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Prior studies on the impact of incentives on physicians’ online participation mainly focused on different incentives while ignoring the difficulty of setting monetary incentives efficiently. Based on goal-setting theory, the current research examines the relationship between incentives with goals of varying difficulty and professional health knowledge sharing (PHKS) in online health knowledge-sharing platforms (OHKSPs).

Four field experiments with different monetary incentives were conducted by one of China’s largest OHKSPs, with whom the researchers cooperated in data collection. Monthly panel data on 10,584 physicians were collected from September 2018 to December 2019. There were 9,376 physicians in the treatment group and 1,208 in the control group. The authors used a difference-in-difference (DID) model to explore the research question based on the same control group and the Chow test with seemingly unrelated estimation (sureg) to compare regression coefficients between four groups. Several robustness checks were performed to validate the main results, including a relative time model, multiple falsification tests and a DID estimation using the propensity score matching method.

The results show that the monetary incentive significantly positively affected the volume of physicians’ PHKS directly with negative spillover to the duration of physicians’ PHKS. Moreover, the positive effect of incentives with higher difficulty on the volume of physicians’ PHKS was significantly smaller than that of incentives with low difficulty. Finally, professional title had a positive moderating effect on the volume of goal difficulty setting and did not significantly moderate the effect on the duration of physicians’ PHKS.

Some limitations of this study are: firstly, because the field experiments were enterprise benefit oriented, the treatment and control groups were not balanced. Secondly, the experiments for different incentive measures were relatively similar, making it challenging to validate a causal effect. Finally, more consideration should be given to the strategy for setting hierarchical incentives in future research.

The research indicates that monetary incentives have a bilateral effect on PHKS, i.e. a positive direct effect on the volume of physicians’ contributions and a negative spillover effect on the duration of physicians’ PHKS. The professional titles of physicians also moderate such bilateral switches of PHKS. Furthermore, when a physician’s energy is limited, the goal difficulty setting of the incentive mechanism tends to be low. The more difficult the incentives are, the more inefficient the effects on physicians’ PHKS will be.

The success of an Electronic Health Record (EHR) system is determined by the numerous facilitators and obstacles that influence physicians' intentions toward using these technologies. This study examines physicians' intentions to use EHR by applying the extended technology readiness and acceptance model (TRAM) factors, the result demonstrability, colleagues' opinions, perception of external control, and organizational support.

Convenience sampling was used to collect data from physicians in Egypt (n = 520). To evaluate the model's hypotheses, this study used the partial least squares structural equation modeling (PLS-SEM) method with WarpPLS.7.

The results revealed that positive TR factors (innovativeness and optimism) positively affect perceived usefulness and ease of use, while negative TR factors (discomfort and insecurity) negatively impact perceived usefulness and ease of use. Furthermore, the result demonstrability and colleagues' opinions positively influence perceived usefulness, while the perception of external control and organizational support positively influence perceived ease of use. In addition, significant relationships between perceived ease of use and usefulness and adoption intention were identified.

This is the first study to apply the TRAM to understand physicians' adoption intentions to use EHR systems. Moreover, this study determined the different roles of positive and negative TR affecting physicians' cognition regarding using EHR systems.

Free knowledge sharing in the online health community has been widely documented. However, whether free knowledge sharing can help physicians accumulate popularity and further the accumulated popularity can help physicians attract patients remain unclear. To unveil these gaps, this study aims to examine how physicians' popularity are affected by their free knowledge sharing, how the relationship between free knowledge sharing and popularity is moderated by professional capital, and how the popularity finally impacts patients' attraction.

The authors collect a panel dataset from Hepatitis B within an online health community platform with 10,888 observations from April 2020 to August 2020. The authors develop a model that integrates free knowledge sharing, popularity, professional capital, and patients' attraction. The hierarchical regression model is used to for examining the impact of free knowledge sharing on physicians' popularity and further investigating the impact of popularity on patients' attraction.

The authors find that the quantity of articles acted as the heuristic cue and the quality of articles acted as the systematic cue have positive effect on physicians' popularity, and this effect is strengthened by physicians' professional capital. Furthermore, physicians' popularity positively influences their patients' attraction.

This study reveals the aggregation of physicians' popularity and patients' attraction within online health communities and provides practical implications for managers in online health communities.

This chapter pays tribute to Andrew Jones' research in health programme evaluation, health-risky behaviour and income-related health inequalities by reviewing policy-relevant empirical studies in these domains using Italian data. In the first section, We discuss the impact of reimbursement systems on healthcare behaviour, particularly the transition from incurred-cost-based to prospective systems in hospitals. We explore incentive-driven practices like up-coding and cream skimming, while also considering the potential advantages of primary care incentives and the mixed outcomes associated with cost-sharing schemes. The second section delves into health-risk behaviours in Italy, encompassing substance use, preventive healthcare and responses to health information. The last section presents some evidence on socioeconomic status (SES)-related health disparities and discusses the necessity of accounting for these factors in the Italian National Health Service (NHS)'s resource allocation formula in line with British NHS experience.

This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.

The brain drain challenge has become a cankerworm confronting not only the public health-care sector in Nigeria but almost all sectors of the national economy. This study aims to explore the push factors responsible for brain drain incidence among the migrated, JAPA, physicians to other global work environments. The study investigates the mediating role of capacity development among migrated, JAPA, physicians between the health-care infrastructural deficit and brain drain syndrome.

This study used a survey cross-sectional research design to examine the 214 migrated physicians in four notable perceived countries (UK, USA, Canada and Australia). The study used a probability sampling strategy to survey a self-administered online research instrument. The study adapted a battery of scales from several authors to measure the relevant constructs of this study. Hierarchical multiple regression was used to examine factors that provoke the incidence of brain drain burden among the JAPA Physicians. While Macro Hayes Process was used to investigate the mediating role of capacity development among migrated physicians.

The study revealed from the “JAPA” physicians that working conditions are turbulent and utterly poor which led to the incidence of brain drain. The study indicated that poor remuneration and benefits are the predominant reason for JAPA physicians to European countries and USA/UK. The findings of the study demonstrated that restricted opportunities and poor standard of living in the country were additional factors responsible for the brain drain of Nigerian physicians to other international countries. The outcome of the study also illustrated that inadequate infrastructure and facilities are the dominant variables that pushed physicians to foreign nations. It was revealed that there is a toxic mix of several issues that led to a brain drain albatross among the migrated physicians from Nigeria. The last part of the study indicated that physicians’ capacity development was a game changer that would discourage brain drain incidence and establish motivation for working in Nigeria's public health-care sector.

The study has given a direction for providing succinct solutions to the cankerworm of brain drain that has depleted the Nigerian public health-care industry. It has proffered a possible trajectory that will reverse the JAPA syndrome among the professional health-care workforce. This will not only benefit the public health-care personnel but also be significant for all the human capital across all the sectors of the national economy of Nigeria.

While spontaneous and voluntary knowledge contribution in online communities promotes value co-creation, dysfunctional knowledge behaviors hamper the effectiveness and development of such communities. The study conceptualizes physicians' proactive knowledge sharing and knowledge withholding behaviors in physician-driven online health communities (OHCs) and integrates the theories of role identity as well as communal and exchange relationships to understand the root causes and motivations behind these two types of knowledge behaviors.

The authors collected survey data from 166 users from one of the largest physician-driven OHCs in China and applied the covariance-based structural equation modeling approach to test the hypotheses.

The findings suggest that (1) physicians' professional role identity had a positive indirect effect on proactive knowledge sharing behaviors through communal motivation, and work pressure weakened this indirect effect; and (2) professional role identity had a negative indirect impact on knowledge withholding behaviors through exchange motivation.

This study extends proactive knowledge sharing and knowledge withholding behaviors from the organizational management domain to the online environment, exploring the underlying causes and motivations behind both behaviors in the unique context of physician-driven OHCs. The findings offer practical suggestions for the effective management of OHC platforms, as well as policy implications that respond to the workforce shortage of healthcare providers, a crisis that is unfolding globally.

This study aims to investigate the combined impact of pharmaceutical marketing strategies, specifically free drug samples and interactions with medical representatives, on physicians’ attitudes and prescribing behavior in Jammu and Kashmir, India.

To achieve this objective, data were collected from a sample comprising 425 physicians. A six-point forced-choice Likert scale was used for data collection, and cluster sampling techniques were used in the study design.

The study reveals significant insights into pharmaceutical marketing’s influence on physician behavior. Free drug samples exert a positive influence on both physician attitudes and prescribing behavior. Physicians’ attitudes, in turn, significantly affect their prescribing decisions. Mediation analysis demonstrates that free drug samples indirectly influence prescribing behavior through shifts in physician attitudes. Effective medical representatives amplify this influence, as stronger associations between free drug samples and physician attitudes are observed when representatives are more effective.

This research contributes by unraveling the intricate dynamics between marketing strategies, physician attitudes and prescribing behavior in Jammu and Kashmir, India. It underscores the importance of ethical pharmaceutical marketing practices, highlighting the substantial role of free drug samples and the crucial function of effective medical representatives in shaping physician behavior. Ultimately, this study sheds light on how responsible pharmaceutical marketing and adept medical representatives can improve health-care outcomes in the region.

Despite the unparalleled importance of value within healthcare, value-based models remain underutilised in the procurement of medical devices. Research is needed to understand what factors incentivise standard, low-priced device purchasing as opposed to value-adding devices with potentially higher overall health outcomes. Framed in agency theory, we examine the conditions under which different actors involved in purchasing decisions select premium-priced, value-adding medical devices over low-priced, standard medical devices.

We conducted 2 × 2 × 2 between-subjects scenario-based vignette experiments on three UK-based online samples of managers (n = 599), medical professionals (n = 279) and purchasing managers (n = 449) with subjects randomly assigned to three treatments: (1) cost-saving incentives, (2) risk-sharing contracts and (3) stronger (versus weaker) clinical evidence.

Our analysis demonstrates the harmful effects of intra-organisational cost-saving incentives on value-based purchasing (VBP) adoption; the positive impact of inter-organisational risk-sharing contracts, especially when medical professionals are involved in decision-making; and the challenge of leveraging clinical evidence to support value claims.

Our results demonstrate the need to align incentives in a context with multiple intra- and inter-organisational agency relationships at play, as well as the difficulty of reducing information asymmetry when information is not easily interpretable to all decision-makers. Overall, the intra-organisational agency factors strongly influenced the choices for the inter-organisational agency relationship.

We contribute to VBP in healthcare by examining the role of intra- and inter-organisational agency relationships and incentives concerning VBP (non-) adoption. We also examine how the impact of such mechanisms differs between medical and purchasing (management) professionals.

There is widespread concern about low adherence to clinical practice guidelines (CPGs) and the low adoption of new medical technologies. To assist the regulatory response, we propose benchmarking clinical practice on the lower bound on the probability that a recommended treatment/new technology achieves a better outcome. This inequality–probability bound can be estimated from marginal outcome distributions. We illustrate the approach by comparing Swedish cardiologists' adoption of drug-eluting stents (DESs) with the inequality–probability bound on this technology improving outcomes. A substantial fraction of cardiologists are below the benchmark.