Northwestern Kellogg School of Management, United States
Organizations are increasingly relying on less-credentialed workers to carry out work that has traditionally been performed by experts, such as lawyers, accountants, or physicians. This causes a restructuring of work within the organization, which has implications for experts’ behavior and performance. In this study, we propose that the use of less-credentialed workers prompts experts to focus on performing tasks that differentiate themselves from the other workers. The experts’ increased specialization stimulates the repeated use and provision of these differentiated tasks, even for clients who may benefit from simpler tasks and services. We suggest that this indicates the routinization of their expertise. Furthermore, we expect that the mismatch between experts’ specialization and clients’ needs will reduce worker performance and service quality. Using a difference-in-differences framework, we examine these propositions by exploring the introduction of obstetric nurses in hospitals in Brazil and its impact on the behavior and performance of obstetricians-gynecologists. We find that obstetricians-gynecologists are more likely to perform a caesarian section following the introduction of obstetric nurses in a hospital, resulting in worse care for low-risk births. This study highlights how the use of less-credentialed workers can increase experts’ specialization while reducing experts’ performance.