Speaker(s): Sean Nicholson (Wharton)
Title:
Abstract
Small-area-variation
studies have demonstrated that people receive a substantially different amount
of medical care depending on where they live, controlling for differences in
prices, income, and health. We
examine why physicians have such divergent views about the appropriateness and
efficacy of medical treatments, and whether physicians’ treatment styles
change over time. Using a data set
that contains the universe of deliveries in Florida over a 9-year period and
consistent physician identifiers, we find that obstetricians have distinct and
widely varying treatment styles. The
variation in risk-adjusted c-section rates across physicians within a region is
five times greater than the variation between regions.
Surprisingly, residency programs explain only two percent of the
variation between physicians in their risk-adjusted c-section rates.
Although treatment styles are quite stable over time, we find evidence
that physicians change their treatment style according to how their peers are
treating patients and, to a lesser extent, according to their patients’ health
outcomes.