What motivates you?

About twenty years ago, I attended a sales motivation course in London. At the beginning of the course, the trainer asked the delegates to each write down the one thing which motivated them the most. The majority of those present wrote down "money". I wrote down achievement. If asked to repeat this exercise, I would still write achievement down. Nothing in the past twenty years has convinced me that money alone can motivate me.

When I embarked on my medical degree in 2008, a group of students were asked by a tutor in basic life support, to reveal the reasons why they were studying medicine. The majority cited money as the main reason. I write this not to judge them but rather to make a wider point. In fact, I can well understand why a lot of people do see financial reward as the main reason to pursue a medical career. Given that many young medical students arrive straight from school entering a world in which money is consistently portrayed as being the be-all and end-all, it is little wonder that they feel motivated by money. Perhaps it has always been this way and people become a little less obsessed as they grow older.

Few people in today's world do anything out of pure altruism so it is unreasonable to expect a medical student to be any different. Talk of medicine being a vocation is the talk of yesteryear. I would argue that the students who said money was their biggest motivator were being a little less than honest though. I say this because even though they will potentially earn a high salary when they eventually qualify, there are many other professions which would offer them far greater financial reward. I suspect that what really motivates a lot of medical students is the challenge of making it through an academically challenging qualification process. In other words, it is the competitive aspect of a medical degree which provides them with their true motivation.

If evidence were ever needed that money seldom achieves true motivation, the FA Cup final provided a good example today. The haves of Manchester City faced the comparative have-nots of Wigan Athletic. The pre-match odds being offered against a Wigan win were about 10-1. In a two horse race, such odds are rare indeed. The odds reflected the chasm in performance between the two teams over the whole season in the league. They also reflected the illogical assumption that a player being paid £200,000 must be more highly motivated than a player being paid £20,000 per week. As today proved, this is simply not the case. To be absolutely fair, the Manchester City players had the same 90 minutes within which to exert their alleged superiority. That they did not do so would appear to reflect the fact that they were not sufficiently motivated. To follow the argument that money is indeed the greatest motivator, you would keep on increasing their wages until they eventually start to win matches like this. The reality of course is that it has little to do with money except that too much can actually become demotivating. I am pleased for Wigan but still think their players are paid far too much money for what they are actually expected to do. How can anybody morally defend wages of £20,000 per week while people abroad and in our own country go hungry? Human nature dictates that few among us would turn down such wages if offered them so in one sense, they are no different to us.

The Royal Society of General Practitioners today expressed concern that long term carers are at risk from depression and mental illness. They claim that General Practitioners need to play a greater role in addressing this. Carers have been propping up our creaking Health Service for donkey's years and remain the unsung heroes in our society, The scandal is not that GPs aren't do more to help them. The real scandal is that our society has become so insular that many such carers have nobody to turn to. When you become a carer, it is shocking how quick your social sphere disappears. You become preoccupied to provide care and get forgotten about in the process. It is a grueling task with limited reward. The motivation for the army of carers who do this invaluable job day in, day out, is seeing the positive effect of their efforts on their loved one. I can say from personal experience that you would definitely not do it for the money because the financial recognition for carers in this country is risible. You do it for the love and the bad days frequently outnumber the good. As far as I can make out, in the unlikely event that such a carer can actually grab a quick half hour to even visit the doctor in the first place, the only real help the doctor could provide would simply be to listen to them and allow them to offload some of their difficulties. If this is all GPs do, it will be a massive step in the right direction.