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A Doctor Will See You Now: Physician-Patient Relationships and Clinical Decisions

Author

Listed:
  • Erin Johnson
  • M. Marit Rehavi
  • David C. Chan, Jr
  • Daniela Carusi

Abstract

We provide novel estimates of the causal impact of physician-patient relationships on physicians’ decisions. Exploiting quasi-random assignment of patients to OBs at childbirth, we find OBs are 25% likelier to perform C-sections when delivering patients they have a preexisting clinical relationship with (their “own patients”). This effect is increasing in the relationship’s strength. OBs also curtail labor sooner, are less likely to employ other invasive procedures (e.g., vacuum or forceps), and avoid complications of long and difficult births for their own patients.

Suggested Citation

  • Erin Johnson & M. Marit Rehavi & David C. Chan, Jr & Daniela Carusi, 2016. "A Doctor Will See You Now: Physician-Patient Relationships and Clinical Decisions," NBER Working Papers 22666, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:22666
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    References listed on IDEAS

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    1. Ity Shurtz, 2014. "Malpractice Law, Physicians' Financial Incentives, and Medical Treatment: How Do They Interact?," Journal of Law and Economics, University of Chicago Press, vol. 57(1), pages 1-29.
    2. Diane Alexander, 2013. "Does Physician Compensation Impact Procedure Choice and Patient Health?," Working Papers 1475, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    3. Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
    4. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    5. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    6. Diane Alexander, 2015. "Does Physician Pay Affect Procedure Choice and Patient Health? Evidence from Medicaid C-section Use," Working Paper Series WP-2017-7, Federal Reserve Bank of Chicago.
    7. Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
    8. George Loewenstein, 2000. "Emotions in Economic Theory and Economic Behavior," American Economic Review, American Economic Association, vol. 90(2), pages 426-432, May.
    9. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    10. Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
    11. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
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    Cited by:

    1. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    2. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    3. Chen, Stacey H. & Chen, Jennjou & Chuang, Hongwei & Lin, Tzu-Hsin, 2023. "Physicians Treating Physicians: Relational and Informational Advantages in Treatment and Survival," IZA Discussion Papers 16048, Institute of Labor Economics (IZA).
    4. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).
    5. Juan‐José Díaz & Victor Saldarriaga, 2019. "Encouraging use of prenatal care through conditional cash transfers: Evidence from JUNTOS in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1099-1113, September.

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

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