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The link between physician motivation and care.

ABSTRACT: Studies report an unexplained variation in physicians' care. This variation may to some extent be explained by differences in their work motivation. However, empirical evidence on the link between physician motivation and care is scarce. We estimate the associations between different types of work motivation and care. Motivation is measured using validated questions from a nation-wide survey of Danish general practices and linked to high-quality register data on their care in 2019. Using a series of regression models, we find that more financially motivated practices generate more fee-for-services per patient, whereas practices characterised by greater altruistic motivation towards the patient serve a larger share of high-need patients and issue more prescriptions for antibiotics per patient. Practices with higher altruism towards society generate lower medication costs per patient and prescribe a higher rate of narrow-spectrum penicillin, thereby reducing the risk of antimicrobial resistance in the population. Together, our results suggest that practices' motivation is associated with several dimensions of healthcare, and that both their financial motivation and altruism towards patients and society play a role. Policymakers should, therefore, consider targeting all provider motivations when introducing organisational changes and incentive schemes; for example, by paying physicians to adhere to clinical guidelines, while at the same time clearly communicating the guidelines' value from both a patient and societal perspective.

SUBMITTER: Oxholm AS

PROVIDER: S-EPMC10972924 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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The link between physician motivation and care.

Oxholm Anne Sophie AS Gyrd-Hansen Dorte D Jacobsen Christian Bøtcher CB Jensen Ulrich Thy UT Pedersen Line Bjørnskov LB

The European journal of health economics : HEPAC : health economics in prevention and care 20230623 3

Studies report an unexplained variation in physicians' care. This variation may to some extent be explained by differences in their work motivation. However, empirical evidence on the link between physician motivation and care is scarce. We estimate the associations between different types of work motivation and care. Motivation is measured using validated questions from a nation-wide survey of Danish general practices and linked to high-quality register data on their care in 2019. Using a serie ...[more]

PMID: 37353668

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Project description:BackgroundPhysicians appear to vary in their motivation towards using virtual care, but to what extent is unclear. To better understand this variance, which is important for supporting physician wellbeing and therefore patient care, the authors used self-determination theory's (SDT) framework. According to SDT, different types of motivation exist, ranging from controlled to autonomous, that lend to differences in engagement, performance, and wellbeing. The authors aimed to determine: (a) if there were distinct groups of physicians based on their quality of motivation towards using virtual care, and if so, (b) how these groups varied in fulfillment of basic psychological needs (autonomy, competence, and relatedness) in the workplace.MethodsIn March-August 2022, the authors collected quantitative, survey-based data from a cross-section of 156 family physicians in Alberta, Canada. The survey contained existing scales that measure types of motivation (autonomous vs. controlled) and basic psychological need satisfaction/frustration at work. Cluster analysis was used to explore profiles of physician motivation towards using virtual care, and analysis of variance was used to determine how each profile differed with respect to workplace need fulfillment.ResultsWith motivation towards using virtual care, three higher-order profiles of physician motivation were identified: autonomous (19% family physicians), controlled (16% of family physicians), and ambivalent (66% of family physicians). The three profiles differed significantly in terms of psychological need fulfillment at work.ConclusionsThis study identifies specific profiles that family physicians currently fall into when it comes to motivation towards using virtual care. In line with SDT, findings suggest that basic psychological needs are fundamental nutrients for physicians to internalize and endorse the value of using virtual care in their practices. Implications for physician wellbeing are discussed.

Project description:BackgroundThe health burden of type 2 diabetes can be mitigated by engaging patients in two key aspects of diabetes care: self-management and regular contact with health professionals. There is a clear benefit to integrating these aspects of care into a single clinical tool, and as mobile phone ownership increases, apps become a more feasible platform. However, the effectiveness of online health interventions is contingent on uptake by health care providers, which is typically low. There has been little research that focuses specifically on barriers and facilitators to health care provider uptake for interventions that link self-management apps to the user's primary care physician (PCP).ObjectiveThis study aimed to explore PCP perspectives on proposed features for a self-management app for patients with diabetes that would link to primary care services.MethodsResearchers conducted 25 semistructured interviews. The interviewer discussed potential features that would link in with the patient's primary care services. Interviews were audio-recorded, transcribed, and coded. Framework analysis and the Consolidated Criteria for Reporting Qualitative Research checklist were employed to ensure rigor.ResultsOur analysis indicated that PCP attitudes toward proposed features for an app were underpinned by perceived roles of (1) diabetes self-management, (2) face-to-face care, and (3) the anticipated burden of new technologies on their practice. Theme 1 explored PCP perceptions about how an app could foster patient independence for self-management behaviors but could also increase responsibility and liability for the PCP. Theme 2 identified beliefs underpinning a commonly expressed preference for face-to-face care. PCPs perceived information was more motivating, better understood, and presented with greater empathy when delivered face to face rather than online. Theme 3 described how most PCPs anticipated an initial increase in workload while they learned to use a new clinical tool. Some PCPs accepted this burden on the basis that the change was inevitable as health care became more integrated. Others reported potential benefits were outweighed by effort to implement an app. This study also identified how app features can be positively framed, highlighting potential benefits for PCPs to maximize PCP engagement, buy-in, and uptake. For example, PCPs were more positive when they perceived that an app could facilitate communication and motivation between consultations, focus on building capacity for patient independence, and reinforce rather than replace in-person care. They were also more positive about app features that were automated, integrated with existing software, flexible for different patients, and included secondary benefits such as improved documentation.ConclusionsThis study provided insight into PCP perspectives on a diabetes app integrated with primary care services. This was observed as more than a technological change; PCPs were concerned about changes in workload, their role in self-management, and the nature of consultations. Our research highlighted potential facilitators and barriers to engaging PCPs in the implementation process.

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The link between physician motivation and care.

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The link between physician motivation and care.

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