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Human needs are often thought of broadly, with an emphasis on food, water, clothing, and shelter. When considering needs in the work environment, it becomes much more complex. There have been many studies surrounding needs in the workplace and how these needs impact employee motivation and attitudes. For many, work is an integral part of an individual’s life and beyond having needs inside of the workplace, the job itself can fulfill their personal needs (Penn State University World Campus [PSU WC], 2015, L. 2).

Since the amount of time spent in the workplace can be significantly more than time spent with family, there is a social construct to consider, as well as how someone may seek self-approval for how they view themselves contributing to society, as these can become basic needs (PSU WC, 2015, L. 2). While there may be many people unsatisfied with certain components of their jobs, there are other considerations to motivating performance and maintaining a positive attitude because of a sense of fulfillment. For example, while tasks and responsibilities may not be a motivator, the people someone is exposed to daily can be a positive motivator, as can a manager who gives praise and rewards efforts. The correlation between motivation and needs is not all-inclusive and can have differences based on varying demographics, such as age, gender, religion, cultural considerations, and beyond (PSU WC, 2015, L. 2). Edwin A. Locke and Douglas Henne (1986) assert that there are criticisms in the study of needs because the concepts are broad and hard to define (as cited in PSU WC, 2015, L. 2).

While there are many moving parts and variations to consider in needs theories, there are several which we will explore to analyze a real-life scenario in the workplace. The following case study will demonstrate that when needs are overlooked or are not considered, it has a direct impact on the success of initiatives within an organization and the overall motivation and well-being of not just the employees, but also those with whom they interact, such as their clients.

Case Description

In 2008, a healthcare system analyzed employee satisfaction surveys for their medical group, which consisted of 70 primary care and specialty physician offices. When compiling the data, a trend was recognized in the results, indicating that employees felt certain job responsibilities were interfering with their ability to provide focused patient care. The responsibilities that appeared to be causing the most hindrance were incoming phone calls (consisting of scheduling appointments and taking messages for the physicians), as well as the referral and authorization processes (involving outbound phone calls to schedule diagnostic testing and referrals to other physicians). Employees responded on the surveys that they would be more satisfied in their positions if they did not have as much on their plate, which led to administration embarking on a plan to improve the overall satisfaction of the employees.

It was determined that the most appropriate course of action would be to remove the inbound phone calls and referral/authorization process from the offices and place them in a centralized services department. Centralized services would consist of two areas: the Contact Center and the Authorization Center. In order to facilitate this growth project, offices were analyzed for their overall utilization of front office and clinical staff, which included a series of direct observations and time studies. If open positions existed within the practices during the analysis, they were put on hold until it could be determined if the position was better suited in centralized services or in the front office. Each office would be required to commit a current front office staff member or an empty position to the staffing component in centralized services. The project would not fall under the same administration as the offices; it was decided to place it in a different service line with an already established contact center for other hospital and outpatient services.

National benchmarks for contact centers were studied to establish pay rates, hours, breaks, and staffing calculations. Employees in the Contact Center would be paid at a $0.50 higher per-hour rate as compared to the existing office staff, and would also be eligible for two additional ten-minute break periods per day. There would also be a considerable difference in scheduling, with contact center staff being able to select preferences of shifts as well as the length of shift (three 12-hour days vs. four 10-hour days vs. five 8-hour days). Existing office staff would be eligible for the positions if they wanted to apply; they would have to proceed with the interview process along with other applicants, but would not be guaranteed a position based on existing status.

Administration also decided to not inform patients of the transition, as it was intended to be seamless and the Contact Center representatives would be handling the process similarly to before. The initial Contact Center representatives would be trained inside of the practices with the existing office staff until trainers were identified to train inside of the actual center. The requirements for the Contact Center representatives were enhanced customer service skills and background, while the office staff requirements were the completion of a medical-geared educational program with either a certificate or an associate’s degree. Office staff were asked to give insight to scheduling nuances, pertinent critical pieces of information, and to assist in streamlining the Contact Center processes.

The transition would be rolled out in a phased approach and started with a brand-new specialty orthopedic offices in the health system. After the first practice, eleven others were selected to transition in the first six months, with the remaining 58 scheduled over a 24-month period, based on size and volume. Bi-weekly meetings were planned with administrators and Contact Center management to track progress and to adjust the roadmap of the project as necessary. Unfortunately, when the first phase went live, it quickly revealed critical areas that were not considered in the project.

When the transition took place, patients noticed immediately. They were no longer speaking to the familiar voices they had come to know for many years, and were skeptical to give information to this new, mysterious “call center” that started answering the phones. They asked to speak to someone at the office; some so distraught that they threatened to report the Contact Center for fraud. The patients also noted that they would prefer to just drive into the office and speak to someone directly. There were also problems with waits and delays. Prior to the Contact Center, if patients called in and all lines were occupied, they received a busy signal. When the Contact Center opened, it started a new queuing system that would require patients to wait for the next representative – no busy signals would ever occur. Even though the patients would have to wait either way, the process change caused the patients to become vocal in sharing this with the staff and their physicians. This quickly created a climate of negativity and the office staff reciprocated their distaste to the patients, such as by saying “you should see what we have to go through here because of them,” or “maybe if you and enough other patients complain, they’ll change it back to the way things were.”

The office staff started issuing numerous complaints to their respective Practice Managers regarding the Contact Center staff making scheduling errors, handling calls incorrectly, and not getting timely referrals and authorizations. Practice Managers became frustrated at the barrage of complaints from staff, physicians, and the patients, and called on Administration to resolve the problem and to create higher standards for the Contact Center. The office staff expressed that they felt distant from their patients; many felt that their role was diminished and that they no longer held the same recognition at the offices because their role had changed so drastically. A pulse-check survey, sent to the twelve phase-one offices, revealed that near 80% of staff members felt that the project was not succeeding; the same percentage were upset that the Contact Center staff, whom they felt had subpar qualifications or knowledge, were making more money, had better incentives, but were doing a poorer job in their roles.

The office staff began lashing out at the Contact Center staff, which in turn prompted the Contact Center staff to share feedback of feeling belittled and unappreciated. Patients started refusing to speak to the Contact Center; instead they faked more severe illnesses to get through to an office triage nurse so they could speak to someone directly. Administration was baffled at why the project was spiraling out of control and promptly called for phase two to be delayed and a root cause analysis to be completed.

In the meantime, another employee satisfaction survey, for the health system, were sent out. Six months into phase one, the survey scores revealed that the office staff was further dissatisfied with their jobs and work environment (as compared to the prior year). Additionally, the Contact Center staff had lower scores on employee moral and felt that they were at a disadvantage. The office staff also indicated that they felt unappreciated by Administration and were taking ownership when patients were complaining about the change.

Practice Managers suggested that relationships be formed between the Office and Contact Center staff, which could be attained through onsite visits and monthly newsletters. The office staff requested a way to track errors, and several town hall meetings were scheduled to discuss the changes with patients. Over the next six months, and two additional “pulse checks,” the project was still met with the same level of resistance and did not appear to have a bright future.


Almost two years after the initial phase, the organization began to move forward with phase two. In an effort to leverage the lessons-learned from the prior phase, the rollout of phase two included informing patients two months in advance (through letters and phone calls), and by including the relevant information on the corporate website. By requiring the staff members to give an understanding on how the changes would impact their roles, and by providing them with additional project opportunities, the Leadership team was able to create higher staff engagement. Prior to the transition, site visits occurred to offer transparency and to help the staff get to know each other. Patient complaints decreased by 75% from the second to third year. Finally, in an effort to reduce the wage differences between the office and Contact Center staff, a commitment was made to increase the office staff’s pay rate.


Maslow’s Hierarchy of Needs

In 1943, Abraham Maslow, an American clinical psychologist, developed one of the first needs-based theories in psychology. He based his theory on observations of his patients (PSU WC, 2015, L. 2). Maslow organized what he believed to be the five categories of needs into a hierarchy. At the bottom of this hierarchy are the most basic of needs, including physiological and safety needs. Following those needs are the higher-order needs that can only be initiated once the basic needs are met. These higher-order needs include love/social, esteem, and finally, self-actualization (PSU WC, 2015, L. 2).

Each need has specific characteristics that separate it from the others (PSU WC, 2015, L. 2). The first of the basic needs, physiological, encompasses all essentials needed for survival, including food, water, and shelter. The second need, safety, includes self-preservation and protection. The first of the higher-order needs, love/social, includes needing acceptance and forming relationships. Esteem needs include gaining recognition, appreciation, and respect for oneself and from peers. Lastly, self-actualization, which is the most abstract of the needs, deals with reaching one’s full potential. Maslow asserted that most people do not actually reach self-actualization, and if they do, it only fuels the need for greater self-actualization (PSU WC, 2015, L. 2).

Maslow’s theory then goes on to explain the relationship between these needs, coining the phrase fulfillment regression. This type of regression posits that the basic needs must be met before the higher-order needs are activated. Maslow asserted that the hierarchy worked like a triangle – people systematically work their way up from the bottom’s most basic need, physiological, to the top, self-actualization (PSU WC, 2015, L. 2). Where one is on the hierarchy depends on prepotent needs, which Maslow defined as needs that are presently unmet. For example, one would not begin to satisfy safety needs, while physiological needs are unmet. It is only when all physiological needs are met, that safety needs will be initiated. When lower-order needs are unmet, there is no motivation to satisfy any subsequent needs (PSU WC, 2015, L. 2). Maslow only saw a few exceptions to this rule, and asserted that at times, many single behaviors can satisfy several needs at the same time (PSU WC, 2015, L. 2).

Figure 1. This figure illustrates Maslow's Hierarchy of Needs. From Pennylvania State University World Campus in PSYCH 482 Lesson 2: Needs Theory: What do I want when I work?, retrieved from Copyright 2015 by Pennsylvania State University.


Maslow’s theory did not receive positive research support because of its vague, untestable, and philosophical nature. However, it did gain popularity amongst practitioners and managers because it had applicability to real-life situations, even though it was not meant to pertain specifically to work motivation (PSU WC, 2015, L. 2). In a practical sense, it is a valid perspective in regards to the outlined case study.

There are three parties in the case study that were affected by the transition to a new Contact Center and Authorization Center. First, patients seemed to be greatly affected by the change from the beginning. Their safety needs were compromised right away because they were no longer speaking to the staff that they had become comfortable with. Instead, they were talking to third party individuals that were unfamiliar with their histories and medical needs, and only newly informed about office procedures and practices. They felt as though their medical needs were not being immediately met, resulting in a feeling of fear and uncertainty about the help they were receiving. The prepotent safety needs of the patients resulted in their social needs also being unmet. Because of their unease with the new Contact Center policy and staff, they no longer felt motivation to form quality relationships at the health organization. This made some patients exaggerate their medical needs in order to be directly connected with office staff members. This could also have made them less inclined to seek medical treatment in general, especially at this particular office. Esteem needs were also not activated because safety and social needs were not being met – the patients no longer felt that they were being recognized and did not feel important. Overall, there was no way for patients to fulfill their social or esteem needs, or reach self-actualization in this situation because their safety needs were unmet.

Second, the office staff initially began complaining to administrative employees about the unsatisfactory work being produced by the Contact Center employees, namely mistakes that were being made that directly affected the office staff. This resulted in prepotent safety needs and feelings of uncertainty about the work of the Contact Center staff. Subsequently, this led to a lack of activation of social needs because they felt no motivation to create and maintain effective relationships with the Contact Center staff. In the same vein, their social needs with patients were negatively affected since frustration was sparked on both sides. This led the office employees to feel little-to-no recognition from patients and performed their jobs less effectively; specifically, their esteem needs could not be activated. Office employees also felt no recognition from administrative employees in regards to their complaints. Safety needs are the most basic prepotent need for the office employees; without first meeting those needs, higher-order needs could not be activated and met.

Lastly, the employees at the Contact Center and Authorization Center felt intimidated by patients, who were threatening to report them for fraud, and thus could not move on to satisfy their social needs and to form relationships with the patients. They were also dealing with unmet social needs with office employees, who were growing increasingly frustrated with their quality of work and projecting their frustrations with the patients onto them. Because of that, they could not go on to fulfill their esteem needs as they felt no recognition or appreciation from either patients or office staff.

In the end, the outcome of this case study was relatively positive because administrative employees recognized the prepotent needs of patients and employees. They initiated phase two of the program in order to help fulfill some of those needs. For example, they implemented notifications to patients regarding the change in procedure two months in advance and made important information available online. This gave patients adequate time to become comfortable with the change and to meet their safety needs; this would hopefully motivate them to fulfill their social needs by forming relationships with the health organization and it would motivate all staff members to eventually become recognized and respected, moving them closer to reaching self-actualization. Also, office employees were given ways to track Contact Center errors, fulfilling safety needs, which led them to be more motivated to form relationships with Contact Center employees. With those relationships intact, a sense of recognition could be felt by both the office and Contact Center staff, motivating them both to fulfill their esteem needs and activate self-actualization. Lastly, the support and changes made by the administration helped all three parties feel safer, and more accepted and respected – fulfilling many of the prepotent needs felt at the onset of the initial program.


Alderfer’s Existence Relatedness Growth (ERG) Theory

Alderfer's Existence Relatedness Growth (ERG) Theory proposes that humans have three fundamental needs: 1) Existence needs include people’s most fundamental survival needs, such as food, water, and shelter, 2) Relatedness needs are people’s need for social relationships ­– our ability to operate in society is dependent on relatedness needs – and 3) Growth needs, which are people’s needs for personal growth (e.g., education; PSU WC, 2015, L. 2).

Figure 2. This figure illustrates Alderfer's ERG Theory. From Pennylvania State University World Campus in PSYCH 482 Lesson 2: Needs Theory: What do I want when I work?, retrieved from 2015 by Pennsylvania State University.

There are three important differences between Alderfer’s ERG theory and Maslow’s Hierarchy of Needs theory (PSU WC, 2015, L. 2):

  1. Alderfer proposes only three needs, as opposed to Maslow’s five.
  2. Alderfer organizes the ERG needs on a concreteness continuum (i.e., existence needs are the most concrete, while growth needs are the most abstract), in contrast with Maslow’s organization as a hierarchy.
  3. Alderfer’s ERG theory suggests that needs do not have to follow a strict hierarchical style; in fact, a person could move back and forth between the needs categories. On the other hand, Maslow’s theory suggests that lower level needs must be satisfied before higher level needs are activated.

“Alderfer proposed the idea of frustration-regression,” which states that an unmet need may cause the individual to regress to a more concrete need (PSU WC, 2015, L. 2, p. 6). For example, if a college student is unable to progress academically (growth need), they might seek social-hour opportunities (relatedness need) instead. If the efforts to satisfy their social needs fail, the student could then regress to existence needs (e.g., overeating).

Alderfer stated two exceptions to the idea of frustration-regression: 1) If the individual is unable to meet their existence needs, the need will become even greater, 2) fulfillment of growth needs will spur the need for greater growth needs (PSU WC, 2015, L. 2).

While ERG theory was intended to improve Maslow’s theory, research support has only shown a small improvement; for example, the examination of people’s reported levels of work need-fulfillment, conducted by Wanous and Zwany (1977), found “good support for the growth category, moderate support for the existence category, and weak support for the relatedness category. They also only found partial support for the idea that need satisfaction at one level would affect need importance at another level,” (as cited in PSU WC, 2015, L. 2, p. 7). Nevertheless, organizations can use the ERG theory to assess and meet the needs of their workplace (PSU WC, 2015, L. 2). For example, if job enrichment and/or promotions are not possible, the company can make sure that employees are able to meet their relatedness (e.g., by setting up a cafeteria where employees can socialize) and existence (e.g., paying a fair livable wage) needs.

According to PSU WC (2015, L. 2), the ERG theory has provided a foundation for future theories involving needs satisfaction. While the empirical evidence for the ERG theory is stronger than Maslow’s theory, it is far from strong (PSU WC, 2015, L. 2). ERG theory suffers from the lack of precision in needs definition and measurement; additionally, it is difficult to use needs to coach employees on how to improve their performance and/or motivation (PSU WC, 2015, L. 2).

In the case study presented above, the biggest need that appears unfulfilled is the relatedness need. This can be seen when the patients were surprised to hear the unfamiliar voices; in effect, it represented a lack of connection they missed with the former staff members. This unfulfilled need was so strong that some patients: 1) asked to speak to someone at the office, 2) threatened to report the center for fraud, 3) preferred to drive into the office to speak with someone directly, 4) refused to speak to the Contact Center, or 5) faked severe illnesses in order to be transferred to the triage nurse.

The unfulfilled relatedness needs are also seen when the office staff felt distant from their patients, or when the office staff felt unappreciated by Administration and started taking ownership of patient complaints. Fortunately, the Practice Managers recognized some of these needs, which prompted them to increase relationship-building opportunities between the Office and Contact Center staff, such as by encouraging onsite visits and monthly newsletters. The Leadership team also increased the relatedness needs fulfillment by engaging with the staff and by taking the time to learn about the impact the changes had on the staff members’ roles.

Additionally, Leadership increased the staff members’ relatedness needs fulfillment by offering them additional project opportunities. This leadership decision also seemed to fulfill the staff members’ growth needs. Finally, a commitment to normalize wages, across both departments, served to fulfill the existence needs of the affected staff members.

McClelland’s Needs Theory

David McClelland was a student under Henry A. Murray, a psychologist that identified twenty different human needs. These needs Murray identified ranged from dominance to autonomy to nurturance. Most of the needs that Murray classified are no longer studied, but three still remain – the need for achievement, the need for power, and the need for affiliation (PSU WC, 2015, L. 2). McClelland further elaborated upon Murray’s need theory and thus created his own motivation theory. A person’s need for affiliation (nAff) results in motivation to seek approval and conform to the needs and expectations of others.

On the other hand, a person’s need for power (nPow) encourages a person to take charge and seek to control others in order to achieve desired results. The need for achievement (nAch) is the reason that people desire to excel in the things they undertake (PSU WC, 2015, L. 2.).

McClelland’s Needs Theory differs from Maslow and Alderfer’s theories in one primary way.  McClelland asserted that needs are learned, rather than innate like Maslow and Alderfer posited (PSU WC, 2015, L. 2). Although this idea is questioned by many researchers (PSU WC, 2015, L. 2), it could have practical implications that could aid managers and practitioners in developing training programs to help redefine employees’ needs.

As previously noted, there were three groups of people that were affected by the changes undertaken by the transition to the Contact and Authorization Centers – 1) the patients, 2) the office staff, and 3) the Contact and Authorization Center employees. Initially, the Contact Center staff likely were high in nAff during their training period because the training was conducted directly by the front office staff.  Naturally, they would want to forge a good relationship with their counterparts in the office. They likely were also high in nAch and wanted to excel in their new responsibilities. Once the complaints started, the Contact Centers’ staff had a reduction in nAff (they no longer cared about the approval of patients or the office staff because of the diminishing relationships due to the frequent complaints) and in nAch (they began to feel as if they could not do anything right, so they were no longer motivated to perform well). The office staff went through a reduction in nPow; although they had initially trained the Contact Centers’ employees, they felt as if the power was taken from them and they no longer had a voice in the process. The patients were also dealing with a reduced nPow, which resulted in them resorting to embellishing on the severity of their illnesses to take back control and to be able to speak to the office staff they trusted and were comfortable speaking to. The patients also felt a reduction in nAff because they now had to speak to strangers about intimate details of their medical history when they had already established relationships with the office staff. They were not happy with the service they were receiving from the Contact and Authorization Centers, so they were not motivated to have a relationship with the employees at either of those locations.

“People are most motivated when their work situation matches their need profile,” (PSU WC, 2015, L. 2, p. 9). This proved correct when the administrative staff initiated phase two of the program to help resolve issues that resulted from the initial change. The patients, whose nPow suffered greatly in the beginning, were given a new sense of power when they were able to access the information online without having to call the Contact Center. The administrative staff provided them with more control by giving them the opportunity to find information on their own. Phase two of the program also acknowledged the reduction of nPow and nAch in the office staff and provided them with the opportunity to track Contact Center errors and engage in other projects. Lastly, the Contact Center regained nAff and nAch with increased social opportunities with the office staff, and more positive relationships with informed and understanding patients.

Self-Determination Theory (SDT) and Basic Needs Theory (BNT)

“Self-determination theory (SDT) is an empirically based theory of human motivation, development and wellness” first postulated in the 1970s and 1980s by Deci and Ryan (Deci & Ryan, 2008, p. 182). This overarching theory addresses basic concepts – including self-regulation, energy and vitality, the impact of the social environment on motivation, and well-being – with its hallmark being the identification of universal psychological needs (Deci & Ryan, 2008). SDT offshoot, the Basic Needs Theory (BNT), asserts that these three basic psychological needs (autonomy, competence, and relatedness) must be met and fulfilled for effective functioning and optimal psychological health (Deci & Ryan, 2008).

Each basic psychological need addresses a different aspect of the human psyche and is fulfilled through different means. Namely, people fulfill their need for autonomy when they are the origins of their decisions; fulfill their need for competence when they have a sense of mastery over their environment; and fulfill their need of relatedness when they establish secure attachments to and are respected by others (Adie, Duda, & Ntoumanis, 2008). When fulfillment of these three basic needs is inhibited, ill-being – of both physical and mental natures – ensues. According to Adie, Duda, and Ntoumanis (2008), autonomy and competence are moderate predictors of well-being, while relatedness had a much weaker relationship to an individual’s well-being; this finding contradicts previous research conducted by Deci and Ryan (2008) that indicates a much stronger relationship between satisfying relatedness and well-being.


Figure 3. This figure illustrates the Basic Needs Theory. From What is Self-Determination Theory in Positive Psychology Program, retrieved from Copyright 2014 by Positive Psychology Program.


In that regard, relatedness appears to be a key need that is not being met within the Contact and Authorization Center consolidation case study. This is on multiple fronts, affecting both administrative and office staff as well as the patients themselves. For instance, the patients had well-established and trusting relationships with their physicians’ offices that were severed when the consolidation took place. The attachment they felt to their healthcare providers and the familiar office staff, they frequently spoke to, was lost. This ultimately resulted in emotional ill-being. As the case study asserts, patients became disgruntled with and distrusting of the Contact Center, feigning illness to speak to the healthcare providers they knew and trusted.

Negative outcomes also resulted from a lack of meeting relatedness needs between the Contact Center staff and the office staff. Due to patients’ needs of relatedness with the individual offices, Contact Center staff voiced concerns that they felt belittled and unappreciated (which are indicative of ill-being). Similarly, the office staff felt underutilized, yet overwhelmed by the reactions of the physicians and their patients. Despite training with the office staff, positive relationships between the Contact Center employees and current office employees were not established.

Also of importance is the finding that a lack of personal causation and self-determination leads to decreased health outcomes, including emotional exhaustion (Adie, Duda, & Ntoumanis, 2008). This also carries a key connection to the Contact and Authorization Center consolidation case study. However, within this case study, the key connection with autonomy is with competence. When the administrative staff, within the disparate offices, lost their autonomy (or the ability to control office decisions) they lost their competence. The mastery of their environment was at the whim of the decisions made by individuals within the Contact Center. This shift of authority was particularly troublesome as the office staff had to deal with the fallout of the Contact Center’s scheduling errors, waits and delays, and the inappropriate handling of phone calls. These issues led to burnout and frustration with all parties involved, including the Contact Center staff, office staff, physicians and patients. These issues also exacerbated the lack of relatedness between the Contact Center and office staff.

Ultimately, the health system’s administration sought to give some autonomy back to its employees and increase relatedness and competence across the organization and its stakeholders. The organization informed patients of impending consolidations directly, through phone calls and mailings. This enabled patients to still feel connected, and not rejected, from an organization they so trusted. The health system’s administration also sought to increase relatedness amongst its staff, implementing town hall meetings, site visits, and newsletters for Contact Center and office personnel. Autonomy and competence were given back to both the Contact Center and office staff in three ways: 1) by training staff, 2) by ensuring errors were tracked and handled appropriately, and 3) giving staff ownership of upcoming projects. While these measures may not be adequate to circumvent all ill-being caused by the transition, they should be able to reduce some of the anxiety, tension, and frustration felt by all parties involved.


In general, needs theories can lend a hand in understanding why people are or are not motivated in workplace contexts. Based on the broad topic of needs theories, when a specific need is unmet, overlooked, or ignored, it can hinder overall well-being and satisfaction of other needs. Each different needs theory discussed in this paper, including Maslow’s Hierarchy of Needs, Alderfer’s Existence, Relatedness, and Growth (ERG) Theory, McClelland’s Needs Theory, and Basic Needs Theory (BNT), can be used to analyze workplace situations in terms of the motivation and success of involved individuals. The case study outlined in this paper includes three groups of people – the patients, the office staff, and the Contact and Authorization Center staff – whose motivation and well-being can be evaluated through the different needs theory lenses.

Maslow’s Hierarchy of Needs, which is the main perspective used to analyze this case study, illustrates that, because some of the basic needs (physiological and safety) were unmet for all three parties, there was no motivation to satisfy higher-order needs (social/love, esteem and self-actualization). The main prepotent need in this health organization was safety, leaving all three parties without motivation to move higher and satisfy the three higher-order needs. Alderfer’s ERG Theory uses similar needs, including existence needs, relatedness needs, and growth needs, which parallel Maslow’s hierarchy. Relatedness needs suffered for the health organization’s employees and patients. McClelland’s Needs Theory outlines need for affiliation, need for power, and need for achievement, which all suffered in varying degree in the case study. Lastly, BNT includes three basic needs – autonomy, competence, and relatedness – which were not met, leading to ill-being of the patients, the office staff, and the Contact and Authorization Center staff.

Although none of the individual needs theories garnered a significant amount of research support, only slightly improving with each subsequent theory, they all have practical implications to help create policies and initiations to help all parties involved achieve their needs and well-being, as is illustrated in this case study. The administrative employees and managers in the health organization ultimately realized that certain needs were not being met, resulting in the ineffectiveness of the new program, and initiated policy changes to aid in the satisfaction of needs and well-being of all parties involved.


Adie, J. W., Duda, J. L., and Ntoumanis, N. (2008). Autonomy support, basic need satisfaction and the optimal functioning of adult male and female sport participants: A test of basic needs theory. Journal of Motivation and Emotion, 32, 189-199.

Deci, E. L., and Ryan, R. M. (2008). Self-Determination Theory: A Macrotheory of Human Motivation, Development, and Health. Canadian Psychology, 49.3, 182-185.

Pennsylvania State University World Campus (2015). PSYCH 484 Lesson 2: Need theories: What do I want when I work?. Retrieved on September 1, 2015 from

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