This week Seth Godin put out a remarkable blog talking about the question, “What’s it for” and how that ties into the real reason things are done.  Take a look at the blog on Seth’s website and read it over a couple times.  Note the distinction he makes between the question of “what’s it for” and “why” as the purest reason you’re doing something.  I also like the way he weaves in the issues of profits and pleasing your boss.  Take some time and see how this fits in your world.

Perhaps the best place to start would be with your company.  What is your company in business for?  This is a huge question that demands some real honesty.  Let’s say you can only have one answer.  What would it be?  Is your company primarily in business to make money?  To drive the stock price higher?  To make patients healthier?  To treat everyone with a particular disease?  To help physicians help patients?  To keep a lot of people employed?  To help your community?  To drive innovation?  To seek medical breakthroughs?  To grow bigger and have a larger slice of the market?

Now take it down to the level of the product you work on.  What is the product for?  Is it on the market to make money for your company?  Is it on the market to help patients?  Is it there to provide a safer or a more effective alternative?  Is it on the market for all patients with a particular disorder or only those who have failed other therapies?  Is it only for commercially insured patients?  Only for those who can afford tier three co-pays or who can get enrolled in a voucher program?  Is it only for those “on the top of the pyramid” or for everyone?

And now the really tough part.  What are you in the business for?  Are you here to make money?  Is the reason you work to help patients?  Are you here to get promoted?  Are you here to please your boss?  To have a lot of people work for you?  To build your image or your self respect?  To grow intellectually?  To have a nice place to hang out with others?  Do you work for the stock options?  The health insurance?  The retirement plan?  What is the real answer?

Although I ask a lot of questions it is important to recognize there is no right answer.  I am sure that if you talk with a hundred of your peers you would get a wide variety of answers if everyone is being honest.  Long ago one of my first bosses taught me that, “Some people live to work and others work to live” and both need to be respected.  There is nothing wrong with companies making profits or individuals making money as long as it is all done ethically.  There is nothing wrong with trying to get promoted or trying to grow market share relative to your competition.  The problems all come when there is misalignment.

If the answer to all these questions is very clear and everyone is lined up accordingly then things are prefect.  If the company is in business to generate as much profit as possible and your brand is on the market to generate profit and if your motivation to work is to make money and your income is tied to the profit then everything is perfect, right?  If your company is in business to drive innovation in healthcare and your product is a breakthrough and you work for scientific/intellectual stimulation then again everything is good.  The concern comes when things are not lined up.  When you want long-term patient satisfaction and your company wants short-term profits.  When you want innovation and your boss wants stability.  When you work for the science and the company wants to drive the stock price through downsizing.  I think you can see the potential conflicts?  Perhaps the worse situation is when you design and do things that are in conflict with what you work for.  That is what kills motivation the most.

Before you throw your hands up in despair, let me suggest a couple simple starting points.  Start by trying to really figure out what you are doing this work for and then see where there are major points of alignment with your company and those you work with.  My bet is when you dig deep you will find there is more alignment then misalignment.  The fun part will come when you look at the things that happen every day, the strategies and tactics for the business.  Chances are this is where the real misalignment is and with some solid challenge and action these can be brought into alignment.  The whole process really begins with having the guts to ask the questions and being brave enough to face up to the answers.