Halos and Egos: Rankings and Interspecialty Deference in Multispecialty U.S. Hospitals

This paper examines how media rankings shift patterns of collaboration and deference between professional groups within organizations. Diversified and multidisciplinary organizations such as universities and hospitals often face distinct subunit evaluations that can influence coordination on interdependent tasks. Using patient-level treatment data for more than five million in-patient stays, I find that changes in the “best hospitals” rankings do not meaningfully shift treatment patterns by physicians in hospitals. However, when specialties were ranked in the top echelons (i.e., top 10) or had high categorical prestige, they were less likely to involve other specialties (i.e., ego effect) and had a higher chance of performing procedures on patients admitted in other specialties (i.e., halo effect). These effects were mostly confined to minor (i.e., less invasive) procedures, implying that the impact of external rankings on patient outcomes is relatively benign. This paper was accepted by Olav Sorenson, organizations.