Competition among physicians is widespread, but compelling empirical evidence on the impact on service provision is … limited, mainly due to lack of exogenous variation in the degree of competition. In this paper we exploit that many GPs, in … observe the same GP in two different competitive environments; with competition (own practice) and without competition …

as a wage determinant. We furthermore show that a promotion affects both intrinsic and extrinsic motivation significantly …, though in two different ways: An expected promotion increases extrinsic motivation whereas intrinsic motivation is highest … subsequent to a realized promotion. The relationship between extrinsic motivation and expected promotions implies that promotions …

Early studies often found that offering economic incentives for undertaking prosocial and intrinsically motivated … activities can crowd out motivation to perform these activities. More recent work highlights nuanced and important features … related to whether crowding out (or substitution) is likely to occur. In many cases, incentives succeed in encouraging more …