IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v13y2023i1d10.1186_s13561-023-00458-3.html
   My bibliography  Save this article

Does patient behaviour drive physicians to practice defensive medicine? Evidence from a video experiment

Author

Listed:
  • Lotte Daniels

    (Hasselt University)

  • Wim Marneffe

    (Hasselt University)

Abstract

Objective By manipulating patients’ critical attitude in a video experiment, we examined whether physicians are more intended to perform defensive acts because of a higher perceived liability risk in Belgium. Methods We assigned 85 practicing gynaecologists/obstetricians and orthopaedists randomly to four hypothetical video consultations, in which the patients show either a critical attitude (i.e., getting ahead of the facts, showing distrust) or a non-critical attitude (i.e., displaying more neutral questions and expressions). We asked the physicians about the care they would administer in the presented cases and the expected likelihood that the patient would sue the physician in case of a medical incident. Results By manipulating patients’ verbal critical attitude (which indicates patients’ intention to take further steps), while keeping constant physician’s communication, patients’ clinical situation, preferences, and non-verbal behaviour in the videos, we were able to discover differential treatment styles driven by physicians’ perceived liability risk among patients with a different critical attitude. We found that physicians perform 17 percentage points more defensive acts (e.g., surgeries and diagnostic tests that are not medically necessary) when experiencing a high liability risk. Conclusions Our results show that patients’ critical attitude drives physicians’ perceived liability risk and consequent defensive behaviour among obstetricians/gynaecologists and orthopaedists.

Suggested Citation

  • Lotte Daniels & Wim Marneffe, 2023. "Does patient behaviour drive physicians to practice defensive medicine? Evidence from a video experiment," Health Economics Review, Springer, vol. 13(1), pages 1-13, December.
    • Handle: RePEc:spr:hecrev:v:13:y:2023:i:1:d:10.1186_s13561-023-00458-3
    DOI: 10.1186/s13561-023-00458-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-023-00458-3
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1186/s13561-023-00458-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jong‐Yi Wang & Janice C. Probst & Carleen H. Stoskopf & Jimy M. Sanders & James F. McTigue, 2011. "Information asymmetry and performance tilting in hospitals: a national empirical study," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1487-1506, December.
    2. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CERGE-EI Working Papers wp540, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    3. David Dranove & Yasutora Watanabe, 2009. "Influence and Deterrence: How Obstetricians Respond to Litigation against Themselves and Their Colleagues," American Law and Economics Review, American Law and Economics Association, vol. 12(1), pages 69-94.
    4. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    5. Brandon Roberts & Irving Hoch, 2009. "Malpractice litigation and medical costs in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 18(12), pages 1394-1419, December.
    6. Brandon Roberts & Irving Hoch, 2007. "Malpractice litigation and medical costs in Mississippi," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 841-859, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    2. Paola Bertoli & Veronica Grembi, 2018. "Medical Malpractice: How Legal Liability Affects Medical Decisions," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 235-261, Emerald Group Publishing Limited.
    3. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    4. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    5. Bertoli,P.; Grembi,V.;, 2017. "Exploring the nexus between certainty in injury compensation and treatment selection," Health, Econometrics and Data Group (HEDG) Working Papers 17/17, HEDG, c/o Department of Economics, University of York.
    6. Sebastian Panthöfer, 2022. "Do doctors prescribe antibiotics out of fear of malpractice?," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 19(2), pages 340-381, June.
    7. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    8. Rosa Ferrer, 2015. "The Effect of Lawyers' Career Concerns on Litigation," Working Papers 844, Barcelona School of Economics.
    9. Guccio, Calogero & Lisi, Domenico, 2016. "Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system," Regional Science and Urban Economics, Elsevier, vol. 61(C), pages 1-17.
    10. Castro, M.F.; & Ferrara, P.; & Guccio, C.; & Lisi, D.;, 2018. "Medical Malpractice Liability and Physicians’ Behavior:Experimental Evidence," Health, Econometrics and Data Group (HEDG) Working Papers 18/11, HEDG, c/o Department of Economics, University of York.
    11. Sofia Amaral-Garcia & Mattia Nardotto & Carol Propper & Tommaso Valletti, 2022. "Mums Go Online: Is the Internet Changing the Demand for Health Care?," The Review of Economics and Statistics, MIT Press, vol. 104(6), pages 1157-1173, November.
    12. Castro, Massimo Finocchiaro & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2019. "Medical malpractice liability and physicians’ behavior: Experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 166(C), pages 646-666.
    13. Finocchiaro Castro, Massimo & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2021. "Optimal mixed payment system and medical liability. A laboratory study," MPRA Paper 110276, University Library of Munich, Germany.
    14. Paola Bertoli & Veronica Grembi, 2018. "Courts, scheduled damages, and medical malpractice insurance," Empirical Economics, Springer, vol. 55(2), pages 831-854, September.
    15. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    16. Brandon Roberts & Irving Hoch, 2009. "Malpractice litigation and medical costs in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 18(12), pages 1394-1419, December.
    17. Charles L. Baum, 2020. "The effects of medical malpractice tort reform on physician supply an analysis of legislative changes from 2009 to 2016," Southern Economic Journal, John Wiley & Sons, vol. 87(2), pages 540-575, October.
    18. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Neighborhoods, networks, and delivery methods," Journal of Health Economics, Elsevier, vol. 80(C).
    19. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    20. Shurtz, Ity, 2013. "The impact of medical errors on physician behavior: Evidence from malpractice litigation," Journal of Health Economics, Elsevier, vol. 32(2), pages 331-340.

    More about this item

    Keywords

    Defensive medicine; Medical liability; Video experiment; Patient behaviour;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:hecrev:v:13:y:2023:i:1:d:10.1186_s13561-023-00458-3. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.