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Intrinsic and extrinsic motivations in primary care: An explanatory study among French general practitioners


  • Sicsic, Jonathan
  • Le Vaillant, Marc
  • Franc, Carine


Like many other OECD nations, France has implemented a pay-for-performance (P4P) model in primary care. However, the benefits have been debated, particularly regarding the possibly undesirable effects of extrinsic motivation (EM) on intrinsic motivation (IM).

Suggested Citation

  • Sicsic, Jonathan & Le Vaillant, Marc & Franc, Carine, 2012. "Intrinsic and extrinsic motivations in primary care: An explanatory study among French general practitioners," Health Policy, Elsevier, vol. 108(2), pages 140-148.
  • Handle: RePEc:eee:hepoli:v:108:y:2012:i:2:p:140-148 DOI: 10.1016/j.healthpol.2012.08.020

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    References listed on IDEAS

    1. Pelletier-Fleury, Nathalie & Le Vaillant, Marc & Hebbrecht, Gilles & Boisnault, Philippe, 2007. "Determinants of preventive services in general practice: A multilevel approach in cardiovascular domain and vaccination in France," Health Policy, Elsevier, vol. 81(2-3), pages 218-227, May.
    2. Yann Videau & Philippe Batifoulier & Y Arrighi & Maryse Gadreau & Bruno Ventelou, 2010. "Le cycle de vie des motivations professionnelles en médecine de ville : une étude dans le champ de la prévention," Post-Print halshs-01228541, HAL.
    3. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1998. "Context, composition and heterogeneity: Using multilevel models in health research," Social Science & Medicine, Elsevier, vol. 46(1), pages 97-117, January.
    4. Robert Gibbons, 1998. "Incentives in Organizations," Journal of Economic Perspectives, American Economic Association, vol. 12(4), pages 115-132, Fall.
    5. Hughes, David, 1993. "General practitioners and the new contract: promoting better health through financial incentives," Health Policy, Elsevier, vol. 25(1-2), pages 39-50, September.
    6. Lindenberg, Siegwart, 2001. "Intrinsic Motivation in a New Light," Kyklos, Wiley Blackwell, vol. 54(2-3), pages 317-342.
    7. Jinhu Li & Jeremiah Hurley & Philip DeCicca & Gioia Buckley, 2014. "Physician Response To Pay‐For‐Performance: Evidence From A Natural Experiment," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 962-978, August.
    8. 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.
    9. Nigel Rice & Andrew Jones, 1997. "Multilevel models and health economics," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 561-575.
    10. Kreps, David M, 1997. "Intrinsic Motivation and Extrinsic Incentives," American Economic Review, American Economic Association, vol. 87(2), pages 359-364, May.
    11. Gene-Badia, Joan & Escaramis-Babiano, Georgia & Sans-Corrales, Mireia & Sampietro-Colom, Laura & Aguado-Menguy, Francoise & Cabezas-Pena, Carmen & Puelles, Pedro Gallo de, 2007. "Impact of economic incentives on quality of professional life and on end-user satisfaction in primary care," Health Policy, Elsevier, vol. 80(1), pages 2-10, January.
    12. Roland Bénabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," Review of Economic Studies, Oxford University Press, vol. 70(3), pages 489-520.
    13. Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
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    Cited by:

    1. Claudia Keser & Emmanuel Peterlé & Cornelius Schnitzler, 2014. "Money talks - Paying physicians for performance," CIRANO Working Papers 2014s-41, CIRANO.
    2. Allen, Thomas & Whittaker, William & Sutton, Matt, 2017. "Does the proportion of pay linked to performance affect the job satisfaction of general practitioners?," Social Science & Medicine, Elsevier, vol. 173(C), pages 9-17.
    3. repec:spr:eujhec:v:18:y:2017:i:5:d:10.1007_s10198-016-0813-2 is not listed on IDEAS
    4. Saint-Lary, Olivier & Sicsic, Jonathan, 2015. "Impact of a pay for performance programme on French GPs’ consultation length," Health Policy, Elsevier, vol. 119(4), pages 417-426.
    5. Zweifel, Peter & Janus, Katharina, 2016. "Physician ethics: undermined or enhanced by modes of payment?," Annual Conference 2016 (Augsburg): Demographic Change 145708, Verein für Socialpolitik / German Economic Association.
    6. Sicsic, Jonathan & Krucien, Nicolas & Franc, Carine, 2016. "What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers," Social Science & Medicine, Elsevier, vol. 167(C), pages 116-127.

    More about this item


    General practitioners; Intrinsic motivation; Extrinsic motivation; Payment for performance; Multiple correspondence analysis; Multilevel analysis;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


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