An Experimental Design on the Crowding-Out of Physician Motivation in Healthcare Systems under New Public Management

Giacomo Maino (Università degli Studi di Milano)

Abstract

This study proposes a controlled laboratory experiment to examine how physicians behave when overseen by a cost-conscious manager. Inspired by existing literature, this experiment will differ by highlighting the role of managers.

Many public healthcare systems incorporate New Public Management (NPM) principles to improve efficiency and accountability, addressing the concerns about rising healthcare costs. However, these regulatory frameworks may (1) displace the patient-regarding motivation of physicians; and (2) alter the understanding about the reciprocal responsibilities of healthcare stakeholders, including patients.

The experiment will explore these reciprocal responsibilities. Furthermore it will provide insights on (1) whether the physician behavior might increase healthcare expenditures, and thus the pressure healthcare budgets that was the very reason behind the reforms; and (2) on the possible drop in the benefits that patients receive from medical services when altruistic motivations are displaced.

Download the file