Motivate physicians through technology

In the modern medical environment of unpaid insurance claims, malpractice lawsuits and rushed patient encounters, many doctors feel unmotivated and unhappy.

Could the use of improved healthcare technology make doctors feel motivated and fulfilled again?

The hierarchy of needs

Motivating others is always difficult task. But according to Dan Heath, author of Made to Stick, all employers need to do to effectively motivate employees is get out of the basement – Maslow’s basement that is.

According to Abraham Maslow, human needs are distributed in a hierarchical structure with the most basic needs, which he calls deficiency needs, stacked at the bottom. These are such needs as food and water (physiological), and shelter and job security (safety). The higher needs, which he calls being needs, are at the top of the pyramid. These include, love, belonging, esteem and self-actualization. Maslow believed that to reach the higher levels of the pyramid, one must first achieve satisfaction of the previous stages.

In Heath’s book, he states that this view might not be completely accurate, since humans can pursue different levels of the hierarchy simultaneously. As he puts it, “otherwise there would be no starving artists.”

The right focus breeds the right motivation

Most businesses focus solely on the needs in only one stage of the pyramid – the deficiency needs at the lowest tier, which Heath calls “the basement.” And I’d say that’s the reason why so many healthcare companies fail to motivate their doctors.

Most companies (and most people) assume that they can effectively motivate people by offering primarily monetary incentives. We tend to believe that most people are residing in the lower floors of Maslow’s hierarchy, primarily pursuing financial gain to fulfill the deficiency needs by attaining food, clothes, housing, insurance, and other essentials.

But this manner of thinking is old-fashioned and fails to promote long-lasting inspiration. This motivating technique fails to tap employees’ most powerful source of personal strength: the higher floors of the hierarchy – the being needs.

An employer who focuses on employees’ needs in the higher tiers of the pyramid – esteem by ourselves and others, the sense of belonging, self-actualization – is targeting the key elements of personal self-worth, which inspires more powerful and enduring motivation.

An unmotivated structure

The current healthcare system tries to entice doctors to achieve success in the field through “basement” thinking, offering financial incentives for seeing a higher number of patients or ordering lots of tests. Even pay-for-performance programs fail to motivate because they are essentially pay-for-compliance approaches. By giving doctors monetary rewards for completing more steps without necessarily measuring the outcomes that those steps lead to, pay-for-performance programs promote conformity within specific structures and sets of expectations, rather than motivating physicians to achieve the best results.

Daniel Pink pinpoints a salient observation on this idea in his book Drive, The Surprising Truth About What Motivates Us. “While complying can be an effective strategy for physical survival,” he notes, “it is a lousy one for personal fulfillment.”

Focusing on extrinsic motivators leads to compliance, but targeting the higher needs, which are intrinsic motivators, leads to employee engagement. And only true engagement can produce a worker who feels fulfilled, inside and outside the hospital or office. As Pink says, “compliance will get you through the day, but engagement will get you through the night.”

A better technique through technology

Focusing on Maslow’s basement by dangling financial incentives in front of doctors is an outdated, carrot-and-stick technique of compliance-only motivating. In his book, Pink presents a better, research-based approach to motivating that has three essential components: Autonomy: the desire to direct our own lives; Mastery: getting better at something that matters; and Purpose: the desire to do something bigger than ourselves.

Those three components all reside in the higher floors of Maslow’s hierarchy because they can lead directly to self-actualization and fulfillment. And I believe that, thanks to modern innovation, technology can grant doctors all three of those motivational tools: Autonomy, Mastery, and Purpose.

Technology can clearly provide physicians with more autonomy. Consider the development of telemedicine. By enabling physicians to see patients electronically, telemedicine allows doctors to practice their craft from remote locations. The ability to consult with patients from wherever they are empowers docs to travel freely and still practice, giving them more control and autonomy in their jobs.

By promoting easier access to information, technology undoubtedly facilitates mastery. Using electronic health records (EHRs) allows physicians to engage in health information exchange (HIE) with other providers. The improved access to patient information that HIE enables allows doctors to spend more, better quality time with their patients and reduce the number of errors they make. This certainly helps them get better at practicing medicine.

Lastly, technology can streamline the business of medicine, helping physicians regain the purpose that got them into medicine in the first place. Over the course of their careers, physicians can get weighed down by a number of concerns. Presently, the challenging reimbursement environment and constant threat of claim denials is often at the top of physicians’ lists of anxieties. Using billing technology in the medical practice that checks and validates claims before submitting them to payers can lower denials and reduce the headaches that come with them, allowing doctors to focus solely on caring for their patients instead of worrying about Medicare.

Fulfillment, not finances

In promoting the adoption of new technologies, medical practices, hospitals, and IT providers alike have focused more on the government’s financial incentive programs than the genuine opportunities for physician fulfillment that so many new healthcare innovations can help provide. But shifting the focus to improved motivation could make healthcare businesses more excited to adopt new technology instead of seeing implementation as a burden.

Modern technology can be a powerful tool for not only improving patient care, but also enabling a higher-tiered focus on physician motivation – one dedicated to promoting more autonomy among doctors, easier mastery of the practice of medicine, and a renewed sense of purpose in healthcare.

Embracing change and innovation is the only way to solve the troubles of the medical field. Technology has the power to pull health care out of Maslow’s basement, and I believe it will.

Juan J. Reyes is a pediatrician and Director of Clinical Technologies at CareCloud.  He can be reached on Twitter @jjreyes.

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  • Katherine Ellington

    Whether it’s autonomy, mastery or fulfillment that motivates physicians and other health professional forward, its worthwhile to have physician voices weighing-in with commentary!  We need to be the change we want to see for health and health care. Innovation, disruption and technology have the potential for medicine, health and healthcare.  Progress comes with skeptics and naysayers and that’s fine. Mobile platforms information technology are moving throughout society and the world and it’s just we need to improve health.

  • Jonathan Marcus

    Made to Stick is not concerned with Maslow’s pyramid.  I think you’re quoting the wrong book.

  • Anonymous

    The motivational concepts are right, but current technology and (even more so) its implementation does not help achieve that.  Even speaking as a physician who “grew up” with EHRs, so to speak, I find them cumbersome and frustrating, often causing annoying delays, failing to interface with each other thus requiring irritating phone calls to or from hospitals, pharmacies, etc.  Also, the process of translating findings into “template” is far from seamless, and ends up wasting time.  As implemented, EHRs also lack the capacity to perform some functions that have a lot of potential to improve health care, such as patient portals and telemedicine visit capability.  For some reason, there seem to be many barriers to embracing such functions.

  • Anonymous

    “Using electronic health records (EHRs) allows physicians to engage in health information exchange (HIE) with other providers. The improved access to patient information that HIE enables allows doctors to spend more, better quality time with their patients and reduce the number of errors they make.”
    Every practicing doc knows there is nothing LESS motivating and MORE time-wasting than having to wade through gigabytes of cut-and-pasted garbage to look for the one piece of clinically useful information.

  • Anonymous

    I agree with SaraJMD. Until the technology works more reliably and effectively, and errors can much more easily be corrected, the effect is far from motivating. Mandates and penalties to force participation in such insufficiently developed technologies create more alienation and frustration.

  • Anonymous

    There are no starving artists.  There are only those who dabble unworthy or unproductive pursuits.  If you ain’t making a living producing product (artwork) others want to buy … then you ain’d an artist (except in your own mind). 

  • Bruce Ramshaw

    I agree with the concept of enabling intrinsic motivation.  However, the system structures currently in place (individual physician practice and hospital vertical department silos and hierarchy) will predictably prevent that because of the increasing complexity and increasing pace of change within our health care system (and our world in general).  The solution is to redesign our system structures with diverse teams providing care (including the physicians).  Then allow autonomy, mastery and purpose to be owned by the care team (which also includes patients and family members).  We have moved beyond the information age to the age of networks and relationships.  I believe that industrial revolution organization structures and work models will not allow for individual autonomy, mastery and purpose no matter what technology or tools are developed.

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