Provider Decision Making and Patient Outcomes
*Names in bold indicate Presenter
The first two papers examine the effect of time pressure on primary care physicians, exploiting detailed appointment schedule information to observe how physicians respond to unanticipated, but common shocks – including no-shows, same-day cancellations, walk-in appointments, and late patients. Results show that time-constrained primary care physicians spend less time with patients, perform fewer procedures, record fewer diagnoses, and refer patients to specialists more often. Time-constrained physicians also modify their prescribing behavior in ways of particular concern to policymakers, including increases in potentially inappropriate antibiotic and opioid prescribing.
The third paper studies the behavior of busy physicians in a common inpatient setting: childbirth. Unlike the primary care context in which appointments are generally scheduled in advance, OBGYNs may be more or less busy, based on the number of women in labor at any given time. This paper finds that busy physicians are considerably more likely to perform discretionary Cesarean deliveries, particularly for patients at low risk of birth complications.
Taken together, these papers suggest that physicians respond to time pressure in ways that may increase health care spending and/or reduce the quality of care and negatively affect patient outcomes. The findings presented in this panel are particularly relevant for policymakers considering medical workforce adequacy and regulation.