文章基本信息

标题：When peer comparison information harms physician well-being
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作者：Joseph S. Reiff ; Justin C. Zhang ; Jana Gallus 等
期刊名称：Proceedings of the National Academy of Sciences
印刷版ISSN：0027-8424
电子版ISSN：1091-6490
出版年度：2022
卷号：119
期号：29
DOI：10.1073/pnas.2121730119
语种：English
出版社：The National Academy of Sciences of the United States of America
摘要：Significance Motivating physicians to adhere to medical best practices is a constant concern for health system leaders and policymakers. Meanwhile, burnout rates among physicians are rising—often resulting in mental health problems, job turnover, and higher healthcare costs. In our study, a commonly used behavioral intervention—informing physicians about how their performance compares to that of their peers—has no statistically significant impact on performance. However, it does decrease physicians’ job satisfaction and increase burnout. We uncover one mechanism behind this backfiring effect, namely, that the intervention may signal a lack of leadership support. Consistent with this account, we find that training leaders to offer support offsets the negative impact. We discuss lessons for the design, implementation, and evaluation of behavioral interventions and policies. Policymakers and business leaders often use peer comparison information—showing people how their behavior compares to that of their peers—to motivate a range of behaviors. Despite their widespread use, the potential impact of peer comparison interventions on recipients’ well-being is largely unknown. We conducted a 5-mo field experiment involving 199 primary care physicians and 46,631 patients to examine the impact of a peer comparison intervention on physicians’ job performance, job satisfaction, and burnout. We varied whether physicians received information about their preventive care performance compared to that of other physicians in the same health system. Our analyses reveal that our implementation of peer comparison did not significantly improve physicians’ preventive care performance, but it did significantly decrease job satisfaction and increase burnout, with the effect on job satisfaction persisting for at least 4 mo after the intervention had been discontinued. Quantitative and qualitative evidence on the mechanisms underlying these unanticipated negative effects suggest that the intervention inadvertently signaled a lack of support from leadership. Consistent with this account, providing leaders with training on how to support physicians mitigated the negative effects on well-being. Our research uncovers a critical potential downside of peer comparison interventions, highlights the importance of evaluating the psychological costs of behavioral interventions, and points to how a complementary intervention—leadership support training—can mitigate these costs.
关键词：enpeer comparisonwell-beinghealthcarefield experiment