What motivates you?
Recently, I read an article about a theory relating to human motivation, personality and optimal functioning. Self Determination Theory is based on research and developed by Edward L. Deci and Richard M. Ryan. The hypothesis is that people have three basic psychological needs which are: competence – the desire for mastery, relatedness – desire for connection with others and autonomy – desire for having a sense of control.
Competence and autonomy struck me as particularly problematic areas for physicians and nurses, lacking a sense of these leading to burnout. Competence is needed to get through nursing and medical education, and again in mastering essential skills and knowledge in your field. Yet, so much of what occurs for patients is not dependent on you. Outcomes which may only be equivocal over the course of time may wear down your sense of competence and value. You have a high level of responsibility with little control over outcomes.
Autonomy, perhaps you feel like your autonomy has been taken away by third party payers and the large organization you work for controlling your decisions. The onerous regulations imposed on you and fear of lawsuits impact how you do things both for better and worse. There are times when you may even wonder when your own judgment is being called upon.
Do you ever feel like a data entry clerk? For so many, EHR feels like a waste of time since much of the documentation is done to avoid penalties and meet the regulatory requirements. Much of what must be included bears little relevance to the problem which needs to be focused on. In addition to interfering with your autonomy, EHR also interferes with your “relatedness” with patients leading to less satisfaction for you and for the patient.
Here’s a link to an interesting video about a study Deci conducted. The results were interpreted as showing that participants’ behavior, which was initially intrinsically motivated, became controlled by the rewards, and this lead to undermined sense of autonomy.
In another research project, giving people positive feedback about their performance on an activity increased intrinsic motivation. Deci claimed that positive feedback can satisfy the need for competence and this can in turn enhance a person’s intrinsic motivation. I think it also is a form of social connection, thus satisfying the human need for “relatedness” as well. When physicians work in isolation behind closed doors with patients this positive feedback is often missing.
So, what motivates you? The carrot of pay and reimbursement, the stick of a law suit and quality control or something else. Share your thoughts.
Leave comments, or contact me to share in a more personal way.
Dina, 203.744.YOU3 (9683)
Revitalize Your Life
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