The effect of professional culture on intrinsic motivation among physicians in an academic medical center.

Today, most healthcare organizations aim to manage professionals' motivation through monetary incentives, such as pay for performance. However, addressing motivation extrinsically can involve negative effects, such as disturbed teamwork, gaming the system, and crowd-out of intrinsic motivation. To offset these side effects, it is crucial to support professionals' intrinsic motivation actively, which is largely determined by enjoyment- and obligation-based social norms that derive from professionals' culture. For this study, a professional culture questionnaire was designed and validated, the results of which uncovered three factors: relationship to work, relationship to colleagues, and relationship to organization. These factors served as independent variables for regression analyses. Second, Amabile's validated work preference inventory was used to measure intrinsic motivation as a dependent variable. The regression analysis was controlled for sex, age, and experience. The study revealed that relationship to work had the strongest (and a positive) impact on intrinsic motivation in general and on Amabile's intrinsic subscales, enjoyment and challenge. Relationship to organization had a negative impact on intrinsic motivation and both subscales, and relationship to colleagues showed a low positive significance for the intrinsic scale only. Healthcare organizations have mostly focused on targeting professionals' extrinsic motivation. However, managing dimensions of professional culture can help support professionals' intrinsic motivation without incurring the side effects of monetary incentives.