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Why Are Residents Reluctant to Consult Attending Physicians?

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  • Otto H. Swank

    (Erasmus University Rotterdam)

Abstract

A physician performs two tasks: making diagnoses and determining treatments. To reduce medical error, residents are supposed to consult their supervisors when they face uncommon circumstances. However, recent research shows that residents are reluctant to do so. This paper presents a model that explains (i) which residents shy away from consulting; (ii) when residents are reluctant; (iii) the importance of protocols in the medical sector; and (iv) when consulting is a sign of strength or a sign of weakness. Furthermore, I show that encouraging residents to consult by investigating mishaps leads to another distortion: residents will give too much weight to own assessments.

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Bibliographic Info

Paper provided by Tinbergen Institute in its series Tinbergen Institute Discussion Papers with number 09-042/1.

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Date of creation: 14 May 2009
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Handle: RePEc:dgr:uvatin:20090042

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Web page: http://www.tinbergen.nl

Related research

Keywords: Medical error; medical decision-making; reputational concerns; consulting;

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  1. Canice Prendergast, 2003. "The Limits of Bureaucratic Efficiency," Journal of Political Economy, University of Chicago Press, vol. 111(5), pages 929-958, October.
  2. Bauke Visser & Otto H. Swank, 2005. "On Committees of Experts," Tinbergen Institute Discussion Papers 05-028/1, Tinbergen Institute.
  3. Ottaviani, Marco & Sorensen, Peter, 2001. "Information aggregation in debate: who should speak first?," Journal of Public Economics, Elsevier, vol. 81(3), pages 393-421, September.
  4. Shachar Kariv, 2005. "Overconfidence and Informational Cascades," Levine's Bibliography 122247000000000406, UCLA Department of Economics.
  5. Holmstrom, Bengt, 1999. "Managerial Incentive Problems: A Dynamic Perspective," Review of Economic Studies, Wiley Blackwell, vol. 66(1), pages 169-82, January.
  6. Luis Garicano, 2000. "Hierarchies and the Organization of Knowledge in Production," Journal of Political Economy, University of Chicago Press, vol. 108(5), pages 874-904, October.
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