Financial Incentives and Prosocial Motivation Among Physicians in a Faith-Based Society

How do healthcare professionals respond to financial incentive within mission-driven public hospitals in a faith-based society? This paper challenges previous research findings that healthcare professionals in mission-driven hospitals are prosocially motivated to serve the poor patients, and that performance-based financial incentives tend to crowd out such motivation. We used data from fifty-six interviews with healthcare professionals from three tertiary public teaching hospitals in Peshawar, Pakistan, to investigate the effect of a performance-related pay scheme. We found that the high professional standards and strong religious beliefs of the physicians were key to maintaining their prosocial motivation to serve the poor patients in their communities. We conclude that financial incentive does not always erode prosocial motivation in public-sector organizations, and that prosocial motivation itself may be determined by professional and social context.