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Rx for Delivery System Transformation: Satisfied Doctors Who Find More Joy in Practice

Aug 20, 2013, 4:32 PM, Posted by Susan Dentzer

Susan Dentzer

In my last post, I wrote about what would best motivate physicians to transform health care: carrots, sticks or something else. The case for “something else” was made in a series of innovation sessions presented at a recent American Board of Internal Medicine (ABIM) Foundation forum. They focused on evolving health care delivery models aimed at increasing quality, decreasing cost and enhancing patient-centered care.

Readers of Daniel Pink’s book Drive will be familiar with his thesis about “Type I” human behavior: the kind that is less concerned with “the external rewards to which an activity leads and more with the inherent satisfaction of the activity itself.” Many innovations presented at the forum echoed that theme—augmenting the satisfaction that doctors get from focusing most of their attention on helping patients.

Engaging doctors: At the forum, Craig Sammit, the CEO of Wisconsin-based Dean Health noted that “extrinsic” motivators, such as showing doctors how their relative performance data stacked up against their peers, had substantial impact in spurring improvement. But he observed that the measures that were most effective in transforming the way care is delivered  at Dean were those that helped make the organization “the best place for a physician to work.”

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Carrots, Sticks, or Something Else? Motivating Doctors to Transform Health Care

Aug 14, 2013, 2:14 PM, Posted by Susan Dentzer

Craig Sammit Craig Sammit, MD, president and CEO of Dean Health System, and Holly Humphrey, MD, dean for Medical Education at the University of Chicago Pritzker School of Medicine

An old joke has it that the doctor’s pen is the costliest technology in medicine, since money typically flows where physicians’ prescriptions and other orders decide that it should go. As a result, influencing these decisions is key to achieving the Triple Aim of better health and health care at lower cost.

But what’s more likely to influence doctors: external factors, such as bonuses for improving the quality of care, or internal factors, such as appealing to their sense of altruism or satisfaction with their work?  In other words, carrots, sticks, or something altogether different—what Daniel H. Pink, author of Drive, calls “our innate human need to direct our own lives, to learn and create new things, and to do better by ourselves and our world”?

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