Mar 14, 2018 - Clinical Fellow in Medicine, Harvard Medical School, 2015-Present. Education ... better, with health faci
Scott S. Lee Brigham and Women’s Hospital 75 Francis Street Boston, MA 02115
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Employment Resident in Internal Medicine (Primary Care Track), Brigham and Women’s Hospital, 2015-Present. References: Bill Taylor Brigham and Women’s Hospital [email protected]
Joel Katz Brigham and Women’s Hospital [email protected]
Clinical Fellow in Medicine, Harvard Medical School, 2015-Present.
Education Ph.D. Health Policy and Management, Harvard Graduate School of Arts and Sciences and Harvard Business School, 2015. Thesis Title: “Three Field Experiments on Incentives for Health Workers” References: Nava Ashraf London School of Economics [email protected]
Paul Farmer Harvard Medical School [email protected]
Michael Kremer Harvard University [email protected]
Rob Huckman Harvard Business School [email protected]
M.D. Harvard Medical School, 2015. M.P.A. Development Studies, Princeton University, Woodrow Wilson School of Public and International Affairs, 2006. M.Phil. Environment and Development, Highest Honors, University of Cambridge, 2004. A.B. Anthropology and Religion, summa cum laude, Certificate in African Studies, Harvard College, 2003.
Economics Publications and Work in Progress (* Denotes alphabetical authorship and equal contribution to work) Lee SS. “Intrinsic Incentives: A Field Experiment on Leveraging Intrinsic Motivation in Public Service Delivery,” January 2018, 1–44. (Job Market Paper) Although extrinsic and intrinsic motivation likely jointly explain the effort of many agents engaged in public service delivery, canonical models of incentives in firms focus on the former. In the context of a rural health worker program in India, I develop and test a novel
Scott S. Lee
mobile phone app designed to increase agents’ intrinsic returns to effort. At one year of follow-up, the self-tracking app leads to a 24% increase in performance as measured by the main job task (home visits). Moreover, the app is most effective when it leverages pre-existing intrinsic motivation: it produces a 41% increase in performance in the top tercile of intrinsically motivated workers, but no improvement in the bottom tercile. This treatment effect persists over time for the most intrinsically motivated workers, whereas early improvements decay among the most extrinsically motivated workers. Supplementary evidence suggests that the treatment effect on performance is mediated primarily by making effort more intrinsically rewarding, and not by other mechanisms such as the provision of implicit extrinsic incentives. Despite these effects on worker performance, I find no effect on health outcomes. Ashraf N, Bandiera O, Lee SS. “Awards Unbundled: Evidence from a Natural Field Experiment,” Journal of Economic Behavior and Organization, 100 (April 2014): 44–63.* Organizations often use non-monetary awards to incentivize performance. Awards may affect behavior through several mechanisms: by conferring employer recognition, by enhancing social visibility, and by facilitating social comparison. In a nationwide health worker training program in Zambia, we design a field experiment to unbundle these mechanisms. We find that employer recognition and social visibility increase performance while social comparison reduces it, especially for low-ability trainees. These effects appear when treatments are announced and persist through training. The findings are consistent with a model of optimal expectations in which low-ability individuals exert low effort in order to avoid information about their relative ability. Ashraf N, Bandiera O, Lee SS. “Losing Prosociality in the Quest for Talent?: Sorting, Selection, and Productivity in the Delivery of Public Services” (Previously, “Do-Gooders and Go-Getters: Career Incentives, Selection, and Performance in Public Service Delivery”), March 2018. Working paper, 1– 59.* Incentives affect not only the effort of agents on the job, but also the selection of agents into the job. In health care, one particular dilemma is that lucrative financial incentives may attract workers whose goals are not aligned with the service mission of health care delivery. In conjunction with the Government of Zambia, we experimentally vary the salience of career benefits (i.e., opportunities for promotion) during a national recruitment drive for a newly created health worker position. In so doing, we provide the first experimental evidence on whether incentives for health care providers attract different agents and whether this selection affects performance. Totaling three years of follow-up, we measure outcomes over a six-month recruitment period, a twelve-month training period, and an eighteen-month deployment period. We find that advertising career incentives attracts health workers who have higher skills, are equally prosocial, are more likely to stay in the job, and perform better, with health facility and household survey data showing substantial improvements in an array of health outcomes. In rural settings, where health worker shortages are often a binding constraint, providing career opportunities—and advertising these at the recruitment stage—may be an effective strategy for improving health care delivery. Impact of worker autonomy and empowerment on heath worker performance in Zambia (field experiment), with Nava Ashraf and Oriana Bandiera. Impact of a community-based early childhood development mobile phone application on child health and development in rural Kenya (field experiment).
Other Peer-Reviewed Publications DeRenzi B, Dell N, Wacksman J, Lee SS, Lesh N. “Supporting Community Health Workers in India through Voice- and Web-Based Feedback,” Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems, May 2017: 2770-2781.
Scott S. Lee
DeRenzi B, Wacksman J, Dell N, Lee SS, Lesh N, Borriello G, Ellner A. “Closing the Feedback Loop: A 12-month Evaluation of ASTA, a Self-Tracking Application for ASHAs,” Proceedings of the Eighth International Conference on Information and Communication Technologies and Development, June 2016: 1-10. Palazuelos D, Ellis K, Im DD, Peckarsky M, Schwarz D, Farmer DB, Dhillon R, Johnson A, Orihuela C, Hackett J, Bazile J, Berman L, Ballard M, Panjabi R, Ternier R, Slavin S, Lee SS, Selinsky S, Mitnick CD. “5-SPICE: The Application of an Original Framework for Community Health Worker Program Design, Quality Improvement, and Research Agenda-Setting,” Global Health Action, 2013, 6: 1-12.
Other Publications Whidden C, Kayentao K, Liu JX, Lee SS, Keita Y, Diakité D, Keita A, Diarra S, Edwards J, Yembrick A, Holeman I, Samaké S, Johnson A. “Improving Community Health Worker Performance Using a Supervision mHealth Visual Dashboard Tool: A Randomized Controlled Trial,” December 2017. Manuscript. Ellner A, Pace C, Lee SS, Weigel J, Farmer P. “Embracing Complexity: Towards Integrated Biosocial Platforms for Health Service Delivery,” In Structural Approaches in Public Health, Marni Sommer and Richard Parker, Eds. Routledge Press, 2013. Porter M, Lee SS, Rhatigan J, Kim JY. “Partners In Health: HIV Care in Rwanda,” Harvard Business School Case 709-474, 2010.
Teaching Experience Core Medicine Rotation, Principal Clinial Experience, Harvard Medical School. 2015–Present. Medicine Sub-Internship, Harvard Medical School. 2016–2017. Teaching Fellow, Harvard University, Economics 1460: The Economics of Health Care Policy. Spring 2013. Instructor: Joseph Newhouse. TF Rating: 5.0/5.0 (all TF mean: 4.34/5.0).
Grants USAID Development Innovation Ventures. Recruiting and Motivating Community Health Workers: A Nationwide Household Survey, 2015-Present. $898,902. (Co-Principal Investigator, with Nava Ashraf and Oriana Bandiera.) International Growth Center. Nationwide household survey to evaluate the impact of Zambia’s national community health worker program, 2014–2016. $118,820. (Co-Principal Investigator, with Nava Ashraf and Oriana Bandiera.) Grand Challenges Canada, Saving Brains Initiative. Impact of community-based early childhood development screening on child health and development in Kenya, 2013–2015. $270,000. (Principal Investigator.) Weiss Family Program Fund. Impact of intrinsic incentives on the performance of community health workers in India, 2013–2015. $33,912. (Principal Investigator.) USAID Development Innovation Ventures. Impact of non-monetary incentives on the performance of health trainees in Zambia, 2012–2014. $100,000. (Co-Principal Investigator, with Nava Ashraf and Oriana Bandiera.)
Scott S. Lee
Abdul Latif Jameel Poverty Action Lab. Impact of worker autonomy and empowerment on the performance of community health workers in Zambia, 2012–2014. $250,000. (Co-Principal Investigator, with Nava Ashraf and Oriana Bandiera.) UBS Optimus Foundation. Developing a mobile phone platform for community health workers in Kenya, 2012–2014. $125,000. (Principal Investigator.) Massachusetts General Hospital, Center For Global Health. Developing a mobile phone platform for community health workers in India and Kenya, 2012–2014. $100,000. (Principal Investigator.) International Growth Center. Impact of career incentives on the selection and performance of health workers in Zambia, 2010–2013. $369,448. (Co-Principal Investigator, with Nava Ashraf and Oriana Bandiera.)
Research and Service Experience Recruitment Chair, Atrius Health Residency Program in Primary Care, 2015–Present. Curriculum Co-Chair, Atrius Health Residency Program in Primary Care, 2015–Present. Co-Founder and President, Common Hope for Health, 2006–Present. Adviser, Ugunja Community Resource Center (Ugunja, Kenya), 2001–Present. Research Assistant, Michael Kremer, Harvard University, 2009–2011. Non-Resident Tutor in Medicine, Harvard College, 2006–2010. Policy Analyst, World Health Organization, Department of HIV/AIDS, 2005. Research Assistant, Partners In Health, 2000–2003.
Professional Affiliations Member, American Economic Association, 2013–Present. Research Network Member, Innovations for Poverty Action, 2010–Present.
Referee Service New England Journal of Medicine Review of Economics and Statistics Journal of Development Economics Journal of Economic Behavior and Organization Healthcare: The Journal of Delivery Science and Innovation Innovations for Poverty Action, Institutional Review Board USAID Development Innovation Ventures
Scott S. Lee
Presentations 2017: Northeast Universities Development Conference; Harvard University Department of Economics, Development Seminar. 2015: Harvard University Department of Economics, Development Lunch; Harvard University Department of Economics, Organizational Economics Lunch; Harvard Medical School Department of Health Care Policy, Research Seminar; Harvard Medical School, Physician as Leader (course). 2014: World Bank, Development Impact Evaluation (DIME) Seminar; Harvard University Department of Economics, Development Lunch. 2013: Harvard Medical School Department of Health Care Policy, Research Seminar.
Honors and Awards Paul and Daisy Soros Fellowship for New Americans, 2007–2009. Dean’s Community Service Award, Harvard Medical School, 2008. Gates Cambridge Scholarship, 2003–2004. Phi Beta Kappa, Harvard College, 2003. Thomas Temple Hoopes Prize, Harvard College, 2003. W.E.B. DuBois Prize for top student in African Studies, Harvard College, 2003. Rudolph Virchow Prize for top undergraduate thesis, Society for Medical Anthropology, 2003. John Harvard Scholarship, Harvard College, 2000–2003. Last updated: March 14, 2018