How the Design of Ranking Systems and Ability Affects Physician Effort

• 成果类型: Article; Early Access
• 署名作者: Huesmann, Katharina; Ndiaye, Yero Samuel; Waibel, Christian; Wiesen, Daniel
• 署名单位: University of Munster; University of Cologne; Max Planck Society; University of Cologne; Erasmus University Rotterdam - Excl Erasmus MC; Erasmus University Rotterdam
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.2022.00990
• 发表日期: 2025
• 关键词: ability; Lab-in-the-field experiment; rankings; relative performance feedback; status concerns

摘要

Although relative performance feedback in the form of rankings appears to be effective in improving health outcomes, it may have either motivating or demotivating effects for individual physicians. Potential factors influencing such effects include a physician's ability and the design of the ranking system itself; however, there is limited understanding of these factors. Using a controlled lab-in-the-field experiment with practicing and future physicians as subjects (N = 352), we systematically analyze effort within small teams under different ranking systems. Exogenously varying the number and position of the thresholds defining the ranking system, we observe that the addition of a threshold to create a new rank is motivating-that is, increases effort-only among individuals capable of exceeding that threshold; the effort of other individuals may remain unchanged or even decrease. In particular, a highly granular ranking system with ranks spanning the entire range of possible outcomes maximizes overall physician effort; high thresholds serve to motivate high-ability individuals, whereas moderate and low thresholds provide opportunities for improvement to lower-ability individuals who cannot reach the high thresholds. Our results suggest that, to motivate their teams effectively, clinical leaders should provide rank feedback using a system under which physicians of all ability types can improve their rank through increased effort.