Sales organizations frequently struggle to align employee engagement, retention, and performance with organizational goals. Disengagement contributes to high turnover, productivity losses, and diminished organizational outcomes (Johnson & Friend, 2025; Schroth, 2019). These challenges are intensified in healthcare sales due to regulatory requirements, complex product knowledge, and ethical standards (Ahearne et al., 2025; Bercaw, 2025). Thus, high-pressure sales roles demand leadership practices that address individual motivation and organizational expectations (Ahearne et al., 2025).
Leadership practices emphasizing intrinsic motivation and psychological empowerment effectively boost creativity, engagement, and retention, particularly within demanding sectors (Ahearne et al., 2025; Zhang & Bartol, 2010). However, traditional leadership frameworks often overlook the holistic career needs of sales professionals, which creates gaps in recruitment, development, and retention strategies (Shukla & Tripathi, 2025). These gaps become especially pronounced with ethical pressures and technological advancements, such as artificial intelligence (AI), which, as a result, influence decision making and organizational success (Johnson & Friend, 2025; Shukla & Tripathi, 2025). Collaborative relationships between sales and marketing further highlight the importance of motivational leadership practices for improving customer satisfaction and organizational performance. Additionally, leadership support for autonomy significantly improves job satisfaction and retention in these high-demand environments (Shank & Robinson, 2019).
To address these issues, the Sales Performance through Individual Realization, Impact, and Transformation (SPIRIT) model integrates self-determination theory (SDT) and leader-member exchange (LMX) theory. This model combines individual autonomy with relational support to offer a framework to enhance engagement, adaptability, and retention, particularly in healthcare sales (Moschko & Blazevic, 2023). By synthesizing SDT's motivational elements (i.e., autonomy, competence, and relatedness) with LMX's relational trust, the SPIRIT model provides structured leadership strategies for dynamic environments (Deci et al., 2017; Robin et al., 2023). Integrating these theories advances the understanding of motivational and relational dynamics in sales leadership while enhancing employee engagement and organizational outcomes.
Employee disengagement costs U.S. businesses an estimated $15 billion annually, with sales teams disproportionately contributing to these losses due to high turnover that impacts customer satisfaction (Schroth, 2019). Existing sales leadership frameworks fail to integrate motivational and relational leadership theories, so organizations lack effective tools to align employees' needs for autonomy with organizational goals. This gap contributes to the lack of a structured approach to providing relational support that fosters engagement and long-term retention (Wang et al., 2023).
To address these challenges, the SPIRIT model integrates SDT and LMX theory to provide a conceptual framework for enhancing employee engagement, retention, and performance. By integrating individual autonomy and relational support, the model offers a foundation for addressing these persistent challenges while guiding future research into sales leadership and organizational alignment (Moschko & Blazevic, 2023).
The novelty of this study lies in its integration of SDT and LMX theory to create a conceptual framework specifically tailored to the unique challenges of sales environments. While substantial research exists on SDT and LMX independently, little attention has been paid to their combined application in addressing the high turnover rates and disengagement prevalent in sales organizations, particularly in healthcare sales. This conceptual framework synthesizes theoretical insights to explore how the dual emphasis on intrinsic motivation and relational trust can enhance engagement, performance, and retention in high-pressure sales environments. This approach provides actionable insights for leaders to align individual autonomy with organizational objectives while fostering high-quality relational support and advancing a scholarly understanding of how integrated leadership approaches can fulfill the complex needs of modern sales professionals.
The SPIRIT model integrates SDT and LMX theory to form a comprehensive framework for addressing leadership challenges by emphasizing intrinsic motivation and relational trust, particularly in healthcare sales environments characterized by high-pressure and complex client interactions (Ahearne et al., 2025). The model comprises three interrelated components: individual realization, focusing on autonomy through participative decision making; impact, emphasizing competence by aligning contributions with measurable outcomes; and transformation, fostering relatedness through trust and adaptability in leadership relationships (Deci & Ryan, 2012). By integrating SDT and LMX theory, the SPIRIT model provides a structured theoretical approach for addressing employee engagement, retention, and performance challenges, which are particularly relevant in demanding healthcare sales environments characterized by high-performance expectations and regulatory complexities.
SDT forms the theoretical foundation of the SPIRIT model by identifying autonomy, competence, and relatedness as core psychological needs driving employee engagement and performance (Deci & Ryan, 2012; Kaylyn & Hagger, 2024). Autonomy empowers healthcare sales professionals to navigate client relationships and regulatory complexities effectively through participative goal setting and individualized feedback (Fauzi & Desiana, 2025). Competence enhances confidence, technical proficiency, and interpersonal effectiveness that address dual requirements in healthcare sales involving technical expertise and relationship management (Gagné et al., 2022).
Autonomy-supportive leadership mitigates disengagement through structured yet flexible goal setting that acknowledges individual strengths in demanding sales contexts where stress and regulatory compliance intensify employee burnout risks (Bercaw, 2025). Additionally, relatedness strengthens team cohesion and trust-based relationships to create an environment conducive to open communication and collaborative problem solving (Kaylyn & Hagger, 2024). The SPIRIT model operationalizes these SDT components through participative decision making, competence-building feedback, and relational trust, which collectively improve employee resilience, performance, and retention in healthcare sales organizations (Deci & Ryan, 2012; Kaylyn & Hagger, 2024).
LMX theory focuses on leader-employee relationship quality while highlighting trust, respect, and communication as central factors for effective leadership in high-pressure sales settings with demanding client interactions (Pan et al., 2023; Wang et al., 2005). High-quality LMX relationships promote engagement, performance, and retention, particularly in healthcare sales, where continuity in employee-client relationships supports organizational goals and stability (Robin et al., 2023). Conversely, low-quality LMX characterized by limited leader support negatively influences team dynamics and reduces organizational effectiveness (Robin et al., 2023).
Psychological safety is another positive outcome of high-quality LMX since it enables employees to openly express ideas, address client concerns, and meet regulatory requirements in healthcare sales environments (Adel et al., 2024). Leaders who build trust through transparent goal setting, structured feedback, and inclusive decision making promote adaptability among team members and support customized solutions for client interactions (Conroy & Vogus, 2025). Within the SPIRIT model, LMX aligns with impact and transformation by connecting relational trust to increased employee engagement, improved organizational commitment, and reduced turnover in healthcare sales organizations (Northouse, 2025).
This study utilized a theoretical research approach to develop the SPIRIT model, a conceptual framework designed to address employee disengagement and turnover in sales leadership contexts, particularly within healthcare sales organizations. By synthesizing diverse theoretical perspectives, the study created a structured method for analyzing complex organizational dynamics that emphasized motivational and relational dimensions (Arendt & Fuhse, 2022).
The primary objective was integrating SDT and LMX theory to align employee autonomy with organizational goals through supportive leadership relationships. The literature review included key research on SDT (Deci & Ryan, 2012; Ryan & Deci, 2020), LMX (Lord & Smith, 1983; Robin et al., 2023), and contemporary sales leadership (Ahearne et al., 2025; Moschko & Blazevic, 2023), which emphasized psychological safety and employee engagement. Analysis of these sources identified themes informing the three core components of the SPIRIT model: individual realization, impact, and transformation. They provided a coherent foundation to effectively address challenges in sales leadership.
Individual realization, grounded in SDT, integrates autonomy, self-awareness, and personal growth to mitigate disengagement and turnover in demanding sales environments (Deci & Ryan, 2012; Olafsen et al., 2025). Through participative decision making, autonomy enables employees to navigate client strategies and regulatory compliance effectively, which reinforces organizational alignment (Kidron & Rispler, 2025). Self-awareness enhances alignment between personal values and organizational goals, which is crucial in healthcare sales and is characterized by ethical complexities (Redmond, 2025). Moreover, structured growth initiatives, such as mentorship and coaching programs, further support employee development by reinforcing competence – another key element of SDT – and strengthening retention (Abdul-Azeez et al., 2024; da Silva, 2025; Karpagavalli & Suganthi, 2024). Autonomy, self-awareness, and growth-oriented practices collectively address the root causes of disengagement to foster an empowered culture that enhances individual and organizational outcomes in high-pressure sales contexts (Olafsen et al., 2025).
Impact aligns individual contributions with organizational priorities by fostering purpose through goal congruence and participative leadership practices. Aligning daily responsibilities with strategic objectives reduces role ambiguity and enhances accountability, which is especially critical in healthcare sales environments (Dechawatanapaisal, 2025; Syukri et al., 2025). When employees perceive their roles as meaningful, motivation and resilience increase while supporting strategic alignment amid complex decision cycles and ethical considerations common in healthcare sales (Imran et al., 2025; Miao & Nduneseokwu, 2025; Wu, 2025).
Effective feedback mechanisms reinforce alignment by providing structured insights that enhance performance and accountability (Kabanda & Barrena-Martinez, 2025). In healthcare sales contexts, actionable and timely feedback – including AI-driven personalized platforms – enables strategy refinement and promotes adherence to organizational standards (da Silva, 2025). Therefore, the SPIRIT model positions feedback as essential for maintaining organizational alignment, fostering continuous learning, and addressing disengagement (Badu & Micheli, 2025).
Transformation emphasizes continuous learning, resilience, and sustained growth, which are crucial for navigating dynamic sales environments, particularly in healthcare (Aripin et al., 2024). Structured learning initiatives, peer coaching, and technology-based training facilitate knowledge sharing and cohesion to address evolving client demands and complex regulatory pressures (Barbu et al., 2025; Olmos-Vega & Stalmeijer, 2025). Organizations prioritizing continuous learning experience lower turnover and improve alignment between employee development and organizational goals, both of which enhance sustained client relationships (Kayes, 2025).
Adaptive feedback mechanisms, supported by AI-driven performance dashboards, clarify expectations and build resilience critical to healthcare sales professionals (Bullemore, 2024; Friend et al., 2024; Hekneby & Olsen, 2024). Leadership practices fostering psychological safety enable employees to interpret feedback developmentally rather than evaluatively, which strengthens technical skills and client interactions (Viterouli et al., 2024). Integrating dynamic capabilities theory and AI-based analytics, the SPIRIT model positions transformation as central to sustained organizational growth by addressing turnover, client retention, and regulatory compliance in rapidly evolving sales markets (de Vasconcelos Gomes et al., 2025; Donald et al., 2024).
The SPIRIT model addresses sales leadership challenges by integrating SDT and LMX theory to create a comprehensive framework emphasizing intrinsic motivation and relational trust (Robin et al., 2023). This integration differentiates the SPIRIT model from established frameworks such as transformational and servant leadership. Transformational leadership primarily inspires followers through shared vision, idealized influence, and intellectual stimulation, whereas servant leadership prioritizes employee welfare and personal growth (Northouse, 2025). Although these models contribute significantly to leadership theory, they individually lack a structured integration of intrinsic motivation and relational support to address contemporary sales leadership challenges (Gagné & Deci, 2005; Ryan & Deci, 2020).
By synthesizing SDT and LMX principles, the SPIRIT model explicitly operationalizes autonomy, competence, and relatedness as interconnected dimensions essential to aligning individual motivations with organizational objectives. This structured alignment strengthens employee engagement, enhances performance, and reduces turnover by fostering relational trust and psychological safety (Robin et al., 2023). Hence, the SPIRIT model uniquely fills theoretical and practical gaps in existing frameworks by providing a systematic approach that aligns employee autonomy, competence development, and high-quality relational exchanges with organizational goals, which are particularly relevant in high-pressure environments such as healthcare sales (Sayyed et al., 2025).
The SPIRIT model addresses critical gaps in existing leadership theory by offering dual emphasis on intrinsic motivation and relational trust. While adept at fostering inspiration and unity, transformational leadership often lacks the tailored strategies needed to meet the diverse motivational requirements of individual team members, particularly in high-stakes environments such as healthcare sales (Helalat et al., 2025). Similarly, although valuable, servant leadership's focus on altruism and employee welfare can struggle to balance employee wellbeing with the stringent performance demands of competitive business environments (Helalat et al., 2025). By integrating the psychological constructs of SDT – autonomy, competence, and relatedness – with the relational dimensions of LMX theory, the SPIRIT model provides a structured framework for aligning individual and organizational priorities in demanding contexts (Godfrey et al., 2025; Ryan & Deci, 2020). This framework addresses disengagement and burnout while creating pathways for enhanced collaboration and sustained performance. Future research is needed to empirically validate the components of the SPIRIT model, assess its adaptability across industries, and explore its long-term impacts on employee wellbeing and organizational outcomes.
The healthcare sales environment presents unique challenges, including stringent regulatory constraints, prolonged sales cycles, and high-performance expectations (Sayyed et al., 2025). These complexities necessitate leadership models prioritizing adaptability and resilience. These qualities are central to the SPIRIT framework. By emphasizing autonomy and competence, the SPIRIT model equips sales professionals to effectively address these challenges by fostering innovation and a proactive approach to problem solving (Gagné & Deci, 2005; Robin et al., 2023). By operationalizing SDT's psychological constructs – autonomy, competence, and relatedness – and LMX's relational dynamics, SPIRIT offers a dual pathway to mitigate disengagement and burnout, both of which are prevalent issues in this domain (Robin et al., 2023). Leadership practices such as participative goal setting, structured feedback mechanisms, and mentorship programs enhance professional growth and align individual and organizational goals to create a sustainable model for performance excellence (Ryan & Deci, 2020; Sayyed et al., 2025). Future empirical research can explore the nuanced interactions between the components of the SPIRIT model and the dynamics of healthcare sales to provide actionable insights for refining the model further.
➢ Recommendations for sales leaders
Sales leaders can apply SPIRIT-aligned leadership methods to support employee engagement, accountability, and psychological safety. Structured autonomy, which balances employee decision making within clear organizational guidelines using participative goal setting and structured feedback, allows employees to effectively manage ethical and regulatory issues common in healthcare sales (Olafsen et al., 2025). Regular developmental meetings between leaders and team members strengthen relationships and allow individuals to see their contributions linked to organizational goals, which reinforces purpose (Miao & Nduneseokwu, 2025). Creating a psychologically safe workplace promotes open communication, adaptability, and collaborative problem solving, which are all essential in high-pressure sales roles (Adel et al., 2024; Viterouli et al., 2024). Moreover, mentorship programs pairing experienced team members with newer employees support professional growth and organizational continuity (Abdul-Azeez et al., 2024).
➢ Recommendations for organizations
Organizations can establish support systems consistent with the SPIRIT model to promote employee autonomy, competence, and trust. Comprehensive feedback approaches combining performance evaluation with developmental coaching can be prioritized (Kabanda & Barrena-Martinez, 2025). Investing in learning infrastructure, such as learning management platforms and peer-to-peer knowledge sharing, allows employees to respond effectively to changing client expectations and regulatory requirements (Kayes, 2025). Organizational adjustments, including flatter hierarchies and transparent communication processes, significantly improve the quality of leader-member relationships and trust, particularly within healthcare sales environments (Syukri et al., 2025).
Organizations can prioritize collaboration across departments through interdepartmental mentoring and joint problem-solving activities to support organizational cohesion and adaptability. Recognition initiatives celebrating individual and collective successes align employees with organizational objectives (da Silva, 2025). Integrating technology, such as AI analytics, provides personalized insights into performance, which supports individualized coaching and employee development (Dua, 2025). These organizational structures contribute to environments supportive of long-term engagement, reduced turnover, and improved overall sales results.
The SPIRIT model integrates SDT and LMX theory to balance employee autonomy with organizational goals to effectively manage engagement and retention within healthcare sales contexts characterized by high-performance expectations and regulatory requirements (Deci & Ryan, 2012; Sayyed et al., 2025). Combining intrinsic motivation and relational trust, the model offers actionable methods for sales leaders, HR practitioners, and organizational strategists to improve employee engagement, relationship quality, and organizational outcomes (Robin et al., 2023). The SPIRIT model provides a theoretical synthesis addressing gaps within existing leadership models to effectively position organizations within modern sales environments.
➢ Study Limitations and Recommendations for Future Research
This study has several limitations that highlight opportunities for future research (Arendt & Fuhse, 2022). As a conceptual framework, the SPIRIT model requires empirical validation across diverse organizational and client contexts to confirm its practical effectiveness (Northouse, 2025). Future studies can employ mixed-method designs and longitudinal analyses to examine the SPIRIT model's impact on engagement, turnover, and performance (Gagné & Deci, 2005). Furthermore, comparative research across industries and cultures can refine the model and identify factors influencing successful implementation (Shukla & Tripathi, 2025). Finally, investigating interactions between SPIRIT components and technology integration, such as AI analytics, can offer valuable insights into dynamic sales environments (Dua, 2025).