Motivation is the key to change for “disruptive physicians”

“Motivation” comes from the Latin word for “to move’”. It is a goal-oriented behavior. In addition to motivating ourselves, it is important to learn how to create an environment where others can become motivated.

When change is mandated, it almost automatically triggers a negative response in the participant. Hence motivational interviewing may be necessary to move the participant towards constructive interaction. Motivation interviewing is a strategy for engaging resistant clients in the change process.

In working with “disruptive physicians” as defined in the new JCAHO guidelines for Health Care Organizations, it is helpful to know what some of the intrinsic and /or pragmatic motivators are for changing physician behavior.

Some of the intrinsic motivators are:

·Increase in self esteem

·Increase of peer support

·Improvement in patient satisfaction

·Increase in team morale

·Increase in interpersonal relationships

·Decrease in stress and workplace tension

Some of the more pragmatic reasons for change are:

·Reduction in salary

·Risk of loss of Hospital Admitting Privileges


·Risk of litigation

·Increase in malpractice insurance

·Improvement in bedside manners score

In executive coaching, the goal is to engage the physician/client in examining the value in the status quo, the value of change, the optimism for change and the intent to change. If the client can be encouraged to articulate his or her commitment to any are all of the above, this can be converted to self-dialog to aid in the change process.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management


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