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A Disconnect Between Work and Reward

Those three things – autonomy, complexity, and a connection between effort and reward – are, most people agree, the three qualities that work has to have if it is to be satisfying.

-Malcolm Gladwell “Outliers”

The following phrase caught my eye while I was reading Outliers written by one of my favorite authors, Malcolm Gladwell – author of The Tipping Point and Blink. It neatly sums up what I believe is a common frustration amongst doctors.

The work in medicine is complex. Most people will agree that diagnosing and treating disease in itself is fascinating. Communicating effectively with people and helping patients live better healthier lives is difficult but rewarding.

However, modern medical practice is facing ever increasing pressures from government, health insurers and patients themselves to change how health care is delivered. There is less and less autonomy for doctors, who now have to follow countless guidelines and documentation. A lot of the new regulations are good, but many are set in place for legal reasons in case of lawsuits.

Medicine is also becoming more complex. Complexity is a good thing in one’s work according to Gladwell, however medicine is speeding towards an information overload. With health care information, genetics, new synthetic drugs, treatments and legal issues arising, doctors are faced with ever increasing workloads. Sure, doctors today work less than the medical generation before, but the current system is severely understaffed and overburdened.

Finally, the connection between effort and reward is becoming strained. Doctor compensation especially in primary care roles aren’t being addressed. Taking extra time to see a patient, which requires more effort and hopefully leading to a better outcome, isn’t rewarded accordingly. Preventative care which requires enormous efforts on the parts of both health care providers and patients isn’t reimbursed.

Many of these factors are out of the doctor’s and health care provider’s control. There needs to be a repairing of these broken connections in order to improve future medical costs and care.

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One Comment

  1. FD
    FD January 4, 2009

    I don’t know about the system in the US but those who make the regulations should have been a medical doctor too.

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