Ethics

What motivates physicians--and how health care needs to change

. 3 MIN READ

What would inspire you to provide the best care—a financial reward, or knowing you would get rapid feedback that could help you improve?

Studies show physicians are more motivated by intrinsic values that uniquely define the profession, such as actionable data and information-sharing capabilities, rather than external values, such as financial rewards.

In a recent JAMA Viewpoint on professionalism, AMA Executive Vice President and CEO James L. Madara, MD, discusses how the health care environment should be changed from one that is governed by burdensome financial regulations to one that gives physicians what they need to provide the highest quality care.

A disconnect between what really motivates physicians and the current incentive system that largely relies on such external motivators as financial penalties is creating misalignment.

The Viewpoints points out that physicians often find themselves embedded in systems that:

  • “Diminish time with patients (due to administrative demands on their time—often of trivial nature)”
  • “Provide tools that are far from optimized for clinical care (such as the current state of most electronic health records)”
  • “Rely on extensive sets of measures, many of which fail to relate to either practice type on one hand or on actual outcome on the other”

The solution to realigning the health care system lies in obtaining “active and ongoing quantitative and qualitative studies of environmental influences that promote the professionalism naturally embedded in physicians,” Dr. Madara wrote.

It also requires “applying what is learned toward structuring new delivery system environments that naturally leverage the motivators intrinsic in physicians.” And this is not easy.

Changing the health care environment to better match physicians’ needs to provide high-quality care is one challenge the AMA has taken on through its Professional Satisfaction and Practice Sustainability initiative.

Results from a recent AMA study conducted by the RAND Corporation revealed how physicians are actually implementing new payment models.

The study found that doctors are trying to make these moves but need help successfully managing the transition, including how to respond to the many quality programs and metrics from payers and need for more timely and accurate clinical data to ensure long-term success. These findings will guide the AMA’s work in improving alternative payment models and find ways to help physician practices make successful transitions to new models.

A 2013 study released by the AMA and RAND found that being able to provide high-quality care to their patients is the primary reason for job satisfaction among physicians, while obstacles to doing so are a key source of stress in the profession.

The AMA is taking the insights its gleaned from its research and discussions to create tools for physicians that will help put the joy back in practice.

Read more about professionalism and challenges for medicine at AMA Wire®.

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