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Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan
OBJECTIVE: The aim of this study was to systematically and simultaneously examine the association of intrinsic and extrinsic motivating factors with physician burnout and job dissatisfaction. DESIGN: A nationally representative survey was fielded from September to November 2017. SETTING: Hospitals a...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066621/ https://www.ncbi.nlm.nih.gov/pubmed/32161163 http://dx.doi.org/10.1136/bmjopen-2019-035948 |
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author | Tung, Yu-Chi Chou, Ying-Yi Chang, Yu-Hsuan Chung, Kuo-Piao |
author_facet | Tung, Yu-Chi Chou, Ying-Yi Chang, Yu-Hsuan Chung, Kuo-Piao |
author_sort | Tung, Yu-Chi |
collection | PubMed |
description | OBJECTIVE: The aim of this study was to systematically and simultaneously examine the association of intrinsic and extrinsic motivating factors with physician burnout and job dissatisfaction. DESIGN: A nationally representative survey was fielded from September to November 2017. SETTING: Hospitals and clinics throughout Taiwan. PARTICIPANTS: A total of 6674 physicians. MAIN EXPOSURE MEASURE: The main exposure measures were intrinsic motivators (sense of calling, personally rewarding hours per day and meaningful, long-term relationships with patients) and extrinsic motivators (income, work hours, autonomy, and pay-for-performance (P4P) and bundled payment initiatives). MAIN OUTCOME MEASURES: The main outcome measures were physician burnout and job dissatisfaction. RESULTS: A total of 1152 physicians returned the surveys. More sense of calling and personally rewarding hours per day were associated with less physician burnout (OR 0.16, 95% CI 0.10 to 0.26 and OR 0.25, 95% CI 0.13 to 0.47, respectively) and job dissatisfaction (OR 0.35, 95% CI 0.21 to 0.57 and OR 0.46, 95% CI 0.26 to 0.83, respectively). Longer work hours were associated with more physician burnout (OR 2.67, 95% CI 1.54 to 4.63) and job dissatisfaction (OR 1.71, 95% CI 1.05 to 2.79). Not receiving P4P bonuses from their organisations was associated with more physician burnout (OR 1.56, 95% CI 1.02 to 2.38). Not sharing the losses from caring for patients included in the bundled payment system was associated with less physician burnout (OR 0.59, 95% CI 0.36 to 0.97). CONCLUSIONS: Fostering a healthcare work environment that supports intrinsic motivation and improves work hours may reduce physician burnout and job dissatisfaction. Rewarding physicians fairly and equitably may prevent them from feeling burned out. Value-based care delivery and payment model innovations, such as bundled payments, may encourage healthcare professionals to coordinate care through the standardisation of care to decrease burnout. |
format | Online Article Text |
id | pubmed-7066621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-70666212020-03-20 Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan Tung, Yu-Chi Chou, Ying-Yi Chang, Yu-Hsuan Chung, Kuo-Piao BMJ Open Health Services Research OBJECTIVE: The aim of this study was to systematically and simultaneously examine the association of intrinsic and extrinsic motivating factors with physician burnout and job dissatisfaction. DESIGN: A nationally representative survey was fielded from September to November 2017. SETTING: Hospitals and clinics throughout Taiwan. PARTICIPANTS: A total of 6674 physicians. MAIN EXPOSURE MEASURE: The main exposure measures were intrinsic motivators (sense of calling, personally rewarding hours per day and meaningful, long-term relationships with patients) and extrinsic motivators (income, work hours, autonomy, and pay-for-performance (P4P) and bundled payment initiatives). MAIN OUTCOME MEASURES: The main outcome measures were physician burnout and job dissatisfaction. RESULTS: A total of 1152 physicians returned the surveys. More sense of calling and personally rewarding hours per day were associated with less physician burnout (OR 0.16, 95% CI 0.10 to 0.26 and OR 0.25, 95% CI 0.13 to 0.47, respectively) and job dissatisfaction (OR 0.35, 95% CI 0.21 to 0.57 and OR 0.46, 95% CI 0.26 to 0.83, respectively). Longer work hours were associated with more physician burnout (OR 2.67, 95% CI 1.54 to 4.63) and job dissatisfaction (OR 1.71, 95% CI 1.05 to 2.79). Not receiving P4P bonuses from their organisations was associated with more physician burnout (OR 1.56, 95% CI 1.02 to 2.38). Not sharing the losses from caring for patients included in the bundled payment system was associated with less physician burnout (OR 0.59, 95% CI 0.36 to 0.97). CONCLUSIONS: Fostering a healthcare work environment that supports intrinsic motivation and improves work hours may reduce physician burnout and job dissatisfaction. Rewarding physicians fairly and equitably may prevent them from feeling burned out. Value-based care delivery and payment model innovations, such as bundled payments, may encourage healthcare professionals to coordinate care through the standardisation of care to decrease burnout. BMJ Publishing Group 2020-03-10 /pmc/articles/PMC7066621/ /pubmed/32161163 http://dx.doi.org/10.1136/bmjopen-2019-035948 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Health Services Research Tung, Yu-Chi Chou, Ying-Yi Chang, Yu-Hsuan Chung, Kuo-Piao Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title | Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title_full | Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title_fullStr | Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title_full_unstemmed | Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title_short | Association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in Taiwan |
title_sort | association of intrinsic and extrinsic motivating factors with physician burnout and job satisfaction: a nationwide cross-sectional survey in taiwan |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066621/ https://www.ncbi.nlm.nih.gov/pubmed/32161163 http://dx.doi.org/10.1136/bmjopen-2019-035948 |
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