Download This PaperWhen peer comparison information harms physician well-being
Reiff, J. S., Zhang, J., Gallus, J., Dai, H., Pedley, N., Vangala, S., Leuchter, R., Goshgarian, G., Fox, C. R., Han, M., & Croymans, D. (2022). When peer comparison information harms physician well-being. Proceedings of the National Academy of Sciences of the United States of America. 119 (29).
8 Pages Posted: 12 Oct 2021 Last revised: 18 Jul 2022
Date Written: November 30, 2021
Abstract
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.
Note:
The first two authors contributed equally to this work.
Funding: UCLA Health Department of Medicine
Declaration of Interest: None to declare.
Ethics Approval Statement: This research was reviewed by the UCLA Institutional Review Board and was found to not meet the definition of human subjects research as defined by federal regulations for human subject protections. Therefore, neither certification of exemption nor approval were required by the UCLA Institutional Review Board.
Trial Registration: clinicaltrials.gov numbers: NCT04237883
Keywords: peer comparison, well-being, healthcare, field experiment
JEL Classification: I12
Suggested Citation: Suggested Citation