Are physicians' motivations stable over time? An investigation before, during, and after a pandemic

Many healthcare systems struggle with recruitment and retention of physicians for specific specialities or in certain locations. One solution may be to design policies that appeal to their work motivations. Recent studies show that physicians’ motivations vary and also link with their behaviour. However, little is known about whether physicians’ motivations are stable over time. We exploit a major shock to physicians’ working conditions to investigate stability in their motivations. Using unique survey data on a balanced panel of 448 general practitioners (GPs) in Denmark, this study examines GPs’ motivations before, during, and after the COVID-19 pandemic. We examine GPs’ intrinsic motivation, extrinsic motivation, user orientation, and public service motivation to capture both their self-centred and pro-social motivations. A series of fixed effects and quantile regression models show that each type of motivation follows a distinct pattern with regards to the timing and direction of changes during the study period. However, across all motivations the magnitude of these changes appears small. Subgroup analyses suggest that older GPs and male GPs exhibit higher stability in some motivations, and that practice and area characteristics do not affect motivation trends. Our results support that physicians’ motivations are fairly stable overall and thereby may serve as useful inputs to policy design. Policymakers can thus better align the goals of the healthcare system with those of its workers, serving to promote a more sustainable and productive healthcare workforce.