Effective Contract and Motivation: Can Reforms Improve the Work of Russian Doctors?

Publication type Article
Status Published
Occupation: Chief Researcher
Affiliation: Institute of sociology of FCTAS RAS
Address: Russian Federation, Moscow
Occupation: Head of department of Health Care Administration and Economy, Director of the Centre for Health Policy
Affiliation: National Research University Higher School of Economics
Address: Russian Federation, Moscow
Journal nameSotsiologicheskie issledovaniya
EditionIssue 5

Since 2012 the reform of the salary system of workers in the budgetary sphere, called the introduction of an effective contract, has been implemented in Russia. The paper presents the results of a study of the reform impact on the labor motivation of physicians. Empirical data are obtained by conducting in-depth interviews with physicians and heads of state medical institutions in Moscow and one of the regions in the European part of the country in 2016. The study revealed multidirectional impact for physicians’ readiness to work more and better by effective contract. There are three groups of doctors. The first and largest group: physicians who free a positive impact of motivation incentives for physicians’ motivation at work. The second group: physicians who are convinced that an effective contract does not affect their motivation. The third group: physicians who believe that effective contract has led to a weakening of physicians’ motivation. The article gives an explanation of the results of the study. Results of the study also clearly show that the changes in the physician’s remuneration system aimed exclusively on the growth of salary of doctors are necessary, but not sufficient. The impact of an effective contract on the achievement motivation (the desire to improve their professional capabilities and results) was different for experienced and young doctors. The most pronounced increase in the achievement motivation was observed for the majority of young doctors. A special part of the research paper was devoted to informal payments which influence physicians’ motivation. The research has shown that these payments may smooth motivational effect caused by the new rules of remuneration. This fact is typical for Moscow, while in the region, this effect is not cleary expressed.

Keywordsphysicians’ motivation, effective contract, achievement motivation, informal payments
AcknowledgmentWith the support of HSE Academic Fund Programme.
Publication date05.06.2019
Number of characters24828
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