Working poor: a qualitative analysis of work motivation in the healthcare sector

this study focuses on analyzing the phenomenon of the “working poor” in the Russian healthcare system and identifying the mechanisms of the “economic motivation trap,” whereby an increase in wages does not lead to the expected growth in labor productivity. The problem lies in the fact that, despite the high social significance and initial non-material motivation of healthcare workers, systemic factors lead to their widespread professional burnout and economic dissatisfaction. The aim of the article is to qualitatively analyze the set of motivating and demotivating factors that determine the work behavior of medical personnel under conditions of institutionalized poverty. The results of the study show that healthcare workers initially choose their profession primarily based on altruistic motives (the desire to help people), rather than considerations of prestige or stability. However, in the course of their work, this intrinsic motivation is systematically eroded. The main demotivating factors are not only the low level of pay, but even more so the overwhelming workload and excessive bureaucratization, which have the highest correlation with the professional burnout index. An analysis of adaptation strategies revealed that the most common one—intensification of labor (working 1.5-2 job loads) – is assessed by the workers themselves as the least effective and only exacerbates exhaustion.

working poor, work motivation, healthcare, professional burnout, motivation trap