Physician Compensation Supply of Medical Services

When making treatment choices, do physicians consider patient health and economic impacts?

A paper by Ge et al. (2022) aims to answer this question with a discrete choice experiment survey of medical students at Shandong University in China. Respondents had to select a preferred treatment which varied over 3 dimensions: profit to the physician, patient health benefit, and patient financial cost. The paper abstract is below:

The assumption of patient-regarding physicians has been widely adopted in the health economics literature. Physicians’ patient-regarding preferences are often described as the concern for the health benefits of medical treatments, and thus closely related to the norms and ethics of the medical profession. In this paper, we ask whether physicians’ patient-regarding preferences include a concern for their patient’s consumption opportunities alongside patient’s health benefits. To identify and quantify physicians’ preferences, we design and conduct an incentivized laboratory experiment where choices determine separately the health benefits and the consumption opportunities of a real patient admitted to the nearest hospital. We find strong evidence that future physicians care about their patients’ consumption opportunities.

This study does have a number of key limitations. One key limitation of the study is that respondents are explicitly presented with treatments that vary over these 3 dimensions. In the real world, physicians may not consider financial implications for patients, or may only do so for the poorest patients. Second, the respondents are medical studies. As medical studies are likely less wealthy than regular physicians, they may be more sensitive to patients’ financial situation compared to regular physicians. Nevertheless, the findings are interesting. Ellis and McGuire (1990) created a framework where physicians care about their profits and health benefits; based on the results from Ze et al. (2022), one may also have to add some altruistic parameter into the physician’s utility function for a treatment’s impact on patient finances.

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