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Ethics and Incentives: An Evaluation and Development of Stakeholder Theory in the Health Care Industry

Published online by Cambridge University Press:  23 January 2015

Heather Elms ,
Shawn Berman  and
Andrew C. Wicks
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Abstract:

This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory’s focus on ethics, without recognition of the effects of incentives, severely limits the theory’s ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.

Type
Articles
Information
Business Ethics Quarterly , Volume 12 , Issue 4 , October 2002 , pp. 413 - 432
Copyright
Copyright © Society for Business Ethics 2002

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References

American Cancer Society. 1998. What Are the Key Statistics about Colorectal [Colon and Rectal] Cancer? American Cancer Society: www.cancer.org.Google Scholar
American Medical Association. 1997. Socioeconomic Characteristics of Medical Practice. Chicago: American Medical Association.Google Scholar
Angell, Maria. 1993. “The Doctor as Double Agent.” Kennedy Institute of Ethics Journal 3: 279–286.CrossRefGoogle ScholarPubMed
Azevedo, David. 1996. “Did an HMO Doctor’s Greed Kill Joyce Ching?” Medical Economics 73: 43–56.Google ScholarPubMed
Black, Henry C. 1968. Black’s Law Dictionary (Revised Fourth Edition). St. Paul, Minn.: West Publishing Co.Google Scholar
Bodenheimer, Thomas. 1999. “Physicians and the Changing Medical Marketplace.” New England Journal of Medicine 340: 584–588.CrossRefGoogle ScholarPubMed
Bowie, Norman E. and Freeman, R. Edward. 1992. “Ethics and Agency Theory: An Introduction.” In Bowie, N. E. and Freeman, R. E. (eds.), Ethics and Agency Theory: An Introduction. New York: Oxford University Press, 3–24.Google Scholar
Ching v. Gaines and Engeberg. 1995. California Superior Court, Ventura County, Case 137656.Google Scholar
Clarkson, Max B. E. 1991. “Defining, Evaluating, and Managing Corporate Social Performance: A Stakeholder Management Model.” In Post, J. E. (ed.), Research in Corporate Social Performance and Policy. Greenwich, Conn.: JAI Press, 331–358.Google Scholar
Collins, James and Porras, Jerry. 1994. Built to Last: Successful Habits of Visionary Companies. New York: HarperBusiness.Google Scholar
Davidson, David V., Knowles, Barbara E., and Forsythe, Lynne M. 1996. Business Law: Principles and Cases in the Legal Environment. Cincinnati: Southwestern College Publishing.Google Scholar
Donaldson, Thomas and Preston, Lee E. 1995. “The Stakeholder Theory of the Corporation: Concepts, Evidence, and Implications.” Academy of Management Review 20: 65–91.CrossRefGoogle Scholar
Donaldson, Thomas and Dunfee, Thomas W. 1994. “Towards a Unified Conception of Business Ethics: Integrative Social Contracts Theory.” Academy of Management Review 19: 252–284.Google Scholar
Eisenhardt, Kathleen M. and Bourgeois, L. Jay. 1988. “Politics of Strategic Decision Making in High Velocity Environments: Toward a Mid-range Theory.” Academy of Management Journal 31: 737–770.CrossRefGoogle Scholar
Eisenhardt, Kathleen M. 1989. “Building Theories from Case Research.” Academy of Management Review 14: 532–550.CrossRefGoogle Scholar
Emmons, David W. and Kletke, Phillip R. Forthcoming. “Physician Practice Size 1991–1995.” In Conners, Ronald (ed.), Organization and Management of Physician Services. Chicago: American Hospital Publishing.Google Scholar
Evan, William and Freeman, R. Edward. 1993. “A Stakeholder Theory of the Modern Corporation: Kantian Capitalism.” In Beauchamp, T. and Bowie, N. E. (eds.), Ethical Theory and Business. Englewood Cliffs, N.J.: Prentice-Hall, 75–84.Google Scholar
Fama, Eugene F. 1980. “Agency Problems and the Theory of the Firm.” Journal of Political Economy 88: 288–307.CrossRefGoogle Scholar
Fennell, Mary L. and Alexander, Jeff A. 1993. “Perspectives on Organizational Change in the US Medical Care Sector.” Annual Review of Sociology 19: 89– 112.CrossRefGoogle Scholar
Flood, Anne B. and Fennell, Mary L. 1995. “Through the Lenses of Organizational Sociology: The Role of Organizational Theory and Research in Conceptualizing and Examining Our Health Care System.” Journal of Health and Social Behavior (Extra Issue): 154–169.CrossRefGoogle ScholarPubMed
Freeman, R. Edward and Gilbert, Daniel. 1988. Corporate Strategy and the Search for Ethics. Englewood Cliffs: Prentice-Hall.Google Scholar
Freeman, R. Edward. 1994. “The Politics of Stakeholder Theory: Some Future Directions.” Business Ethics Quarterly 4: 409–421.CrossRefGoogle Scholar
Freeman, R. Edward. 1984. Strategic Management: A Stakeholder Approach. Boston: Pitman.Google Scholar
Friedman, Milton. 1970. “The Social Responsibility of Business Is to Increase Profits.” New York Times (13 September).Google Scholar
Gilbert, Daniel. 1992. The Twilight of Corporate Strategy. New York: Oxford University Press.Google Scholar
Gonzalez, Michael. 1997. Personal communication (by telephone), October 20.Google Scholar
Hardin, Russell. 1988. Morality within the Limits of Reason. Chicago: University of Chicago Press.Google Scholar
Hargadon, Andrew and Sutton, Robert. 1997. “Technology Brokering and Innovation in a Product Development Firm.” Administrative Science Quarterly 42: 716–749.Google Scholar
Henderson, Rebecca M. and Clark, Kim B. 1990. “Architectural Innovation: The Reconfiguration of Existing Product Technologies and the Failure of Established Firms.” Administrative Science Quarterly 35: 9–30.CrossRefGoogle Scholar
Hiepler, Mark O. 1997a. Anatomy of an HMO and New Theories of Liability against Specific HMO Entities. Unpublished manuscript.Google Scholar
Hiepler, Mark O. 1997b. Physician Liability in Managed Care. Unpublished manuscript.Google Scholar
Hoechst Marion Roussel. 1997. HMO-PPO Digest. Data provided by SMG Marketing Group. Kansas City: Hoechst Marion Roussel.Google Scholar
Jacobi, John V. 1997. “Patients at a Loss: Protecting Health Care Consumers through Data Driven Quality Assurance.” University of Kansas Law Review, 705–786.Google Scholar
Jones, Thomas M. 1995. “Instrumental Stakeholder Theory: A Synthesis of Ethics and Economics. Academy of Management Review 20: 404–437.Google Scholar
Jones, Thomas M. and Wicks, Andrew. 1999. “Convergent Stakeholder Theory.” Academy of Management Review 24: 206–222.CrossRefGoogle Scholar
Kerr, Eve, Mittman, Brian, Hays, Ron D., Siu, Albert L., Leake, Barbara, and Brook, Robert H. 1995. “Managed Care and Capitation in California: How Do Physicians at Financial Risk Control Their Own Utilization?” Annals of Internal Medicine 123: 500–504.CrossRefGoogle ScholarPubMed
Kieser, Alfred. 1994. “Why Organization Theory Needs Historical Analyses—and How This Should Be Performed.” Organization Science 5: 608–620.CrossRefGoogle Scholar
Klein, Benjamin, Crawford, Robert G., and Alchian, Armen A. 1978. “Vertical Integration, Appropriable Rents and the Competitive Contracting Process.” Journal of Law and Economics, 297–326.CrossRefGoogle Scholar
Krattenmaker, Thomas G. and Salop, Stephen C. 1986. “Anticompetitive Exclusion: Raising Rivals’ Costs to Achieve Power over Price.” Yale Law Journal 96: 209–293.CrossRefGoogle Scholar
Kwon, Michelle. 1997. “Move Over Marcus Welby, M.D., and Make Way for Managed Care: The Implications of Capitation, Gag Clauses, and Economic Credentialling.” Texas Tech Law Review 28: 829–859.Google Scholar
McGinley, James D. 1997. Personal communication (by telephone), November 24.Google Scholar
Miles, Robert H. and Cameron, Kim S. 1982. Coffin Nails and Corporate Strategies. Englewood Cliffs, N.J.: Prentice-Hall.Google Scholar
Miles, Robert H. 1987. Managing the Corporate Social Environment: A Grounded Theory Approach. Englewood, Cliffs, N.J.: Prentice-Hall.Google Scholar
Mitchell, Ronald K., Agle, Bradley R., and Wood, Donna J. 1997. “Toward a Theory of Stakeholder Identification and Salience: Defining the Principle of Who and What Really Counts.” Academy of Management Review 22: 853–886.CrossRefGoogle Scholar
Morgan, Gareth and Smircich, Linda. 1980. “The Case for Qualitative Research.” Academy of Management Review 5: 491–500.Google Scholar
Morreim, Haavi. 1992. Balancing Act: The New Medical Ethics of Medicine’s New Economics. Kluwer.Google Scholar
Olmos, David R. 1996. “Cutting Medical Costs—or Corners?” Los Angeles Times, May 5: A1, A18.Google Scholar
Paine, Lynne S. 1994. “Managing for Organizational Integrity.” Harvard Business Review 2: 106–17.Google Scholar
Palermo, B. J. 1996. “Capitation on Trial.” California Medicine, February: 25–29.Google Scholar
Phillips, Robert. 1997. “Stakeholder Theory and a Principle of Fairness.” Business Ethics Quarterly 7: 51–66.CrossRefGoogle Scholar
Picinic, Nancy J. 1997. “Physicians, Bound and Gagged: Federal Attempts to Combat Managed Care’s Use of Gag Clauses.” Seton Hall Legislative Journal 21: 567–619.Google ScholarPubMed
Robinson, James C. 1995. “Healthcare Purchasing Market Changes in California.” Health Affairs 14: 117–30.CrossRefGoogle ScholarPubMed
Robinson, James C. and Casalino, Lawrence P. 1995. “The Growth of Medical Groups Paid through Capitation in California.” New England Journal of Medicine 333: 1684–1687.CrossRefGoogle ScholarPubMed
Rodwin, Mark A. 1993. Medicine, Money, and Morals: Physicians’ Conflicts of Interest. New York: Oxford University Press.CrossRefGoogle Scholar
Rowley, Timothy. 1997. “Moving beyond Dyadic Ties: A Network Theory of Stakeholder Influences.” Academy of Management Review 22: 887–910.CrossRefGoogle Scholar
Selznick, Phillip. 1949. TVA and the Grassroots. Berkeley: University of California Press.Google Scholar
Starr, Paul. 1982. The Social Transformation of American Medicine. New York: Basic Books.Google Scholar
Stigler, George J. 1963. “United States v. Loew’s Inc.: A Note on Block-Booking.” Supreme Court Review.CrossRefGoogle Scholar
Sutton, Robert. 1997. “The Virtues of Closet Qualitative Research.” Organization Science 8: 97–106.CrossRefGoogle Scholar
Weaver, Gary and Trevino, Linda. 1994. “Normative and Empirical Business Ethics.” Business Ethics Quarterly 4: 129–144.CrossRefGoogle Scholar
Wicks, Andrew and Freeman, R. Edward. 1998. “Organization Studies and the New Pragmatism: Positivism, Anti-positivism, and the Search for Ethics.” Organization Science 9: 123–140.CrossRefGoogle Scholar
Wicks, Andrew. 1995. “The Business Ethics Movement.” Business Ethics Quarterly 5: 603–620.CrossRefGoogle Scholar
Yin, Robert. 1984. Case Study Research. Beverly Hills: Sage.Google Scholar