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How can physicians flourish?

Doctors can only perform at the best of their ability in an environment that acknowledges and strengthens ‘calling and comradeship’. According to PhD student Myra van den Goor of the University of Twente, these human- and relationship-directed values have been pushed to the background in recent years by a more commercial, business-like climate in health care – one dominated by the importance of procedures and efficiency. Van den Goor: “I argue that attention should once again be directed towards the person, rather than towards process, registration and production. My findings and recommendations show how doctors work at a high level of performance in an extremely dynamic environment, and what they need in order to remain ‘simply’ good doctors.”

Calling and comradeship

In van den Goor’s view, two overarching themes express the essence of physician performance: : Comradeship (positive, supportive relationships with direct colleagues based on mutual trust, safety, and reciprocal care and responsibility) and Calling (a career that provides a sense of meaning or purpose and is used to help others). Van den Goor explains: “The most important lesson to be learnt from this thesis is that in physicians’ perspective  calling and comradeship are essential to good performance. For doctors, it’s all about commitment to the patient, passion, motivation, support from colleagues, mutual trust, and a sense of safety.”

Recommendations at the individual, group, and organisational level

To support doctors, van den Goor has recommendations at three levels. At the level of the individual doctor, for instance, it is ‘own welfare first’: take good care of yourself, both physically and mentally. This is the foundation of good performance. At the same time it is important to keep developing your skills and to give attention to your own leadership qualities. At the second level, the group level, it is to invest in a culture of trust, openness and safety. Such a culture can be stimulated through sharing with, and learning from, each other. As examples of this van den Goor suggests group reflection, team-building, strength-based efforts and social activities. Finally, with regard to her recommendations at the organisational level, an organisational focus on collaboration  enhances the quality of care, patient safety, and patient satisfaction. According to van den Goor, for enthusiastic doctors to work in enthusiastic teams it is vital that the organisation actively facilitates formal peer support, multidisciplinary consultation and group reflection. The organisational provision of more informal support and contact moments also has a demonstrably positive effect on comittment and engagement.


Van den Goor’s findings are based on 84 interviews with physicians from hospitals throughout the Netherlands, 786 reflections written by doctors, 105 questionnaires and the results of 25 disciplinary hearings. The thesis is therefore based on the accounts, experiences, feelings, viewpoints and opinions of doctors themselves. Van den Goor: “The essence of performance, and what doctors need in order to do their work as best and engaged as possible, really comes from the doctors themselves.’ 

Myra van den Goor

Myra van den Goor worked for many years as a general practitioner and is a co-founder and partner of Q3. In her consultation and supervision work within Q3 she supports the professional development of thousands of physicians and their teams. She will defend her thesis on Friday, 12 June at 2.30pm. Its defence at the University of Twente (TechMed Centre) is entirely digital and can later be viewed online. Professor T. Bondarouk and Professor J. van der Palen (the BMS faculty, HRM and OMD departments) are her promotors. See also Hartkamer, a one-off publication based on her thesis Calling and Comradeship; unravelling the essence of physician performance, on the core of being a doctor. 

drs. M.M.J. van Hillegersberg - Hofmans (Martine)
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