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The Efficiency of Slacking off: Evidence From the Emergency Department

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  • David C. Chan

Abstract

Work schedules play an important role in utilizing labor in organizations. In this study of emergency department physicians in shift work, schedules induce two distortions: First, physicians “slack off†by accepting fewer patients near end of shift (EOS). Second, physicians distort patient care, incurring higher costs as they spend less time on patients assigned near EOS. Examining how these effects change with shift overlap reveals a tradeoff between the two. Within an hour after the normal time of work completion, physicians are willing to spend hospital resources more than six times their market wage to preserve their leisure. Accounting for overall costs, I find that physicians slack off at approximately second†best optimal levels.

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  • David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    • Handle: RePEc:wly:emetrp:v:86:y:2018:i:3:p:997-1030
    DOI: 10.3982/ECTA13565
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    1. Sam Watson’s journal round-up for 25th June 2018
      by Sam Watson in The Academic Health Economists' Blog on 2018-06-25 11:00:28

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    6. Moscelli, G.; & Sayli, M.; & Blanden, J.; & Mello, M.; & Castro-Pires, H.; & Bojke, C.;, 2023. "Non-monetary interventions, workforce retention and hospital quality: evidence from the English NHS," Health, Econometrics and Data Group (HEDG) Working Papers 23/13, HEDG, c/o Department of Economics, University of York.
    7. Maria R. Ibanez & Michael W. Toffel, 2020. "How Scheduling Can Bias Quality Assessment: Evidence from Food-Safety Inspections," Management Science, INFORMS, vol. 66(6), pages 2396-2416, June.
    8. Rachet-Jacquet, Laurie & Gutacker, Nils & Siciliani, Luigi, 2021. "Scale economies in the health sector: The effect of hospital volume on health gains from hip replacement surgery," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 704-729.
    9. David C Chan & Matthew Gentzkow & Chuan Yu, 2022. "Selection with Variation in Diagnostic Skill: Evidence from Radiologists [The Determinants of Productivity in Medical Testing: Intensity and Allocation of Care]," The Quarterly Journal of Economics, Oxford University Press, vol. 137(2), pages 729-783.
    10. Moscelli, Giuseppe & Sayli, Melisa & Blanden, Jo & Mello, Marco & Castro-Pires, Henrique & Bojke, Chris, 2023. "Non-monetary Interventions, Workforce Retention and Hospital Quality: Evidence from the English NHS," IZA Discussion Papers 16379, Institute of Labor Economics (IZA).
    11. Lawrence Jin & Rui Tang & Han Ye & Junjian Yi & Songfa Zhong, 2020. "Time Dependency in Physician Decision-Making," AEA Papers and Proceedings, American Economic Association, vol. 110, pages 284-288, May.
    12. Saravanan Kesavan & Susan J. Lambert & Joan C. Williams & Pradeep K. Pendem, 2022. "Doing Well by Doing Good: Improving Retail Store Performance with Responsible Scheduling Practices at the Gap, Inc," Management Science, INFORMS, vol. 68(11), pages 7818-7836, November.
    13. Farzad Zaerpour & Marco Bijvank & Huiyin Ouyang & Zhankun Sun, 2022. "Scheduling of Physicians with Time‐Varying Productivity Levels in Emergency Departments," Production and Operations Management, Production and Operations Management Society, vol. 31(2), pages 645-667, February.
    14. Elena Lucchese, 2024. "How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 652-673, April.
    15. Freedman, Seth & Golberstein, Ezra & Huang, Tsan-Yao & Satin, David J. & Smith, Laura Barrie, 2021. "Docs with their eyes on the clock? The effect of time pressures on primary care productivity," Journal of Health Economics, Elsevier, vol. 77(C).
    16. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2020. "Capacity constraints and time allocation in public health clinics," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 324-336, March.
    17. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2019. "Capacity Constraints and the Provision of Public Services: The Case of Workers in Public Health Clinics," NBER Working Papers 25706, National Bureau of Economic Research, Inc.

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