Goals Vs. Energy: The Missing Piece in Patient Motivation

GOALSDr. Geoffrey Williams of the University of Rochester is a bit unusual among research psychologists in that he is also a physician. As a result, his research on self-determination theory and how to support people’s sense of autonomy as they work toward their goals is infused with a clinical perspective and a focus on health behaviors.

When I saw him speak recently, Dr. Williams made a really interesting point about how physicians are trained to work with patients. There is a lot of awareness that doctors aren’t given a lot of relationship skills training in medical school (see this AHRQ report or this British Medical Journal careers column), but other skills may also go untaught. Specifically, Williams said:

Medical training focuses on how to set goals for patients but not how to energize them toward the goals.

Helping to motivate people is hard work, and we don’t systematically equip our health care providers to do it. A medical doctor may take a psychology course in order to understand common psychopathology, but my guess is that courses on motivation and positive functioning are rarely if ever part of the required curriculum.

I’ve argued before that doctors don’t necessarily know how to set patient-centric goals, as their training focuses on clinical metrics. Williams adds another layer to the issue by pointing out that even when those patient-centric goals occur, doctors don’t always have exposure to a framework that lets them help patients get there.

Some people have an intuitive understanding of how to talk to someone to help energize them toward goals. When those people become doctors, they have the potential be very effective in helping their patients achieve their best health. For the rest of us, wouldn’t it be nice if the medical education field took a thoughtful look at how to incorporate motivational training into their approach?