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Cover Focus Business Administration: What You Didn't Learn In Medical School | Sep 2015

Maslow’s Hierarchy and Managing Individuals

A hurricane is headed straight for your house. An armed robber is at the window of your car. A forest fire is nearby, and you hear the winds whistle as it approaches. Are you feeling safe? What does your instinct tell you should be done? Are you thinking about dating, parties, vacation, personal growth, or what book to read next in that moment? Have you ever considered why not?

In 1943, psychologist Abraham Maslow laid out his “Theory of Human Motivation,” in the journal Psychological Review, which attempted to define how individuals find motivation at different stages and in diverse situations.

He argued that people, in general, must have physiologic needs sated prior to being worried about, or motivated to undertake, anything more. From there, individuals would seek safety, then attempt to find a feeling of belongingness. Only then could people seek esteem and ultimately self-actualize.


In more basic terms, let’s pretend you are a caveman or cavewoman. Without food, water, and a cave, very little else matters. You do not seek love or to have children. You do not wish to grow personally or decorate your cave. You simply do whatever it takes to find simple sustenance and a rock over your head.

Once that has been accomplished, you realize that, although you have food, water, and a cave, there is a lion in your cave, and you do not feel safe. At this stage, you seek safety—better shelter, a good club to beat attacking lions, and perhaps a bucolic lifestyle farther from predators.

Finally, you can find a mate—ideally a relatively well-bathed caveperson with whom to have some cavekids. You meet some cavebuddies to pray to the rain gods with on Saturdays and even try to improve your hunting skills. You invent a wheel and fire to the surprise and splendor of the “cavemunity” and ultimately achieve enlightenment. All is right in cave world.


Interesting stuff, sure, but how does it apply to contemporary times and modern business? Let’s now look at the employees at your practice. As a physician leader, you must multitask: performing surgery, treating patients, seeing consultations, managing emotions, building and retaining a team of workers, and ideally creating a lasting legacy so you may sell your practice one day for a handsome profit.

One of the great misdemeanors of management is the tendency to confuse your own level in Maslow’s hierarchy with that of each employee. You may feel safe, loved, and a part of a team and be seeking self-actualization, but that is often because you have been doing your job for years and cannot be fired. When you consider the mental state of your junior and senior employees, we can tease out common mistakes many physician leaders make using Maslow’s Hierarchy.

Level 1: Physiological Needs | Mistake = Hiring People Who Are Desperate

Often, practice leaders confuse a desperate job seeker with a hungry go-getter. The latter is ideal, as nobody wants a lazy or unmotivated employee. If you hire someone desperate, however, who is simply seeking food for the family table, shelter, or to save his or her home, he or she may be dangerous. Indeed, imagine if you could not pay your rent or feed your family. What would you resort to? Would you want yourself in an office with cash? I recommend picking only hungry people to join your team to avoid desperate acts by desperate people. Sometimes, bad things are done by good people, often out of desperation.

Level 2: Safety | Mistake = Joking About Employment Status

Many times, I have heard doctors or managers jokingly say, “Good morning. You are 2 minutes late. I guess we need to start looking for a replacement.” Yes, mistakes like tardiness should be addressed, and certainly chronic mistakes can and should lead to loss of employment. With that said, remember that even nonchalant threats to their employment status immediately takes any employee off of other more self-actualized levels of Maslow’s hierarchy and back down to questioning his or her safety. If job safety is threatened, you can bet the employee is looking online for new jobs that night and not thinking about how he or she can grow personally and professionally within the organization.

Level 3: Love and Belonging | Mistake = Not Having Fun

Is your workplace a joy to come to? Are there occasional surprises, parties, and cakes for birthdays and traditions that are repeated annually? If not, your people may not feel they belong. Once you provide fair wages and a safe environment, start to create culture. Culture starts with rules and expectations but thrives with traditions and a bit of joy. Have a holiday party. Take people to lunch occasionally. Think of something silly that makes people feel a part of the team. (At YellowTelescope, we make a bobblehead doll in the image of each employee and present it on his or her second work anniversary.) Part of culture is establishing work ethic, expectations, and rules, but part of it is also the feeling of belongingness.

Level 4: Esteem | Mistake = Lacking Opportunity for New Challenges

As your team matures, let’s assume all members are feeling safe, loved, and a part of the culture. To avoid boredom, which leads to the desire to find a new outlet for personal growth, simply provide that prospect. Invest in your people’s personal growth. Esteem and confidence come from learning. Buy your team a book to read together on leadership, service, or sales. Invest in a seminar or conference for your team to attend. Consider hiring some consulting services to challenge yourself to become better. Contests do not hurt, either, and having fun with it helps at every level.


As my director John Berry once said, “Self-actualization means you turn into a beam of light, so it is pretty hard to achieve.” There are, however, many lessons that can be easily learned and implemented as you go from being a caveperson in the managerial sense to a self-actualized visionary leader. Start by hiring hungry but not desperate people. See your results soar by creating a safe environment, with new challenges and a culture based on both results and the concept of family fun. n

Jon Hoffenberg
• president of YellowTelescope and SEOversite.com

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