Incentives.... or not?

OK! Although incentives may seem like a pretty black and white topic, I feel as though it could be debated. In another HSA class that I am currently taking we were assigned to discuss our views on incentives. When I first took a look at the assignment I thought that it would be a no brainer but after reading my classmates responses I started thinking; Should incentives be used to encourage production of quality work?? Although many people would say yes, for the obvious reasons; such as motivation of work and better outcomes, I tend to disagree. Some say that for individuals who lack motivation incentive is a perfect way to get them moving in their area of work. I, however, tend to disagree. A friend of mine who works in a nearby hospital as a registration representative is the perfect example of how incentives can go wrong. Registration representatives are given goals to meet (i. e payment collection) in a specific time period. Although they may get their goals achieved it has been reported that during this process the amount of quality delivered to the patients has declined, through telephone calls to the patients demanding payment for services rendered the representatives can come off as harsh, rude and unforgiving towards patients who may have spent their last dollar. The patients then complain to the corporate hospital offices along with spreading this information to neighbors and potiental patients, thereby leaving the hospital with a bad reputation. This in effect places a bad name on the healthcare organization which can then lead to a decline in profit for that organization.

Then again..... Incentives can also be used in a manner in which they help the organization achieve awards ( i.e Joint Commission recognition and Quality awards). They may also help to motivate individuals and produce outcomes that may have not be produced without the incentive. They can also convince future employees to work for your organizations by informing them of the incentives are provided. For example, Florida Hospital provides a sign on bonus of $2500 dollars for new Graduate Nurses, pending an agreement to work with the organization for 12 months. This incentive no only motivates the employee but it also provides job security for the employee.

I am beside myself on incentives being used to encourage quality work. Should we implement incentives with hopes that it doesn't have a reverse effect? or Should we leave it up to the individual to decide the level of intensity they put into their work?