Using the Hawthorne Effect to Examine the Gap Between a Doctor's Best Possible Practice and Actual Performance

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Using the Hawthorne Effect to Examine the Gap Between a Doctor's Best Possible Practice and Actual Performance

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Leonard, Kenneth L.
Masatu, Melkiory C.

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Kenneth L. Leonard

Abstract

Many doctors in developing countries provide considerably lower levels of quality to their patients than they have been trained to provide. The gap between best practice and actual performance is difficult to measure for individual doctors who differ in levels of training and experience and who face very different types of patients. We exploit the Hawthorne effectâin which doctors change their behavior when a researcher comes to observe their practicesâto measure the gap between best and actual performance. We analyze this gap for a sample of doctors, examining the impact of the organization for which doctors work on the performance of doctors, after controlling for their ability. We find that some organizations succeed in motivating doctors to work at levels of performance that are close to their best possible practice. This paper adds to recent evidence that motivation is at least as important to health care quality as training and knowledge.

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Paper provided by University of Maryland, Department of Agricultural and Resource Economics in its series Working Papers with number 36693.

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Date of creation: 2008
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Handle: RePEc:ags:umdrwp:36693

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References listed on IDEAS
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Glenn W. Harrison & John A. List, 2004. "Field Experiments," Journal of Economic Literature, American Economic Association, vol. 42(4), pages 1009-1055, December. [Downloadable!] (restricted)
Steven D. Levitt & John A. List, 2007. "What Do Laboratory Experiments Measuring Social Preferences Reveal About the Real World?," Journal of Economic Perspectives, American Economic Association, vol. 21(2), pages 153-174, Spring.
Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March. [Downloadable!] (restricted)
Chaudhury, Nazmul & Hammer, Jeffrey S., 2003. "Ghost doctors - absenteeism in Bangladeshi health facilities," Policy Research Working Paper Series 3065, The World Bank. [Downloadable!]
Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," World Bank Research Observer, Oxford University Press, vol. 15(2), pages 199-224, August.

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