1. Gender Difference in Perception of Incentive Compensation Systems by Academic Family Medicine Faculty: A CERA study Deanna R Willis MD MBA Jane Williams PhD MS Kevin Gebke MD George Bergus MD MA-Ed

2. Disclosures Deanna Willis has the following disclosures: – Stockholder in Topera (medical device company for treatment of atrial fibrillation) – Non paid public service spokesperson for stop smoking campaign. Media relations services were provided by Pfizer

3. Background Incentive compensation systems (ICS) in academic medicine has been a topic of interest for years Self-determination theory suggests autonomous motivation can be harmed by ICS Systematic review 1 showed positive: – Financial impact – Clinical productivity – Scholarly activity 1 Andreae MC, Blad K, Cabana MD. Physician compensation programs in academic medical centers. Health Care Manage Rev. 2006 Jul-Sep;31(3):251-8.

4. Background Little is known about gender based perception of ICS systems – Bocoum YF et al. Which Incentive package will retain regionalized health personnel in Burkina Faso: A Discrete Choice Experiment. Hum Resourc Health. 2014 May 12; 12 Suppl 1: S7 2 Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary care in England. N Engl J Med. 2009 Jul 23;361(4):368-78.

5. Background Organizational psychology principles related to satisfaction, motivation, and retention: – Knowledge of the ICS – Positive perception of due process (adequate notice, fair judgment and fair hearing) – Perceived validity – Procedural justice – Distributive justice – Alignment with strategic objectives

6. Methods CAFM CERA omnibus survey Spring 2013 Active members of CAFM organizations: – STFM, ADFM, AFMRD, NAPCRG Active member=attended a CAFM organization meeting since 1/1/2010 or listed as a member of committee or group within a CAFM organization Email survey with personalized greeting, letter from President of CAFM organizations, link to survey Non-responders sent two follow up emails

7. Method 35 survey question set Embedded in the CAFM CERA omnibus survey Focused on aspects of ICS design and implementation and the relationship to individual faculty satisfaction, motivation, and retention – Perceived appropriateness/validity/credibility – Understanding of ICS – Due process (adequate notice, fair distribution, appeal mechaism, timely/frequent reporting, meaningful input, applied consistency, strategic alignment)

8. Results Overall response rate 52.9% – 581 respondents out of 1099 potential ICS subset response rate 46.5%

10. Results: Motivation Comparing Male and Female respondents on “My ICS system motivates me to give more time or energy to certain activities” Scale of 1-5 with 1 being Strongly Disagree, 3 being neutral, and 5 being strongly agree 193 male respondents 131 female respondents T test assuming equal variance: p=0.03

11. Results: Teamwork Comparing Male and Female respondents on “Our ICS has increase teamwork in our unit” Scale of 1-5 with 1 being Strongly Disagree, 3 being neutral, and 5 being strongly agree 195 male respondents 131 female respondents T test assuming equal variance: p=0.02

12. Results: Retention Response to “Our ICS increases the likelihood that I will stay with my current employer.” Those who agreed or strongly agreed versus those who strongly disagreed, disagreed, or were neutral 168 male respondents 106 female respondents Chi Square: p=0.05

13. Discussion Important differences in how male and female family medicine faculty perceive ICS systems related to: – Motivation – Teamwork – Retention

14. Discussion: Potential Weaknesses Female Respondents may perceive less influence of ICS on motivation and teamwork because of lesser amounts of their total compensation being in ICS CAFM constituency leads to high number of academic leaders as respondents

15. Conclusions First study to explore relationship of gender to perceptions of ICS Further research is needed to understand why gender differences exist in perceptions of motivation, teamwork, and retention