Association of Intrinsic Motivating Factors and Joy in Practice: A National Physician Survey

• Published in: Southern medical journal (Birmingham, Ala.) Vol. 114; no. 9; pp. 583 - 590
• Main Authors: Du, Matthew, Tak, Hyo Jung, Yoon, John D.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-09-2021
• Subjects: Career Choice; Humans; Job Satisfaction; Motivation; Physicians - psychology; Physicians - statistics & numerical data; Surveys and Questionnaires
• ISSN: 0038-4348; 1541-8243
• DOI: 10.14423/SMJ.0000000000001297

In response to the need to identify positive measures that more accurately describe physician wellness, this study seeks to assess the validity of a novel joy in practice measure using validated physician well-being measures and test its association with certain intrinsic and extrinsic motivators.
Secondary data analysis using a nationally representative dataset of 2000 US physicians, fielded October-December 2011. Multivariable logistic models with survey design provided nationally representative individual-level estimates. Primary outcome variables included joy in practice (enthusiasm, fulfillment, and clinical stamina in an after-hours setting). Secondary outcomes were validated measures of physician well-being such as job and life satisfaction and life meaning. Primary explanatory variables were sense of calling, number of personally rewarding hours per day, long-term relationships with patients, and burnout.
The survey response rate was 64.5% (1289/2000). Physicians who demonstrated joy in practice were most likely to report high life satisfaction (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.52-4.98) and high life meaning (OR 2.62, 95% CI 1.41-4.85). Joy in practice was strongly associated with having a sense of calling (OR 10.8, 95% CI 2.21-52.8) and ≥ 7.5 personally rewarding hours per day (OR 3.75, 95% CI 1.51-9.36); meanwhile, it was negatively associated with burnout (OR 0.26, 95% CI 0.14-0.51). Extrinsic factors such as specialty, practice setting, and annual income were not significantly associated with joy in practice in most regressions.
The joy in practice measure shows preliminary promise as a positive marker of well-being, highlighting the need for future interventions that support physicians' intrinsic motivators and foster joy in one's practice.