IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this article or follow this journal

Issues in the Industrial Organization of the Market for Physician Services

  • Gaynor, Martin

What is the nature of the industrial organization of the market for physician services? Is the market 'competitive?' Are there pareto-relevant market failures, such that there is room for welfare improving policies? Economists have devoted a great deal of attention to this market, but it remains relatively poorly understood. Some background on early studies of this market is presented. The nature of the product being bought and sold, and of demand, are then characterized, in order to establish the character of this market. The key features of this market are that the product being sold is a professional service, and the pervasive presence of insurance for consumers. A professional service is inherently heterogeneous, non-retradable, and subject to an asymmetry of information between buyers and sellers. These characteristics are what bestow market power on sellers, further strengthened by the fact that consumers face only a small fraction of the price of any service due to insurance. The implications of this for agency relationships between patients and physicians, and insurers (both private and public) and physicians are then discussed. Agency relationships within physician firms are also considered. Both theoretical and empirical modelling of contracting between insurers and physicians and of the joint agency problems between patient and physician and insurer and physician are recommended as areas for future research. Since failures in this market are seen to derive largely from the structure of information, the potential gains from government intervention may be sharply circumscribed.

(This abstract was borrowed from another version of this item.)

To our knowledge, this item is not available for download. To find whether it is available, there are three options:
1. Check below under "Related research" whether another version of this item is available online.
2. Check on the provider's web page whether it is in fact available.
3. Perform a search for a similarly titled item that would be available.

Article provided by Wiley Blackwell in its journal Journal of Economics & Management Strategy.

Volume (Year): 3 (1994)
Issue (Month): 1 (Spring)
Pages: 211-55

as
in new window

Handle: RePEc:bla:jemstr:v:3:y:1994:i:1:p:211-55
Contact details of provider: Web page: http://www.kellogg.northwestern.edu/research/journals/JEMS/

Order Information: Web: http://www.blackwellpublishing.com/journal.asp?ref=1058-6407&site=1

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Getzen, Thomas E, 1984. "A "Brand Name Firm" Theory of Medical Group Practice," Journal of Industrial Economics, Wiley Blackwell, vol. 33(2), pages 199-215, December.
  2. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
  3. Cotton M. Lindsay, 1973. "Real Returns to Medical Education," Journal of Human Resources, University of Wisconsin Press, vol. 8(3), pages 331-348.
  4. Gaynor, M. & Gertler, P., 1996. "Moral hazard and Risk Speading in Partnerships," Papers 96-09, RAND - Reprint Series.
  5. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
  6. Dionne, Georges, 1984. "Search and Insurance," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 25(2), pages 357-67, June.
  7. Paul R. Milgrom, 1979. "Good Nevs and Bad News: Representation Theorems and Applications," Discussion Papers 407R, Northwestern University, Center for Mathematical Studies in Economics and Management Science.
  8. Roy J. Ruffin & Duane E. Leigh, 1973. "Charity, Competition, and the Pricing of Doctors' Services," Journal of Human Resources, University of Wisconsin Press, vol. 8(2), pages 212-222.
  9. Asher Wolinsky, 1993. "Competition in a Market for Informed Experts' Services," RAND Journal of Economics, The RAND Corporation, vol. 24(3), pages 380-398, Autumn.
  10. Hoerger, Thomas J., 1990. "Two-part pricing and the mark-ups charged by primary care physicians for new and established patient visits," Journal of Health Economics, Elsevier, vol. 8(4), pages 399-417, February.
  11. Randall P. Ellis & Thomas G. McGuire, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-151, Fall.
  12. Dranove, David & Wehner, Paul, 1994. "Physician-induced demand for childbirths," Journal of Health Economics, Elsevier, vol. 13(1), pages 61-73, March.
  13. John A. Rizzo & Richard J. Zeckhauser, 1992. "Advertising and the Price, Quantity, and Quality of Primary Care Physician Services," Journal of Human Resources, University of Wisconsin Press, vol. 27(3), pages 381-421.
  14. Bernheim, B Douglas & Whinston, Michael D, 1986. "Common Agency," Econometrica, Econometric Society, vol. 54(4), pages 923-42, July.
  15. Leffler, Keith B, 1978. "Physician Licensure: Competition and Monopoly in American Medicine," Journal of Law and Economics, University of Chicago Press, vol. 21(1), pages 165-86, April.
  16. Robert T. Masson & S. Wu, 1974. "Price Discrimination for Physicians' Services," Journal of Human Resources, University of Wisconsin Press, vol. 9(1), pages 63-79.
  17. Salant, David J., 1991. "A repeated game with finitely lived overlapping generations of players," Games and Economic Behavior, Elsevier, vol. 3(2), pages 244-259, May.
  18. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
  19. Green, Jerry R. & Stokey, Nancy L., 2007. "A two-person game of information transmission," Journal of Economic Theory, Elsevier, vol. 135(1), pages 90-104, July.
  20. McCarthy, Thomas R., 1985. "The competitive nature of the primary-care physician services market," Journal of Health Economics, Elsevier, vol. 4(2), pages 93-117, June.
  21. Burstein, Philip L. & Cromwell, Jerry, 1985. "Relative incomes and rates of return for U.S. physicians," Journal of Health Economics, Elsevier, vol. 4(1), pages 63-78, March.
  22. Martin Gaynor, 1989. "Competition within the Firm: Theory Plus Some Evidence from Medical Group Practice," RAND Journal of Economics, The RAND Corporation, vol. 20(1), pages 59-76, Spring.
  23. Benham, Lee, 1972. "The Effect of Advertising on the Price of Eyeglasses," Journal of Law and Economics, University of Chicago Press, vol. 15(2), pages 337-52, October.
  24. Hay, Joel & Leahy, Michael J., 1982. "Physician-induced demand : An empirical analysis of the consumer information gap," Journal of Health Economics, Elsevier, vol. 1(3), pages 231-244, December.
  25. MacLeod, W Bentley & Malcomson, James M, 1993. "Investments, Holdup, and the Form of Market Contracts," American Economic Review, American Economic Association, vol. 83(4), pages 811-37, September.
  26. Lee, Robert H., 1990. "Monitoring physicians : A bargaining model of medical group practice," Journal of Health Economics, Elsevier, vol. 9(4), pages 463-481, December.
  27. Oliver Hart & Sanford Grossman, 1985. "The Costs and Benefits of Ownership: A Theory of Vertical and Lateral Integration," Working papers 372, Massachusetts Institute of Technology (MIT), Department of Economics.
  28. Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
  29. Holt, Charles A & Sherman, Roger, 1990. "Advertising and Product Quality in Posted-Offer Experiments," Economic Inquiry, Western Economic Association International, vol. 28(1), pages 39-56, January.
  30. Frank A. Sloan, 1970. "Lifetime earnings and physicians' choice of specialty," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 24(1), pages 47-56, October.
  31. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
  32. David Dranove & Mark A. Satterthwaite, 1992. "Monopolistic Competition When Price and Quality are Imperfectly Observable," RAND Journal of Economics, The RAND Corporation, vol. 23(4), pages 518-534, Winter.
  33. Ross, Stephen A, 1973. "The Economic Theory of Agency: The Principal's Problem," American Economic Review, American Economic Association, vol. 63(2), pages 134-39, May.
  34. Malcomson, James M, 1984. "Work Incentives, Hierarchy, and Internal Labor Markets," Journal of Political Economy, University of Chicago Press, vol. 92(3), pages 486-507, June.
  35. Marder, William D. & Zuckerman, Stephen, 1985. "Competition and medical groups : A survivor analysis," Journal of Health Economics, Elsevier, vol. 4(2), pages 167-176, June.
  36. Frank A. Sloan, 1982. "Effects of Health Insurance on Physicians' Fees," Journal of Human Resources, University of Wisconsin Press, vol. 17(4), pages 533-557.
  37. Kwoka, John E, Jr, 1984. "Advertising and the Price and Quality of Optometric Services," American Economic Review, American Economic Association, vol. 74(1), pages 211-16, March.
  38. Rizzo, John A & Zeckhauser, Richard J, 1990. "Advertising and Entry: The Case of Physician Services," Journal of Political Economy, University of Chicago Press, vol. 98(3), pages 476-500, June.
  39. Rogerson, William P, 1992. "Contractual Solutions to the Hold-Up Problem," Review of Economic Studies, Wiley Blackwell, vol. 59(4), pages 777-93, October.
  40. Nitzan, Shmuel & Tzur, Joseph, 1989. "Price and quality of professional services and codes of ethics," European Journal of Political Economy, Elsevier, vol. 5(1), pages 31-48.
  41. Darby, Michael R & Karni, Edi, 1973. "Free Competition and the Optimal Amount of Fraud," Journal of Law and Economics, University of Chicago Press, vol. 16(1), pages 67-88, April.
  42. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
  43. Robert H. Lee, 1989. "Insurance and Medical List Prices," Journal of Human Resources, University of Wisconsin Press, vol. 24(4), pages 689-708.
  44. Daniel F. Spulber, 1989. "Regulation and Markets," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262192756, June.
  45. Marquis, M. Susan, 1985. "Cost-sharing and provider choice," Journal of Health Economics, Elsevier, vol. 4(2), pages 137-157, June.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:bla:jemstr:v:3:y:1994:i:1:p:211-55. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing)

or (Christopher F. Baum)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.