Emergency Medicine at Westlake Hospital Compensation Structure

...

Paying doctors a straight hourly wage with no monthly bonus may negatively impact the quality of services delivered to patients. According to the case, Dr. Singh heard from patient feedback forms that some doctors were spending very little time with patients. This may be explained by the Expectation Theory, which describes a psychological process where people compare the efforts put into a task and the rewards they receive with others. The theory can be represented by the equation:

[pic 1]

High-performing doctors may become less motivated to continue performing at the current effort of spending time with patients if the rewards they receive are less than the rewards received by a lower-performing doctor who is spending less time with patients. As a result, the overall quality of services doctors deliver to their patients may gradually decrease overtime, theoretically to the level of the lowest performing doctor. For that reason, it is important for doctors to be paid based on a percentage of revenue generated by their charge points.

We believe paying doctors straight hourly wages possibly a higher rate than the current $100/hr. with no monthly bonus will not be a good idea because this will lead to dissatisfaction and unequal share of responsibilities. If we compensate all doctors on hourly rate of $100 or more, there will be clearly some doctors who will treat more patients as compared to other set of doctors who will see less number of patients. This un equal level of responsibilities will add dissatisfaction in the group. Doctors who see more patients will be de motivated. As theories of motivations suggest that motivation is a factor of social perception, specifically perceived justice (distributive justice) in organizations. Doctors with more panel of patients will not feel rewarded enough as they perceive the rewards & procedures for allocating resources are not distributed fairly. Thus, they do not feel connected to the organization.

On the other hand, doctors who see less number of patients will lack motivation of taking additional responsibilities or seeing more patients. As mentioned in the case, monthly records clearly indicate that some doctor routinely treated more patients than others and add dissatisfaction in the group. Moreover, it is quite possible that doctors who see large number of patients may not able to able to spend enough time with patients due to their work load thus patient care is compromised and feedback provided by patients exactly shows similar findings.