Sweetening the Carrot : Motivating Public Physicians for Better Performance
It is widely observed that many physicians working in public health facilities do not put in the required effort and time in their jobs. At the same time, many public physicians remain highly motivated, working long hours for little financial reward, in providing quality health services. This mix of...
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| Format: | Policy Research Working Paper |
| Language: | English |
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World Bank, Washington, DC
2012
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| Online Access: | http://documents.worldbank.org/curated/en/2005/11/6415974/sweetening-carrot-motivating-public-physicians-better-performance http://hdl.handle.net/10986/8563 |
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okr-10986-85632021-04-23T14:02:43Z Sweetening the Carrot : Motivating Public Physicians for Better Performance Garcia-Prado, Ariadna ABSENTEEISM ATTENTION COMPETENCE COMPETENCIES CROWDING DELIVERY OF HEALTH SERVICES ECONOMIC ANALYSIS ECONOMIC REVIEW EFFICIENCY WAGE THEORY EMPLOYMENT RELATIONSHIP ETHICS EXPENDITURES FEE SCHEDULE HEALTH CARE HEALTH ECONOMICS HEALTH PROMOTION HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICE HEALTH SERVICES HIGH WAGES HOSPITAL REVENUES HOSPITALS HOURS OF WORK IMPERFECT INFORMATION IMPLICIT CONTRACTS INCENTIVE STRUCTURES INCENTIVES FOR AGENTS INDIVIDUAL BEHAVIOR INDUSTRIAL PSYCHOLOGY INDUSTRIAL RELATIONS INFORMAL PAYMENTS INTERVENTION INTUITION INVOLUNTARY UNEMPLOYMENT JOBS LABOR CONTRACTS LABOR ECONOMICS LABOR MARKET LABOR PRODUCTIVITY LABOR RELATIONS MARGINAL COST MARGINAL COSTS MEDICAL CARE MOTIVATION NURSES PATIENT PATIENTS PAYMENTS FOR HEALTH SERVICES PERCEPTION PERSONALITY PERSONNEL PHYSICIANS POLICY RESEARCH PRESTIGE PRIMARY CARE PRIMARY HEALTH CARE PSYCHOLOGISTS PSYCHOLOGY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HOSPITALS PUBLIC SECTOR PUBLIC SERVICE REAL WAGE RECOGNITION RETENTION SOCIALIZATION SOCIOLOGISTS UNEMPLOYMENT UNEMPLOYMENT BENEFIT WAGE EFFECT WORK ENVIRONMENT WORK ETHIC WORK IN PROGRESS WORK PLACE WORKER WORKERS WORKING WORKING CONDITIONS WORKPLACE It is widely observed that many physicians working in public health facilities do not put in the required effort and time in their jobs. At the same time, many public physicians remain highly motivated, working long hours for little financial reward, in providing quality health services. This mix of provider-types poses fundamental challenges in the design of compensation mechanisms and monitoring regime in public facilities, where the objective of any reward-control paradigm is to improve the inoptimal performance of some physicians without compromising the effort of those already motivated. This paper presents a model to explain shirking behavior among public physicians and explores combinations of monitoring and incentive mechanisms that meet the twin objectives of inspiring the shirkers without losing the motivated. Drawing on the basic Shapiro-Stiglitz shirking model and the theory of social custom, the paper develops and presents a design of incentive structures that consists of punitive monitoring systems accompanied by non-pecuniary rewards. The analysis shows that intensive monitoring persuades the shirking physicians to improve their performance but may have a negative effect on the morale of those already motivated. The findings indicate that non-pecuniary rewards and recognition for the latter can potentially restore the incentives and counter the deleterious effect of increased supervision. The policy implications are discussed by presenting case studies in the health care context of developing countries. 2012-06-20T19:19:21Z 2012-06-20T19:19:21Z 2005-11 http://documents.worldbank.org/curated/en/2005/11/6415974/sweetening-carrot-motivating-public-physicians-better-performance http://hdl.handle.net/10986/8563 English Policy Research Working Paper; No. 3772 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
ABSENTEEISM ATTENTION COMPETENCE COMPETENCIES CROWDING DELIVERY OF HEALTH SERVICES ECONOMIC ANALYSIS ECONOMIC REVIEW EFFICIENCY WAGE THEORY EMPLOYMENT RELATIONSHIP ETHICS EXPENDITURES FEE SCHEDULE HEALTH CARE HEALTH ECONOMICS HEALTH PROMOTION HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICE HEALTH SERVICES HIGH WAGES HOSPITAL REVENUES HOSPITALS HOURS OF WORK IMPERFECT INFORMATION IMPLICIT CONTRACTS INCENTIVE STRUCTURES INCENTIVES FOR AGENTS INDIVIDUAL BEHAVIOR INDUSTRIAL PSYCHOLOGY INDUSTRIAL RELATIONS INFORMAL PAYMENTS INTERVENTION INTUITION INVOLUNTARY UNEMPLOYMENT JOBS LABOR CONTRACTS LABOR ECONOMICS LABOR MARKET LABOR PRODUCTIVITY LABOR RELATIONS MARGINAL COST MARGINAL COSTS MEDICAL CARE MOTIVATION NURSES PATIENT PATIENTS PAYMENTS FOR HEALTH SERVICES PERCEPTION PERSONALITY PERSONNEL PHYSICIANS POLICY RESEARCH PRESTIGE PRIMARY CARE PRIMARY HEALTH CARE PSYCHOLOGISTS PSYCHOLOGY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HOSPITALS PUBLIC SECTOR PUBLIC SERVICE REAL WAGE RECOGNITION RETENTION SOCIALIZATION SOCIOLOGISTS UNEMPLOYMENT UNEMPLOYMENT BENEFIT WAGE EFFECT WORK ENVIRONMENT WORK ETHIC WORK IN PROGRESS WORK PLACE WORKER WORKERS WORKING WORKING CONDITIONS WORKPLACE |
| spellingShingle |
ABSENTEEISM ATTENTION COMPETENCE COMPETENCIES CROWDING DELIVERY OF HEALTH SERVICES ECONOMIC ANALYSIS ECONOMIC REVIEW EFFICIENCY WAGE THEORY EMPLOYMENT RELATIONSHIP ETHICS EXPENDITURES FEE SCHEDULE HEALTH CARE HEALTH ECONOMICS HEALTH PROMOTION HEALTH SECTOR HEALTH SECTOR REFORM HEALTH SERVICE HEALTH SERVICES HIGH WAGES HOSPITAL REVENUES HOSPITALS HOURS OF WORK IMPERFECT INFORMATION IMPLICIT CONTRACTS INCENTIVE STRUCTURES INCENTIVES FOR AGENTS INDIVIDUAL BEHAVIOR INDUSTRIAL PSYCHOLOGY INDUSTRIAL RELATIONS INFORMAL PAYMENTS INTERVENTION INTUITION INVOLUNTARY UNEMPLOYMENT JOBS LABOR CONTRACTS LABOR ECONOMICS LABOR MARKET LABOR PRODUCTIVITY LABOR RELATIONS MARGINAL COST MARGINAL COSTS MEDICAL CARE MOTIVATION NURSES PATIENT PATIENTS PAYMENTS FOR HEALTH SERVICES PERCEPTION PERSONALITY PERSONNEL PHYSICIANS POLICY RESEARCH PRESTIGE PRIMARY CARE PRIMARY HEALTH CARE PSYCHOLOGISTS PSYCHOLOGY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HOSPITALS PUBLIC SECTOR PUBLIC SERVICE REAL WAGE RECOGNITION RETENTION SOCIALIZATION SOCIOLOGISTS UNEMPLOYMENT UNEMPLOYMENT BENEFIT WAGE EFFECT WORK ENVIRONMENT WORK ETHIC WORK IN PROGRESS WORK PLACE WORKER WORKERS WORKING WORKING CONDITIONS WORKPLACE Garcia-Prado, Ariadna Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| relation |
Policy Research Working Paper; No. 3772 |
| description |
It is widely observed that many physicians working in public health facilities do not put in the required effort and time in their jobs. At the same time, many public physicians remain highly motivated, working long hours for little financial reward, in providing quality health services. This mix of provider-types poses fundamental challenges in the design of compensation mechanisms and monitoring regime in public facilities, where the objective of any reward-control paradigm is to improve the inoptimal performance of some physicians without compromising the effort of those already motivated. This paper presents a model to explain shirking behavior among public physicians and explores combinations of monitoring and incentive mechanisms that meet the twin objectives of inspiring the shirkers without losing the motivated. Drawing on the basic Shapiro-Stiglitz shirking model and the theory of social custom, the paper develops and presents a design of incentive structures that consists of punitive monitoring systems accompanied by non-pecuniary rewards. The analysis shows that intensive monitoring persuades the shirking physicians to improve their performance but may have a negative effect on the morale of those already motivated. The findings indicate that non-pecuniary rewards and recognition for the latter can potentially restore the incentives and counter the deleterious effect of increased supervision. The policy implications are discussed by presenting case studies in the health care context of developing countries. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Garcia-Prado, Ariadna |
| author_facet |
Garcia-Prado, Ariadna |
| author_sort |
Garcia-Prado, Ariadna |
| title |
Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| title_short |
Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| title_full |
Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| title_fullStr |
Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| title_full_unstemmed |
Sweetening the Carrot : Motivating Public Physicians for Better Performance |
| title_sort |
sweetening the carrot : motivating public physicians for better performance |
| publisher |
World Bank, Washington, DC |
| publishDate |
2012 |
| url |
http://documents.worldbank.org/curated/en/2005/11/6415974/sweetening-carrot-motivating-public-physicians-better-performance http://hdl.handle.net/10986/8563 |
| _version_ |
1764407995226128384 |