PurposePrior studies have shown that physician-led hospitals have several advantages over non-physician-led hospitals. This study seeks to test whether these advantages also extend to periods of extreme disruptions such as the COVID-19... more
PurposePrior studies have shown that physician-led hospitals have several advantages over non-physician-led hospitals. This study seeks to test whether these advantages also extend to periods of extreme disruptions such as the COVID-19 pandemic, which affect bed availability and hospital utilization.Design/methodology/approachThe authors utilize a bounded Tobit estimation to identify differences in patient satisfaction rates and in-hospital utilization rates of top-rated hospitals in the United States.FindingsAmong top-rated US hospitals, those that are physician-led achieve higher patient satisfaction ratings and are more likely to have higher utilization rates.Research limitations/implicationsWhile the COVID-19 pandemic generated greater demand for inpatient beds, physician-led hospitals improved their hospitals’ capacity utilization as compared with those led by non-physician leaders. A longitudinal study to show the change over the years and whether physician Chief Executive Officers (CEOs) are more likely to improve their hospitals’ ratings than non-physician CEOs is highly recommended.Practical implicationsRecruiting and retaining physicians to lead hospitals, especially during disruptions, improve hospital’s operating efficiency and enhance patient satisfaction.Originality/valueThe paper reviews prior research on physician leadership and adds further insights into the crisis leadership literature. The authors provide evidence based on quantitative data analysis that during the COVID-19 pandemic, physician-led top-rated US hospitals experienced an improvement in operating efficiency.
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ABSTRACT This study examines the impact of a reduction in compensation on individual sales performance over time. Sales performance data over a two-year time period were obtained for individuals who remained with their organization after... more
ABSTRACT This study examines the impact of a reduction in compensation on individual sales performance over time. Sales performance data over a two-year time period were obtained for individuals who remained with their organization after experiencing a reduction in compensation. Using labor economic theory, this study examines how negative compensation changes affect performance and whether individuals’ pay levels affect their reactions to a negative change in pay. To examine these questions, the study uses an interrupted time series with a nonequivalent no-treatment control group method of design. In addition, an alternative panel specification is used for verification. Data on 292 sales individuals are analyzed. The results show that in response to a reduction in compensation, individuals at high pay levels change their effort less than individuals at lower pay levels. The practical implications of these findings provide important insights into contingencies that affect the outcomes of pay-for-performance sales programs.
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This study exploits the pathway of Hurricane Laura to assess its impact on the spread of COVID‐19. Using US hospital data on confirmed and suspected adult COVID‐19 cases, we find average daily cases per week rose by more than 12%... more
This study exploits the pathway of Hurricane Laura to assess its impact on the spread of COVID‐19. Using US hospital data on confirmed and suspected adult COVID‐19 cases, we find average daily cases per week rose by more than 12% primarily in tropical storm‐affected counties in subsequent weeks. We suspect the key mechanisms involve constraints on social distancing for two reasons. First, there is significant evidence of storm‐induced mobility. Second, lower income areas endured higher growth in hospital cases during the post‐hurricane period. These findings provide crucial insights for policy‐makers when designing natural disaster protocols to adjust for potential respiratory viral illnesses.
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PURPOSE The purpose of this paper is to explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. DESIGN/METHODOLOGY/APPROACH The authors survey causes and... more
PURPOSE The purpose of this paper is to explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. DESIGN/METHODOLOGY/APPROACH The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. FINDINGS The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor-patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients' overall ratings of hospitals. RESEARCH LIMITATIONS/IMPLICATIONS More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse. PRACTICAL IMPLICATIONS When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program's efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use. ORIGINALITY/VALUE The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.
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Natural disasters have been shown to have a significant impact on migration, particularly among individuals who have the resources to move and the human capital potential to succeed after the move. This study expands on prior research by... more
Natural disasters have been shown to have a significant impact on migration, particularly among individuals who have the resources to move and the human capital potential to succeed after the move. This study expands on prior research by examining the impact of disasters on net-migration into high-growth emerging economies. After controlling for a series of macroeconomic factors, the findings show that the frequency of disasters more so than any other impact measure can influence migration decisions.
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Puberty is the most important developmental milestone closely preceding a young adult’s labor market decisions. Thus, we examine the variation in the timing of physical maturity during adolescence to isolate its impact on employment and... more
Puberty is the most important developmental milestone closely preceding a young adult’s labor market decisions. Thus, we examine the variation in the timing of physical maturity during adolescence to isolate its impact on employment and hourly wages for US young adults. Using the National Longitudinal Study of Adolescent to Adult Health data, we find an early maturity premium of about 6% for females and 8% for males, but no employment effects, in excess of gains from height and physical attractiveness. Cognitive and personality factors significantly explain this premium for both genders, but job attributes are also important for males.
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ABSTRACT Corruption has affected systems of governance for thousands of years. Existing evidence suggests that it is especially common in "emerging and developing economies," yet cross-country analysis in this context is... more
ABSTRACT Corruption has affected systems of governance for thousands of years. Existing evidence suggests that it is especially common in "emerging and developing economies," yet cross-country analysis in this context is rare. We examine the impact of political, economic, and media freedom on corruption in a large sample of countries across multiple time periods to investigate the marginal differences within each. The results show that increased economic and press freedoms are associated with lower levels of corruption in developing countries. We find that although increased political freedom through democratization is statistically significant, it reduces corruption only in developed countries and may increase levels of corruption in developing countries.
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Purpose Senior executives in healthcare organizations increasingly display preference for a closer handling of operational levels, bypassing middle managers, and de-emphasizing the need to cultivate the next cadre of leaders, creating the... more
Purpose Senior executives in healthcare organizations increasingly display preference for a closer handling of operational levels, bypassing middle managers, and de-emphasizing the need to cultivate the next cadre of leaders, creating the potential for leadership and performance gaps. The authors argue that middle managers are a vital resource for healthcare organizations and review the benefits for including them in leadership development and succession planning programs. The paper aims to discuss these issues. Design/methodology/approach Current theories and common practices in addition to data collected from government sources (e.g. BLS), business and industry surveys and reports (e.g. Moody’s, Witt/Kieffer, Deloitte, American Hospital Association) are used to classify the roles, skills, and strategic value of middle managers in healthcare organizations. Findings The combination of a greater executive span with less hierarchical depth creates a dual effect of devaluing middle management, and a decrease in middle managers’ autonomy. Healthcare middle managers who stay away or lay low further trigger perceptions of low expectations leading to low morale and high levels of stress. Others become hypereffective or develop exit strategies. Major problems are: rising turnover costs; and insufficient attention to succession planning, internal promotion, and leadership development. Practical implications The outcomes of this study are useful for management development, particularly at times of change. Practitioners and researchers can have a better understanding of the value of middle managers and their development needs as well as the factors and dynamics that can influence their motivation and affect retention. Originality/value Understanding and implementing the ideas developed in this paper by healthcare organizations and other companies can lead to a drastic change in the current perceptions of the importance of middle managers and should lead to long-term retention, well-being, and extrinsic benefits for both the company and its employees.
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Abstract This study improves upon the Difference in Difference approach by examining exogenous shocks using a Generalized Difference in Difference (GDD) technique that identifies economic effects of hurricanes. Based on the Quarterly... more
Abstract This study improves upon the Difference in Difference approach by examining exogenous shocks using a Generalized Difference in Difference (GDD) technique that identifies economic effects of hurricanes. Based on the Quarterly Census of Employment ...
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Purpose The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. Design/methodology/approach The authors survey causes and... more
Purpose The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. Design/methodology/approach The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. Findings The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals. Research limitations/implications More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse. Practical implications When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use. Originality/value The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.
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Over the last few decades several countries have turned to inflation targeting as a policy choice for instilling stability into their economies. Prior studies have shown that inflation targeting has reduced inflation in those countries... more
Over the last few decades several countries have turned to inflation targeting as a policy choice for instilling stability into their economies. Prior studies have shown that inflation targeting has reduced inflation in those countries without significantly impacting GDP. This study seeks to improve upon these results by identifying the impact of timing on the policy decision as well as its impact as related to specific regions of the world. The focus is on developing countries. We find significant regional variation in developing countries in our sample in terms of the direction of changes in inflation following a switch to the inflation targeting policy. Moreover, although the impact of inflation targeting on real GDP is minimal overall, there is a statistically significant increase in real GDP among developing countries in certain regions only, namely, Europe, Latin America, and the Middle East.
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Objective: To highlight clinical and operational issues, identify factors that shape patient responses in Hospital Consumer Assessment of Healthcare Providers a
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While often overlooked, middle managers play important leadership roles for organizations. Whether through communication linkages or simply by greasing the wheel of productivity, organizations with properly motivated middle managers... more
While often overlooked, middle managers play important leadership roles for organizations. Whether through communication linkages or simply by greasing the wheel of productivity, organizations with properly motivated middle managers typically have a stronger core culture and more profitable outcomes. This study seeks to identify key motivational factors for middle managers as well as the disconnect that many organizations have in properly utilizing middle management. We examine the problems stemming from the Pygmalion Effect and hypereffectivity. Our conclusions are supported with survey data and top line BLS demographic data. Using regression analysis, we show that what middle managers say motivates themselves is not always what executives believe motivates middle managers. Implications for leadership development and directions for future research are also provided.
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We highlight clinical and operational issues as well as gaps associated with providers’ communication and the importance of using metrics such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that allow... more
We highlight clinical and operational issues as well as gaps associated with providers’ communication and the importance of using metrics such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that allow consumers to discern how hospitals differ on specific characteristics. We also provide evidence about the importance of developing an effective care partnership between physicians and patients in both primary care practices and multi-specialty groups by strengthening doctor-patient communication (DPC). A partial correlation analysis to ascertain those HCAHPS composite measures that most relate to the overall hospital rating with a specific focus on DPC was conducted. Our findings reveal a significantly positive relationship between DPC and various care measures. From a health policy standpoint, it is imperative that hospital administrators stress open and clear communication between doctors and patients to avoid problems ranging from misdiagnosis to incorrect treatment. Altering the patterns of DPC involves adaptation and training for doctors who are expected to adjust their standard “script” when communicating with patients.
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In the broadest sense, entrepreneurship describes the organization and management of a business enterprise. Typically, we associate entrepreneurship with the running of a business and the assumption of associated risks. It is a critical... more
In the broadest sense, entrepreneurship describes the organization and management of a business enterprise. Typically, we associate entrepreneurship with the running of a business and the assumption of associated risks. It is a critical component of a capitalistic society. Indeed, it could be argued that, because business is the primary engine of economic growth in a capitalistic system, entrepreneurship is the fuel for that engine. We examine these issues and suggest ways to overcome these challenges and become better business leaders. We argue that the solutions to many societal problems require social entrepreneurship characterized by the bold, “heroic” behaviors described by Schumpeterian. We argue that women are poised to assume a central role in this brand of entrepreneurship.
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We explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. We survey causes and costs of miscommunication including perceptual gaps between how physicians... more
We explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. We survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties versus how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. We find that positive DPC correlates with better and more accurate care as well as with more satisfied patients. We utilize an assessment framework, DPCA, empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals. More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. We think that researchers should adopt a qualitative method (e.g., content analysis) for analyzing DPC discourse. When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.
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The onset of Hurricane Laura during the COVID-19 pandemic provides a natural experiment to estimate the effect of reduced social distancing on the spread of COVID-19. To this end, we first provide evidence of hurricane-induced mobility.... more
The onset of Hurricane Laura during the COVID-19 pandemic provides a natural experiment to estimate the effect of reduced social distancing on the spread of COVID-19. To this end, we first provide evidence of hurricane-induced mobility. Then using hospital-level data on confirmed and suspected adult COVID-19 cases, we find that such cases rise by more than 10 percent in hurricane-affected counties in subsequent weeks. Lower income areas endured a higher growth in COVID-19 cases in the post-hurricane period. These findings provide crucial insights for policymakers when designing natural disaster protocols to adjust for potential viral illnesses.