IDEAS home Printed from
   My bibliography  Save this paper

From Salary to the Performance-Based Remuneration of Russian Physicians: How Motivation at Work is Changing


  • Sergey Shishkin

    () (National Research University Higher School of Economics)

  • Aleksandr Temnitsky

    () (National Research University Higher School of Economics)


This paper examines changes in the motivation of physicians at work since the start of the salary reforms in 2008. These reforms included a shift from a fixed salary system to performance-based remuneration and an overall increase in salaries. The data of six surveys of health workers from 2007–2016 were used to reveal physician’s motives at work and to track the changes during this period. The changes were minor, and the directions of these changes were contrary to the expected strengthening of financial motivation at work: the importance of earning money is no longer primary. The share of doctors willing to work more and better on the condition of linking salary with labour contribution did not increase. In contrast, almost 66% of physicians believe that they are working at a high level of quality and performance.The majority of physicians desire an increase in the base salary, not the performance-based part. Doctors who receive bonuses for the intensity, quality and performance of their work, and those who have a higher salary overall also wish to see a higher base salary. This is a clear indication that they wish to strengthen the protective function of the base salary rather than to have increased opportunities for earning money

Suggested Citation

  • Sergey Shishkin & Aleksandr Temnitsky, 2017. "From Salary to the Performance-Based Remuneration of Russian Physicians: How Motivation at Work is Changing," HSE Working papers WP BRP 08/PSP/2017, National Research University Higher School of Economics.
  • Handle: RePEc:hig:wpaper:08/psp/2017

    Download full text from publisher

    File URL:
    Download Restriction: no

    References listed on IDEAS

    1. Elise Huillery & Juliette Seban, 2014. "Performance-Based Financing, Motivation and Final Output in the Health Sector: Experimental Evidence from the Democratic Republic of Congo," Sciences Po publications 2014-12, Sciences Po.
    2. Junui Shen & Kazuhito Ogawa & Hiromasa Takahashi, 2014. "Examining the Tradeoff Between Fixed Pay and Performance-Related Pay: A Choice Experiment Approach," Review of Economic Analysis, Digital Initiatives at the University of Waterloo Library, vol. 6(2), pages 119-131, December.
    3. Scott, A & Schurer, S & Jensen, P H & Sivey, P, 2008. "The Effects of Financial Incentives on Quality of Care: The Case of Diabetes," Health, Econometrics and Data Group (HEDG) Working Papers 08/15, HEDG, c/o Department of Economics, University of York.
    4. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth, 2002. "Health sector reform and public sector health worker motivation: a conceptual framework," Social Science & Medicine, Elsevier, vol. 54(8), pages 1255-1266, April.
    5. Chandler, Clare I.R. & Chonya, Semkini & Mtei, Frank & Reyburn, Hugh & Whitty, Christopher J.M., 2009. "Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians," Social Science & Medicine, Elsevier, vol. 68(11), pages 2078-2088, June.
    6. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth & Stubblebine, Patrick, 2004. "Determinants and consequences of health worker motivation in hospitals in Jordan and Georgia," Social Science & Medicine, Elsevier, vol. 58(2), pages 343-355, January.
    7. Abigail Barr & Magnus Lindelow & Pieter Serneels, 2005. "Intrinsic motivations on the development frontline: Do they exist? Do they endure?," Economics Series Working Papers GPRG-WPS-033, University of Oxford, Department of Economics.
    Full references (including those not matched with items on IDEAS)

    More about this item


    health care; physicians; salary; performance based remuneration; motivation at work; incentives.;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J08 - Labor and Demographic Economics - - General - - - Labor Economics Policies
    • J31 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Wage Level and Structure; Wage Differentials

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hig:wpaper:08/psp/2017. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamil Abdulaev) or (Shamil Abdulaev). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.