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Patient compliance, physician empathy and financial incentives within a principal-agent framework


  • Mealem, Yosef
  • Siniver, Erez
  • Yaniv, Gideon


Compliance with medication regimens among patients with chronic conditions in the U.S. and other developed countries averages only 50%. Numerous studies have attributed poor compliance to physicians’ failure to exhibit sufficient empathy with patients’ problems. Can financial incentives help modify physicians’ empathic behavior? In view of contradicting evidence in the health psychology literature, the present paper addresses this question from a rational-choice perspective, introducing a principal-agent model of physician empathy and patient compliance. The model allows the physician to exhibit empathy with the patient, to which the patient responds by choosing his desired level of compliance, which the physician takes into account when determining the level of empathy she exhibits. The model is first applied to rationally substantiate the evidence that patient compliance rises with physician empathy, and subsequently to examining the relationship between physician empathy and the physician's fee. The analysis reveals that the physician will exhibit less empathy in response to a higher fee, implying that the higher the fee the less compliant her patient will be.

Suggested Citation

  • Mealem, Yosef & Siniver, Erez & Yaniv, Gideon, 2012. "Patient compliance, physician empathy and financial incentives within a principal-agent framework," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 41(6), pages 827-830.
  • Handle: RePEc:eee:soceco:v:41:y:2012:i:6:p:827-830 DOI: 10.1016/j.socec.2012.08.004

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    References listed on IDEAS

    1. repec:ebl:ecbull:v:4:y:2006:i:33:p:1-7 is not listed on IDEAS
    2. Harbaugh, William T., 1998. "What do donations buy?: A model of philanthropy based on prestige and warm glow," Journal of Public Economics, Elsevier, vol. 67(2), pages 269-284, February.
    3. Karine Lamiraud & Pierre-Yves Geoffard, 2007. "Therapeutic non-adherence: a rational behavior revealing patient preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1185-1204.
    4. Morris Altman, 2006. "Opening-up the objective function: choice behavior and economic and non-economic variables—core and marginal altruism," Economics Bulletin, AccessEcon, vol. 4(33), pages 1-7.
    5. Paul Ellickson & Scott Stern & Manuel Trajtenberg, 2001. "Patient Welfare and Patient Compliance -- An Empirical Framework for Measuring the Benefits from Pharmaceutical Innovation," NBER Chapters,in: Medical Care Output and Productivity, pages 539-564 National Bureau of Economic Research, Inc.
    6. Douglas Davis & Edward Millner & Robert Reilly, 2005. "Subsidy Schemes and Charitable Contributions: A Closer Look," Experimental Economics, Springer;Economic Science Association, vol. 8(2), pages 85-106, June.
    7. Andreoni, James, 1989. "Giving with Impure Altruism: Applications to Charity and Ricardian Equivalence," Journal of Political Economy, University of Chicago Press, vol. 97(6), pages 1447-1458, December.
    8. Andreoni, James, 1990. "Impure Altruism and Donations to Public Goods: A Theory of Warm-Glow Giving?," Economic Journal, Royal Economic Society, vol. 100(401), pages 464-477, June.
    9. Squier, Roger W., 1990. "A model of empathic understanding and adherence to treatment regimens in practitioner-patient relationships," Social Science & Medicine, Elsevier, vol. 30(3), pages 325-339, January.
    10. Crumpler, Heidi & Grossman, Philip J., 2008. "An experimental test of warm glow giving," Journal of Public Economics, Elsevier, vol. 92(5-6), pages 1011-1021, June.
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    More about this item


    Physician empathy; Patient compliance; Financial incentives; Fee-for-service; Principal-agent;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior


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