, but improving them only removes dissatisfaction; it does not create motivation. Motivators, including achievement, recognition for achievement, the work itself, responsibility and advancement, produce satisfaction and drive effort. Herzberg argued that managers often try to motivate by adjusting hygiene factors, which at best prevents complaints, and neglect the motivators that actually engage people. Health care management texts note that front-line administrative staff are often managed mainly through pay and policy, even though their work shapes patients' first impressions and the organization's revenue (Buchbinder et al., 2021).

Applying the Theory to Turnover

The raise addressed a hygiene factor, and by Herzberg's logic it should have reduced dissatisfaction about pay without making the job more motivating. Exit interviews after the raise supported this reading. Departing representatives no longer mentioned pay. Instead, they described work that was repetitive and stressful, with patients angry about insurance problems they could not solve; recognition that came only in the form of complaints; no path to advancement; and decisions about their schedules made without their input.

Each of those items is a motivator in Herzberg's scheme. The work itself was experienced as a series of problems without resolution. Achievement was invisible, since no one tracked the claims the team's careful registration kept from being denied. Responsibility was limited, since representatives could not resolve billing questions and had to transfer patients. Advancement was absent. The raise had removed one source of dissatisfaction, but it had not given anyone a reason to stay.

The Scheduling Conflict

The dispute concerned Monday mornings, the busiest period of the week. One senior representative, who had worked at the clinic for eleven years, had always worked Monday mornings at the front window and wanted to keep that assignment. Another senior representative, with eight years of experience, argued that the most experienced staff should rotate through the phone lines on Mondays, when call volume was highest and new staff struggled. Each had supporters. The dispute had moved from the schedule to accusations of favoritism, and two newer staff members said the tension made them want to leave.

The Thomas-Kilmann Conflict Modes

Thomas (1992), reflecting on two decades of conflict research, described five conflict-handling modes arranged along two dimensions: assertiveness, the degree to which a person tries to satisfy his or her own concerns, and cooperativeness, the degree to which a person tries to satisfy the other's concerns. Competing is assertive and uncooperative; accommodating is cooperative and unassertive; avoiding is neither; collaborating is both; and compromising lies in the middle. No mode is always right; the appropriate mode depends on the importance of the issue, the relationship, time available and whether a solution that satisfies both parties is possible.

Choosing a Mode

The manager considered each option. Avoiding, hoping the dispute would fade, had already been tried for two months and had allowed it to spread. Competing, simply issuing a schedule, would be quick but would leave one senior employee feeling defeated and could deepen the divide. Accommodating one side would reward whoever had pushed hardest. Compromising, alternating Mondays between the two approaches, would split the difference without addressing the underlying concern about phone coverage.

Collaborating fit best. The issue mattered to patient access and to retention; both representatives had legitimate concerns, the window's familiarity for regular patients and support for struggling new staff; the relationship mattered for the team; and there was time to work on a solution. Collaboration aims for an outcome that satisfies both parties' underlying interests rather than their stated positions.

What the Manager Did

The manager met with the two senior representatives together, asked each to describe what she was trying to protect rather than what schedule she wanted and listened. The first cared about continuity for regular patients, many of them older, who knew her at the window. The second cared about new staff drowning on the phones. Together they designed a Monday plan: the senior window representative kept her post, the second senior representative led a "phone pod" of two newer staff with a shared headset for coaching and both agreed to mentor newer staff on alternate weeks.

The manager also acted on the motivators. She created a lead representative role with a modest differential, invited the team to help design the schedule each quarter, began a monthly report showing claims accepted on first submission, crediting the team's registration accuracy, and arranged training so representatives could answer common billing questions without transferring patients.

Results

In the following six months, one representative left, compared with three in the same period the year before. The team's engagement survey showed higher scores on recognition and input into decisions. The Monday dispute ended, and the two senior representatives co-led the next quarter's scheduling session.

Conclusion

A pay raise addressed a hygiene factor and removed a complaint, but, as Herzberg's theory predicts, it did not motivate. Turnover fell only when the manager added recognition, responsibility, growth and input into decisions. A scheduling dispute that had been avoided and misread as a personality clash was resolved through collaboration, which the Thomas-Kilmann framework identified as the appropriate mode for an important issue between colleagues with legitimate interests. Motivation and conflict were linked: a team given reasons to stay and a voice in decisions had less to fight about.

References

Buchbinder, S. B., Shanks, N. H., & Kite, B. J. (Eds.). (2021). Introduction to health care management (4th ed.). Jones & Bartlett Learning.

Herzberg, F. (1968). One more time: How do you motivate employees? Harvard Business Review, 46(1), 53-62.

Thomas, K. W. (1992). Conflict and conflict management: Reflections and update. Journal of Organizational Behavior, 13(3), 265-274. https://doi.org/10.1002/job.4030130307