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The Moderating Effect of Job Satisfaction on Physicians' Motivation to Adhere to Financially Incentivized Clinical
Anthony C Waddimba1,2, Howard B Beckman3,4, Thomas L Mahoney4,5
11 Bassett Healthcare Network Research Institute, Cooperstown, NY, USA.
Medical Care Research and Review : MCRR
|February 11, 2016
Summary
Physician professional satisfaction impacts adherence to diabetes guidelines. Discontented physicians are motivated by personal attitudes, not external incentives, requiring tailored strategies for improved guideline adherence.
Area of Science:
- Medical Economics
- Health Services Research
- Physician Behavior
Background:
- Pay-for-performance (PFP) incentives aim to improve adherence to clinical guidelines.
- Physician professional satisfaction may influence responses to PFP and guideline adherence.
- Understanding these dynamics is crucial for effective healthcare quality improvement.
Purpose of the Study:
- To examine how professional satisfaction moderates physicians' motivation to adhere to diabetes guidelines.
- To investigate the differential effects of attitudes and norms on guideline adherence based on physician satisfaction levels.
- To inform strategies for enhancing guideline adherence among diverse physician groups.
Main Methods:
- Cross-sectional survey data from 156 primary care physicians on attitudes.
- Prospective medical record data on guideline adherence.
- Census data on ambulatory care population characteristics.
- Partial least squares structural equation modeling to test theory-driven models for satisfied vs. discontented physicians.
Main Results:
- Physician attitudes motivated adherence, while social norms suppressed it among discontented physicians.
- Satisfied physicians showed less influence from intrinsic/extrinsic factors and biases.
- Discontented physicians, alienated by social pressure, prioritized personal inclinations over external influences.
- Distinct motivational pathways for guideline adherence were observed between satisfied and discontented physicians.
Conclusions:
- Professional satisfaction significantly moderates the impact of incentives and social factors on physician adherence to diabetes guidelines.
- Tailored interventions are necessary; incentives for discontented physicians should align with personal attitudes and address resentment towards peer/organizational pressure.
- Strategies to improve guideline adherence must consider the psychological and motivational profiles of physicians.
Keywords:
adherence to clinical guidelineshealth care qualityjob satisfactionmotivation theoryprimary care physiciansvalue-based pay for performanceMore Related Videos
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