Biography: Kelly is a professor of orthopedic surgery at the University of Pennsylvania.
November 16, 2018
3 min read

BLOG: Focus on within to sidestep burnout

Biography: Kelly is a professor of orthopedic surgery at the University of Pennsylvania.
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In his treatise on human motivation, Drive: The Surprising Truth about What Motivates Us, Daniel Pink delves into the research on what truly propels humans toward achievement. Pink’s research reveals some startling conclusions: Namely, external motivators (money, fame, notoriety, etc.) do not lead to lasting motivation. Rather, external rewards lead to burnout and unfulfilled lives. Pink cites several studies on the discovery that the well-known reward/punishment model of motivation (carrot-and-stick approach) leads to diminished creativity and productivity. Pink references a study noting that art work commissioned by a patron is uniformly less creative and of lesser quality than work produced by artists for the mere fun of it. External pressures to perform not only stifle creativity, but also lead to compromised ambition and energy. Enjoyment-based and intrinsic-based motivation – namely, how creative one feels when engaged in a project, is the chief driver to achievement.

How does one become more inner driven and attain a quantum leap in energy? Pink’s research reveals lasting motivation is predicated on three elements: autonomy, mastery and purpose. Pink labels this type 1 behavior and asserts that this internal motivational mindset is associated with greater success in addition to enhanced physical and mental wellbeing.


When we work on our own terms, we are more productive. Harsh deadlines and overbearing managers throttle creativity and innovation. Micromanagers subvert development of our best selves. In contrast, high achievers have autonomy over their tasks, time, techniques and teams.

Autonomy over task allows workers to feed their passion and clearly spurs innovation. Many companies are instating regular free time for employees to embark on side projects that interest them.  This model is predicated on results, not harsh mandates, and unleashes our full potential. Researchers by and large are more creative when they choose a specific area of study.

Control over time affords workers the choice to engage in their occupation during hours they are most productive. “Morning people” flourish in the early hours of the day, while “night owls” prefer to sleep. Lawyers, known for their billable hours, are enslaved to the clock and, by and large, are a miserable lot. When hours billed is the singular goal, motivation wanes, initiative is vanquished and unethical behavior may manifest while the clock is the master.

Autonomy over technique similarly nurtures individual power and creativity. When mangers lord over employees and direct every step, the human spirit is crushed.

Finally, when we can build a team of our own, we are more satisfied as we endeavor to achieve a common inner goal.


Pink defines mastery as the desire to get better at something that truly matters. Mastery can only arise from pursuits that create engagement, or “flow-like” experiences. The urge to master something novel and engaging is the best predictor of productivity. We have an innate need to be challenged and grow. Challenges must not be overwhelming but be enough to encourage growth. Pink relates that mastery demands grit and an openness to the notion that abilities are infinitely improvable. Those who fully embrace mastery recognize the “journey” (quest for continual improvement) as far more important than an actual realized goal.


Humans have an innate need to be linked to a cause greater than themselves. Any endeavor not linked to a long-term worthy cause or contribution will lead to emotional depletion. Purpose provides renewable energy as one links to a calling greater than self-interest. It is no surprise that volunteerism is rising in America as burned out workers seek more meaning in their lives.

Pink continues by adding that purpose is found in our goals, words and policies. A purpose-driven life has goals that are socially responsible and consider the greater good, while words like “we” and other soul-stirring nouns such as truth, justice and love should be infused into our vocabulary. Finally, policies of purpose-minded organizations reflect a charitable mindset and include regular giving to those less fortunate.


1)     Consider choosing to focus your practice on what gives you joy. If shoulder surgery is your passion, then design your practice to fit your calling.

2)     If you are a morning person, consider commencing office hours earlier and allow free time in the afternoon.

3)     Discuss with your chief or chair how you would like your practice to run. Inject input as to how you want patients treated in your office.

4)     Dedicate yourself to becoming a master surgeon and recognize that you will never attain perfection. Enjoy the journey.

5)     Link what you do to a higher purpose. Recognize that each patient you see is a unique way of mitigating the world’s suffering.

6)     Donate your services to underserved areas. Some of the happiest surgeons I know are ones who dedicate regular time to developing countries.

“One cannot lead a life that is truly excellent without feeling that one belongs to something greater and more permanent than oneself.” – Mihaly Csikszentmihalyi



Pink DH. Drive: The surprising truth about what motivates us. Penguin, 2011.