Over the course of the past several years, I have had the opportunity to read many books addressing issues of human behavior, decision making, leadership, all in an effort to advance what I know and can apply to the important work we do. Out of that grew the development of Gary’s Book Club, depending on my ability to stay motivated in posting routine personal reflections on the content and impact of books I’ve read and incorporated into my work, and often my life.

Alas, like many a well intentioned effort, it falls on harsh times, and as you can tell if you’re reading this, it’s been far too long since I’ve taken the few minutes required to reflect on a recent reading. Which is why this posting is relevant for many reasons, and why I step forward once again.

Let’s face it, it’s all about motivation. We constantly talk about how we can “motivate our patients” to become involved in their care, how we can motivate ourselves to exercise regularly, the list goes on indefinitely. Certainly I was motivated to regularly post something from my eclectic Kindle collection (come on, who reads books now?). Yet it didn’t happen.

In a surprisingly easy, short, yet profound effort, Daniel Pink moves from his success in A Whole New Mind (another great book, by the way) in presenting a provocative and in my mind persuasive book addressing the issue of motivation. And while most of us grew up in the era of “carrot and stick” approaches—“if you do this for me, I’ll reward you with this”—this book exposes the mismatch between what we know from science, but yet what we still apply in business, and of course, in health care.

Drawing on four decades of research, Pink eloquently challenges the ongoing use of carrot and stick efforts as an example of external (extrinsic) motivation. He outlines what he calls the I type, which is the need to understand and support “intrinsic motivation.” Whereas extrinsic motivation (does this sound a bit like pay for performance?) looks to external rewards to drive improvement and motivation, the intrinsic concept refers to doing things for the joy of them.

Pink describes three elements which are worth considering in understanding what motivates people: Autonomy—having personal control over our activity and without that, we feel a void and lack of drive. Mastery—the opportunity to learn to master the tasks we are undertaking. Purpose—having a sense of feeling that what we’re doing is important. As we think about the world we live in, the patients we care for, and the need to “engage” them as active participants in managing their health, understanding and appreciating the difference between extrinsic and intrinsic motivation will shift you to a different and needed way of thinking.

Whether dealing with your family or attempting to motivate those with whom you work, you will gain an understanding of the failure of the reward/punishment approach, and begin to contemplate how the principles described in this book could be of value. The last section of the book is a toolkit section for those of you seeking practical strategies and methods for understanding and using the I type of motivation.

So, as I reflect back on my gap in engaging in these personalized notes on my readings, I became “motivated” upon hearing that people valued these entries (purpose), and they were appreciative of my ability to synthesize and provide a quick sense of the topic (mastery). In addition, it’s all up to me, and it’s my opportunity to share something of value in my own way and my own style. (Autonomy). Additionally, I now find there are hundreds of hits on the Gary’s Book Club link---a useful type of external motivation.

So it’s back at, and by the way, I hope you’re motivated to read Drive—it will be well worth your while.