Management Accounting Section Midyear Meeting

Do Public Disclosures of Physician Performance Improve Patient Care? The Role of Behavioral Factors

• In Event: Healthcare

Abstract

This study examines how a public disclosure of individual surgeons’ performance affects their
patient care (i.e., rates of death and readmission for their patients). While prior research finds
that these disclosures lead to modest performance improvements, our findings suggest that those
average effects mask substantial heterogeneities. Specifically, we find that the disclosure leads
to better performance for surgeons who receive positive performance feedback and for those who
were already improving quickly before the disclosure. However, it leads to worse performance
for surgeons who receive negative feedback and for those who were struggling to improve before
the disclosure. These results hold for both low and high performing surgeons and are unlikely
to be explained by mean-reversion or changes in patient composition. Instead, the reductions
in performance are consistent with behavioral models suggesting that performance feedback can
induce counterproductive behaviors like dejection, anger, confusion, or a switch to ineffective task
strategies. Follow-up experiments with laypersons replicate the surgeon results and suggest that
adverse behavioral responses are caused by both confusion and motivation. Overall, our findings
provide a more complete picture on the effects of physician performance disclosures and suggests
ways in which they can be improved.

Authors

• Manasvini Singh, University of Massachusetts Amherst

• Jacob Theodore Zureich, Tilburg University