TY - JOUR

T1 - Burnout of intrinsically motivated GPs when exposed to external regulation

T2 - A combined panel data survey and cluster randomized field experiment

AU - Pedersen, Line Bjørnskov

AU - Hvidt, Elisabeth Assing

AU - Waldorff, Frans Boch

AU - Andersen, Merethe Kousgaard

PY - 2021

Y1 - 2021

N2 - Burnout among general practitioners (GPs) is a problem in many countries. Research indicates that burnout is less likely to occur among intrinsically motivated employees. Based on self-determination theory, we investigate 1) whether intrinsically motivated GPs are less burned out than their colleagues, and 2) whether the most intrinsically motivated GPs are more likely to burn out when exposed to an external regulatory accreditation programme. General practices in Denmark were cluster randomized to mandatory accreditation in 2016, 2017 or 2018. We measure GPs’ intrinsic motivation and burnout levels one and two years into the accreditation process. We use a balanced panel of GPs (n = 846) to estimate mixed effects ordered logit models. We find that GPs with high intrinsic motivation are less burned out than their colleagues. However, the most intrinsically motivated GPs are significantly more burned out when exposed to accreditation compared to their colleagues. We conclude that being intrinsically motivated may not shield from burnout when external regulation is imposed.

AB - Burnout among general practitioners (GPs) is a problem in many countries. Research indicates that burnout is less likely to occur among intrinsically motivated employees. Based on self-determination theory, we investigate 1) whether intrinsically motivated GPs are less burned out than their colleagues, and 2) whether the most intrinsically motivated GPs are more likely to burn out when exposed to an external regulatory accreditation programme. General practices in Denmark were cluster randomized to mandatory accreditation in 2016, 2017 or 2018. We measure GPs’ intrinsic motivation and burnout levels one and two years into the accreditation process. We use a balanced panel of GPs (n = 846) to estimate mixed effects ordered logit models. We find that GPs with high intrinsic motivation are less burned out than their colleagues. However, the most intrinsically motivated GPs are significantly more burned out when exposed to accreditation compared to their colleagues. We conclude that being intrinsically motivated may not shield from burnout when external regulation is imposed.

KW - Accreditation

KW - Burnout

KW - Cluster randomized field experiment

KW - General practice

KW - Intrinsic motivation

KW - Panel data

U2 - 10.1016/j.healthpol.2021.01.004

DO - 10.1016/j.healthpol.2021.01.004

M3 - Journal article

C2 - 33546912

AN - SCOPUS:85100405673

VL - 125

SP - 459

EP - 466

JO - Health Policy

JF - Health Policy

SN - 0168-8510

IS - 4

ER -