Intended for healthcare professionals

Student Careers

How to improve your motivation at work

BMJ 2004; 329 doi: https://doi.org/10.1136/sbmj.0410365 (Published 01 October 2004) Cite this as: BMJ 2004;329:0410365
  1. Raj Persaud, Gresham professor for public understanding of psychiatry and consultant psychiatrist1
  1. 1Bethlem Royal and Maudsley Hospitals, London

Would you prefer a “kick in the ass” approach or the multifaceted job enrichment strategy? It's time to think about what you want to get out of your work, says Raj Persaud

One of the enormous but unspoken realities about the practice of medicine is that most doctors are basically bored by their jobs. During training, when doctors are acquiring expertise and career possibilities seem exciting, interest is easy to maintain. However, this interest usually begins to wane after they have acquired the core skills of their particular specialty. Then a key psychological mechanism kicks in—denying that they are bored.

In many other careers, because the training is shorter and the commitment to working so hard is less, other professionals can make the decision to change direction and take up another vocation relatively easily. Doctors are much more reluctant than other professionals to bail out of their trade once qualified and tend to struggle on for years despite being extremely bored. The fact that relatives and friends, duped by television medical dramas, believe that every second of being a doctor is the adventure of a lifetime does not help. So what can doctors do to improve their motivation and engage more successfully with their daily tasks?

Theories

The theories of motivation that many employers still use on their employees were shown long ago by psychologists basically not to work.1

Kick in the ass

A key theory is known technically as the “kick in the ass” approach—which basically means that you get punished, humiliated, sacked, docked wages, and so on if you are not cooperating with your management. This approach merely leads to chronically demotivated employees dreaming up complex schemes where they can pretend that they are working hard, usually at just the level required to avoid a kick in the ass. They usually invest …

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