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Related Experiment Videos

Physician commitment to organized delivery systems.

L R Burns1, J A Alexander, S M Shortell

  • 1Health Care Systems Department, Wharton School of the University of Pennsylvania, Philadelphia 19104, USA. burnsL@wharton.upenn.edu

Medical Care
|August 8, 2001
PubMed
Summary
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Health care systems can improve physician commitment by focusing on extrinsic rewards. Segmentation into strategic alliances shows small commitment differences, with utilitarian factors being more influential than administrative involvement.

Area of Science:

  • Healthcare Management
  • Organizational Behavior
  • Physician Relations

Background:

  • Health care systems utilize contracting vehicles to foster physician commitment and alignment.
  • Traditional methods have often failed to improve physician commitment, prompting new partnership strategies.
  • Physician segmentation into tightly linked and loosely linked alliances is an emerging strategy.

Purpose of the Study:

  • To evaluate if segmenting physicians into tightly linked versus loosely linked strategic alliances enhances system commitment.
  • To identify constituent elements within tightly linked alliances that most strongly correlate with physician commitment.

Main Methods:

  • Cross-sectional study design utilizing survey data from 1,965 physicians across 14 health care systems.

Related Experiment Videos

  • Physicians were categorized as tightly linked (e.g., in group practices) or loosely linked (e.g., primarily using system hospitals).
  • Commitment was measured using seven scales assessing attitudes and behaviors, considering instrumental/utilitarian and administrative factors.

    • Main Results:

    • Small but statistically significant differences in commitment were observed between tightly linked and loosely linked physicians.
    • Multivariate analyses indicated that instrumental/utilitarian factors (e.g., age, stipends, admissions) had a stronger association with commitment than administrative involvement.
    • Physician background and practice characteristics were modeled to understand these associations.

    Conclusions:

    • Physician commitment can be influenced by appealing to calculative motivations through extrinsic rewards.
    • Normative involvement in the organization appears less effective in driving physician commitment compared to extrinsic incentives.
    • Healthcare systems should consider strategic use of extrinsic rewards to enhance physician alignment.