What motivates physicians throughout their careers in medicine?

Ratanawongsa, Neda; Howell, Eric; Wright, Scott M.

doi:10.1007/bf02698065

Cited by 42 publications

(43 citation statements)

References 61 publications

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“…4,11,21 In any field, smart individuals will take note of what is rewarded and will direct their activities accordingly. 22,23 As a result, many academic faculty elect to limit their time spent in teaching and in clinical care so as to spend greater time on the activity that brings acknowledgement and reward. 2,24 The faculty are a medical school's most precious resource, and therefore, all should be made to feel valued and appreciated.…”

Section: Discussionmentioning

confidence: 99%

Implications of Academic Medicine's Failure to Recognize Clinical Excellence

Durso¹,

Christmas²,

Kravet³

et al. 2009

Clinical Medicine & Research

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Objective: To better understand the implications of inadequately recognizing clinical excellence in academia by exploring the perspectives of clinically excellent faculty within prominent American departments of medicine.Design: Qualitative study. Setting: 8 academic institutions.Participants: 24 clinically excellent department of medicine physicians. Methods:Between March 1 and May 31, 2007, investigators conducted in-depth semi-structured interviews with 24 clinically excellent physicians at leading academic institutions. Interview transcripts were independently coded by two investigators and compared for agreement. Content analysis identified themes related to clinical excellence in academia.Results: Twenty informants (83%) were Associate Professors or Professors, 8 (33%) were females, and the physicians hailed from a wide range of internal medicine specialties. The mean percent effort spent in clinical care by the physicians was 48%. The five domains that emerged related to academic medicine's failure to recognize clinical excellence were: (1) low morale and prestige among clinicians, (2) less than excellent patient care, (3) loss of talented clinicians, (4) a lack of commitment to improve patient care systems, and (5) fewer excellent clinician role models to inspire trainees.

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Section: Discussionmentioning

confidence: 99%

Implications of Academic Medicine's Failure to Recognize Clinical Excellence

Durso¹,

Christmas²,

Kravet³

et al. 2009

Clinical Medicine & Research

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“…22,23 Intrinsic motivating factors have received relatively scant attention because medical educators and practitioners have thought it too difficult to design institutional strategies and interventions that address stable physician characteristics. [24][25][26] Instead policymakers have tended to focus on extrinsic factors that are more readily manipulated. Several studies of other professions (e.g., nursing, teaching) suggest that intrinsic motivators make particular extrinsic factors salient 27,28 and thereby indirectly affect career satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

2017

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BACKGROUND: Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE: To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfaction, and clinical commitment, while accounting for established extrinsic motivators as well. DESIGN AND PARTICIPANTS: A nationally representative survey of 2000 US physicians, fielded October to December 2011. MAIN MEASURES: Outcome variables were five measures of physician well-being: career satisfaction, life satisfaction, high life meaning, commitment to direct patient care, and commitment to clinical practice. Primary explanatory variables were sense of calling, personally rewarding hours per day, meaningful, long-term relationships with patients, and burnout. Multivariate logit models with survey design provided nationally representative individual-level estimates. KEY RESULTS: Among 1289 respondents, 85.8% and 86.5% were satisfied with their career and life, respectively; 88.6% had high life meaning; 54.5% and 79.5% intended to retain time in direct patient care and continue clinical practice, respectively. Sense of calling was strongly positively associated with high life meaning (odds ratio [OR] 5.14, 95% confidence interval [95% CI] 2.87-9.19) and commitment to direct patient care (OR 2.50, 95% CI 1.53-4.07). Personally rewarding hours per day were most strongly associated with career satisfaction (OR 5.28, 95% CI 2.72-10.2), life satisfaction (OR 4.46, 95% CI 2.34-8.48), and commitment to clinical practice (OR 3.46, 95% CI 1.87-6.39). Long-term relationships with patients were positively associated with career and life satisfaction and high life meaning. Burnout was strongly negatively associated with all measures of physician wellbeing. CONCLUSIONS: Intrinsic motivators (e.g., calling) were associated with each measure of physician well-being (satisfaction, meaning, and commitment), but extrinsic motivators (e.g., annual income) were not associated with meaning or commitment. Understanding the effects of intrinsic motivators may help inform efforts to support physician well-being.

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“…18 Insofar as working in primary care or underserved communities does not necessarily promise a "controllable lifestyle" or higher salaries compared to other specialties, physicians-in-training who choose such work may have other intrinsic motivations that overcome these financial disincentives. 19 One such reason can be a strong sense of vocational identity or "calling" toward such work. 20,21 In this study, we also found that male students and allopathic medical students without previous work in medically underserved settings were less likely to report strong vocational identities.…”

Section: Discussionmentioning

confidence: 99%

Medical School Ranking and Medical Student Vocational Identity

Ravella

Curlin

Yoon

2015

Teaching and Learning in Medicine

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After categorizing allopathic medical schools into four groups based on SMS rankings, we found that medical students who attended allopathic medical schools from the two highest SMS ranking groups were more likely to report scores reflecting strong vocational identities-odds ratio [OR] = 2.9, 95% confidence interval (CI) [1.8, 4.7] and OR = 2.5, 95% CI [1.6, 4.0], respectively. In contrast, we did not find any associations between students from allopathic medical schools with high USNWR rankings and likelihood of reporting scores reflecting strong vocational identities. Insights: Social mission scores for allopathic medical schools may potentially serve as predictors of professional and vocational identity development. Further research is needed to better understand these findings, as this is one of the first studies both to examine allopathic medical students' sense of vocational identity and to explore the use of SMS rankings as predictors of medical students' professional development.

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What motivates physicians throughout their careers in medicine?

Cited by 42 publications

References 61 publications

Implications of Academic Medicine's Failure to Recognize Clinical Excellence

Implications of Academic Medicine's Failure to Recognize Clinical Excellence

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

Medical School Ranking and Medical Student Vocational Identity

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