Original Article
Sustaining the Intrinsic Motivations of the “Good Physician”: A Content Analysis of Medical Students’ and Physicians’ Responses from Two National Surveys
Abstract
Objective: Physician motivation has been described as the reason, purpose, and force that drives people to pursue their work, and motivating factors include those that are intrinsic or extrinsic to the work. Social forces may contribute to motivational disparities between medical school and actual practice.Methods: A secondary data analysis of two national surveys (medical students and practicing physicians from various specialties) was conducted. Content analysis was performed on open-ended survey items that elicited students’ and physicians’ responses to meaningful experiences in medicine.
Results: In the medical student sample, four themes were identified as factors intrinsic to medicine: role models, clinical experiences, patient interactions, and peer interactions. In total, intrinsic factors comprised 86.5% (193/208) of coded responses. In the practicing physician sample, five themes were identified as factors intrinsic to medicine: difficult patient interactions, conflict with colleagues or staff, meaningful patient interactions, involvement in medical education-research-academia, and medicine as a calling/mission. In total, intrinsic factors comprised 24.0% (140/582) of coded responses.
Conclusions: Our findings suggest that the reality of social forces in medicine threatens the ability of practicing physicians to derive meaning from their work, although students and physicians still report intrinsic motivation from establishing meaningful relationships. Further research is needed to explore what strategies enable physicians to wisely navigate the dynamic interactions of intrinsic and extrinsic motivators over various stages of their careers. These strategies could include encouraging reflective spaces in physicians’ workplaces that have a specific focus on sustaining intrinsic motivation in medicine.
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References
1. Ratanawongsa N, Howell EE, Wright SM. What motivates physicians throughout their careers in medicine? Compr Ther 2006;32:210–217.
2. Tak HJ, Curlin FA, Yoon JD. Association of intrinsic motivating factors and markers of physician well-being: a national physician survey. J Gen Intern Med 2017;32:739–746.
3. Huber MT, Ham SA, Qayyum M, et al. Association between job factors, burnout, and preference for a new job: a nationally representative physician survey. J Gen Intern Med 2018;33:789–791.
4. Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med 2003;114:513–519.
5. Lamiani G, Borghi L, Argentero P. When healthcare professionals cannot do the right thing: a systematic review of moral distress and its correlates. J Health Psychol 2017;22:51–67.
6. Balboni MJ, Balboni TA. Hostility to Hospitality: Spirituality and Professional Socialization within Medicine. New York: Oxford University Press; 2018.
7. Program on Medicine and Religion. Project on the Good Physician. https://pmr.uchicago.edu/projects/project-on-the-good-physician/. Published 2021. Accessed January 26, 2021.
8. Hawking M, Kim J, Jih M, et al. "Can virtue be taught?": a content analysis of medical students' opinions of the professional and ethical challenges to their professional identity formation. BMC Med Educ 2020;20:380.
9. Du M, Tak HJ, Yoon JD. Association of intrinsic motivating factors and joy in practice: a national physician survey. South Med J 2021;114:583–590.
10. Hines HG, Avila CJ, Rudakevych TM, et al. Physician perspectives on long-term relationships and friendships with patients: a national assessment. South Med J 2017;110:679–684.
11. Huang SX, Ham SA, Varghese M, et al. Moral elevation, physician role models, and selected markers of professional identity formation and well-being: a secondary analysis from two national surveys. South Med J 2022;115:129–135.
12. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med 2018;283:516–529.
13. Studdert DM, Mello MM, Sage WM, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 2005;293:2609–2617.
14. Shanafelt TD, Dyrbye LN, Sinsky C, et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc 2016;91:836–848.
15. Kuhn CM, Flanagan EM. Self-care as a professional imperative: physician burnout, depression, and suicide. Can J Anaesth 2017;64: 158–168.
16. Graf AC, Jacob E, Twigg D, et al. Contemporary nursing graduates' transition to practice: a critical review of transition models. J Clin Nurs 2020;29:3097–3107.
17. Yoon JD, Ham SA, Reddy ST, et al. Role models' influence on specialty choice for residency training: a national longitudinal study. J Grad Med Educ 2018;10:149–154.
18. Hyde Park Institute. Meaning and purpose in medicine. https://hydeparkinstitute.org/mpm/. Accessed March 10, 2022.
