First Look

Abstract—As an aspiring product manager (PM), there are three primary considerations when evaluating the role: Core Competencies, Emotional Intelligence (EQ), and Company Fit. The best PMs have mastered the core competencies, have a high EQ, and work for the right company for them. The latter requires thinking about the level of technical skill the company requires, its philosophy of the PM role, the stage of the company, and the relationship you’ll have with senior management.

Publisher's link: http://www.hbs.edu/faculty/Pages/item.aspx?num=53689

Abstract—We review the extensive literature since 2000 on the personality traits of entrepreneurs. We first consider baseline personality traits like the Big-5 model, self-efficacy and innovativeness, locus of control, and the need for achievement. We then consider risk attitudes as well as the goals and aspirations of entrepreneurs. Within each area, we separate studies by the type of entrepreneurial behavior considered: entry into entrepreneurship, performance outcomes, and exit from entrepreneurship. This literature shows common results and many points of disagreement, reflective of the heterogeneous nature of entrepreneurship. We label studies by the type of entrepreneurial population studied (e.g., Main Street vs. those backed by venture capital) to identify interesting and irreducible parts of this heterogeneity, while also identifying places where we anticipate future large-scale research and the growing depth of the field are likely to clarify matters. There are many areas, like how firm performance connects to entrepreneurial personality, that are woefully understudied and ripe for major advances if the appropriate cross-disciplinary ingredients are assembled.

Publisher's link: https://www.hbs.edu/faculty/Pages/item.aspx?num=53682

Abstract—Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in obtaining a head CT and investigate patient waiting time based on those bottlenecks. Methods: This observational study included all patients undergoing a head CT between July 1, 2013 and June 30, 2014 at a large, urban academic ED with over 100,000 visits per year. The primary study outcome was total cycle time, defined as the elapsed time between patient arrival and head CT preliminary report, divided into four components of workflow. Results: 8,312 patients who had a head CT were included in this study. The median cycle time from patient arrival to head CT preliminary report was 3 h and 13 min with 39 min of waiting time resulting from bottlenecks. In the 4-step model (time from patient arrival to head CT order, time from head CT order to head CT scheduled, time from head CT scheduled to head CT completed, and time from head CT completed to head CT preliminary report), each process was the bottleneck 30%, <1%, 27%, and 42% of the time, respectively. Conclusion: Demand capacity mismatch in head CT scanning has a significant impact on patient waiting times. This study suggests opportunities to improve wait times through future research to understand the causes of delays in CT ordering, CT completion, and timeliness of radiology reports.

Publisher's link: https://www.hbs.edu/faculty/Pages/item.aspx?num=53695

Abstract—Purpose: Despite growing interest in bundled payments to reduce the costs of care, this payment method remains largely untested in cancer. This 3-year pilot tested the feasibility of a 1-year bundled payment for the multidisciplinary treatment of head and neck cancers. Methods: Four prospective treatment-based bundles were developed for patients with selected head and neck cancers. These risk-adjusted bundles covered 1 year of care that began with primary cancer treatment. Manual processes were developed for patient identification, enrollment, billing, and payment. Patients were prospectively identified and enrolled, and bundled payments were made at treatment start. Operational metrics tracked incremental effort for pilot processes and average payment cycle time compared with fee-for-service (FFS) payments. Results: This pilot confirmed the feasibility of a 1-year prospective bundled payment for head and neck cancers. Between November 2014 and October 2016, 88 patients were enrolled successfully with prospective bundled payments. Through September 2017, 94% of patients completed the pilot with 6% still enrolled. Manual pilot processes required more effort than anticipated; claims processing was the most time-consuming activity. The production of a bundle bill took an additional 15 minutes versus FFS billing. The average payment cycle time was 37 days (range, 15 to 141 days) compared with a 15-day average under FFS. Conclusion: Prospective bundled payments were successfully implemented in this pilot. Additional pilots should study this payment method in higher-volume cancers. Robust systems are needed to automate patient identification, enrollment, billing, and payment along with policies that reduce administrative burden and allow for the introduction of novel cancer therapies.

Publisher's link: https://www.hbs.edu/faculty/Pages/item.aspx?num=53706

Abstract—We consider the real effects of bank lending shocks and how they permeate the economy through buyer-supplier linkages. We combine administrative data on all firms in Spain with a matched bank-firm-loan dataset incorporating information on the universe of corporate loans for 2003–2013. Using methods from the matched employer-employee literature for handling large data sets, we identify bank-specific shocks for each year in our sample. Combining the Spanish input-output structure and firm-specific measures of upstream and downstream exposure, we construct firm-specific exogenous credit supply shocks and estimate their direct and indirect effects on real activity. Credit supply shocks have sizable direct and downstream propagation effects on investment and output throughout the period but no significant impact on employment during the expansion period. Downstream propagation effects are quantitatively larger in magnitude than direct effects. The results corroborate the importance of network effects in quantifying the real effects of credit shocks and show that real effects vary during booms and busts.

Download working paper: https://www.hbs.edu/faculty/Pages/item.aspx?num=53681

Abstract—This paper investigates whether people exhibit last place aversion in queues and its implications for their experiences and behaviors in service environments. An observational analysis of customers queuing at a grocery store, and three online field experiments in which participants waited in virtual queues, revealed that waiting in last place diminishes wait satisfaction while increasing the probabilities of switching and abandoning queues. After controlling for other factors, people in last place were more than twice as likely to switch queues, which increased the duration of their wait and diminished their overall satisfaction. Moreover, people in last place were more than four times more likely to renege from queues, altogether giving up on the service for which they were queuing. The results indicate that this behavior is partially explained by the inability to make a downward social comparison; namely, when no one is behind a queuing individual, that person is less certain that continuing to wait is worthwhile. Furthermore, this paper provides evidence that queue transparency is an effective service design lever that managers can use to reduce the deleterious effects of last place aversion in queues. When people can’t see that they’re in last place, the behavioral effects of last place aversion are nullified, and when they can see that they’re not in last place, the tendency to renege is greatly diminished.

Download working paper: https://www.hbs.edu/faculty/Pages/item.aspx?num=53685

Abstract—We use an experiment to show that employers prefer to hire male over female workers for a male-typed task even when they have identical resumes. Using a novel control condition, we document that this discrimination is not specific to gender. Employers are simply less willing to hire a worker from a group that performs worse on average, even when this group is instead defined by birth month, a non-stereotypical characteristic. A reluctance to discriminate emerges if workers share the gender or birth month of the worker from the worse-performing group, but even then, a small "excuse" counters this reluctance.

Download working paper: http://www.hbs.edu/faculty/Pages/item.aspx?num=53686

Abstract—Individuals frequently exploit "flexibility" built into decision environments to give less. They use uncertainty to justify options benefiting themselves over others, they avoid information that may encourage them to give, and they avoid the ask itself. In this paper, we examine whether a reluctance to give may arise even when such explicit flexibility is absent. We investigate whether merely alerting individuals to an upcoming prosocial ask—that is neither avoided nor occurs in an environment with flexibility—results in reduced prosocial behavior. That is, we investigate whether individuals use time to quickly find ways to decline prosocial asks and thus whether surprising individuals with prosocial asks increases compliance. Results from a field study and complementary online studies provide a clear answer: yes.

Download working paper: https://www.hbs.edu/faculty/Pages/item.aspx?num=50771

Abstract—We give a direct proof of one-sided strategy-proofness for worker–firm matching under continuously transferable utility. A new "Lone Wolf" theorem, Jagadeesan et al. (2017), for settings with transferable utility allows us to adapt the method of proving one-sided strategy-proofness that is typically used in settings with discrete transfers.

Download working paper: https://www.hbs.edu/faculty/Pages/item.aspx?num=53172

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In 2017, management at Poppy, which matched families that required occasional childcare with thoroughly vetted caregivers, was formulating plans for the Seattle-based seed-stage startup’s next phase of expansion. One option was to grow using the same business model through geographic expansion to cities beyond Seattle. Another option was to deepen penetration within Seattle by recruiting caregivers with less experience and by broadening the range of services caregivers could provide, e.g., driving children to appointments.

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