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Disentangling extrinsic and intrinsic motivations: the case of French GPs dealing with prevention

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Author Info
Philippe Batifoulier
Maryse Gadreau
Yves Arrighi
Yann Videau
Bruno Ventelou

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Abstract

The economic literature attaches great importance to the analysis of "professional motivations", in particular examining the possible crowding-out effects between extrinsic and intrinsic motivations. This article applies these questions to the healthcare professions with a view to providing a fair scaling of the implementation of pay-for-performance policies by public decision-makers. We assemble a panel of 528 independent general practitioners in the "Provence-Alpes-Côte d’Azur" region in France and provide an inter-personal statistical decomposition between extrinsic and intrinsic motivations with regard to preventive actions. The proportion of intrinsic motivations is relatively greater among physicians paid with fixed fees. The significant effect of age describes a U shape which can be interpreted as being the result of a "life cycle of medical motivations". Finally, econometric estimations demonstrate a correlation between a small proportion of intrinsic motivation and a feeling of injustice with regard to the reforms. The cross-sectional nature of the data does not allow us to draw any conclusions concerning the direction of the causality. But the above correlation would seem to support the theory that the implementation of a policy based on monetary incentives towards performance is perceived as being offensive and may be accompanied by a reduction in intrinsic motivations in medical practice.

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Publisher Info
Paper provided by University of Paris West - Nanterre la Défense, EconomiX in its series EconomiX Working Papers with number 2009-15.

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Length: 17 pages
Date of creation: 2009
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Handle: RePEc:drm:wpaper:2009-15

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Related research
Keywords: General practitioners; Motivations; Prevention; Payment for performance; Intrinsic and extrinsic incentives; France;

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References listed on IDEAS
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    Other versions:
  2. Roland Benabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," Review of Economic Studies, Blackwell Publishing, vol. 70(3), pages 489-520, 07. [Downloadable!] (restricted)
  3. Janssen, Maarten C. W. & Mendys-Kamphorst, Ewa, 2004. "The price of a price: on the crowding out and in of social norms," Journal of Economic Behavior & Organization, Elsevier, vol. 55(3), pages 377-395, November. [Downloadable!] (restricted)
  4. Frolich, Anne & Talavera, Jason A. & Broadhead, Peter & Dudley, R. Adams, 2007. "A behavioral model of clinician responses to incentives to improve quality," Health Policy, Elsevier, vol. 80(1), pages 179-193, January. [Downloadable!] (restricted)
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  6. James, Harvey Jr., 2005. "Why did you do that? An economic examination of the effect of extrinsic compensation on intrinsic motivation and performance," Journal of Economic Psychology, Elsevier, vol. 26(4), pages 549-566, August. [Downloadable!] (restricted)
  7. Uri Gneezy & Aldo Rustichini, 2000. "Pay Enough Or Don'T Pay At All," The Quarterly Journal of Economics, MIT Press, vol. 115(3), pages 791-810, August. [Downloadable!] (restricted)
  8. Kreps, David M, 1997. "Intrinsic Motivation and Extrinsic Incentives," American Economic Review, American Economic Association, vol. 87(2), pages 359-64, May. [Downloadable!] (restricted)
  9. Armin Falk & Michael Kosfeld, 2006. "The Hidden Costs of Control," American Economic Review, American Economic Association, vol. 96(5), pages 1611-1630, December. [Downloadable!]
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  10. Dirk Sliwka, 2007. "Trust as a Signal of a Social Norm and the Hidden Costs of Incentive Schemes," American Economic Review, American Economic Association, vol. 97(3), pages 999-1012, June. [Downloadable!]
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This page was last updated on 2009-11-23.


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