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Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians

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  • Janet Currie
  • W. Bentley MacLeod

Abstract

Expert performance is often evaluated assuming that good experts have good outcomes. We examine expertise in medicine and develop a model that allows for two dimensions of physician performance: decision making and procedural skill. Better procedural skill increases the use of intensive procedures for everyone, while better decision making results in a reallocation of procedures from fewer low-risk to high-risk cases. We show that poor diagnosticians can be identified using administrative data and that improving decision making improves birth outcomes by reducing C-section rates at the bottom of the risk distribution and increasing them at the top of the distribution.

Suggested Citation

  • Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
  • Handle: RePEc:ucp:jlabec:doi:10.1086/687848
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    References listed on IDEAS

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    Cited by:

    1. Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
    2. Amitabh Chandra & Douglas O. Staiger, 2017. "Identifying Sources of Inefficiency in Health Care," NBER Working Papers 24035, National Bureau of Economic Research, Inc.
    3. Elliott Ash, W. Bentley MacLeod, . "Intrinsic Motivation in Public Service: Theory and Evidence from State Supreme Courts," Journal of Law and Economics, University of Chicago Press, vol. 58(4).
    4. Rudy Douven & Minke Remmerswaal & Robin Zoutenbier, 2015. "Do Extrinsically Motivated Mental Health Care Providers Have Better Treatment Outcomes?," CPB Discussion Paper 319, CPB Netherlands Bureau for Economic Policy Analysis.
    5. repec:pri:cheawb:alexander_d_jul13 is not listed on IDEAS
    6. Gautam Gowrisankaran & Keith A. Joiner & Pierre-Thomas Léger, 2017. "Physician Practice Style and Healthcare Costs: Evidence from Emergency Departments," NBER Working Papers 24155, National Bureau of Economic Research, Inc.
    7. Cotet-Grecu, Anca, 2015. "The impact of non-economic damages caps on obstetrics: Incentives versus practice style," Economics & Human Biology, Elsevier, vol. 17(C), pages 29-41.
    8. Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2018. "Mergers and Birth Outcomes: Evidence from Maternity Ward Closures," IZA Discussion Papers 11772, Institute for the Study of Labor (IZA).
    9. Jason Abaluck & Leila Agha & Christopher Kabrhel & Ali Raja & Arjun Venkatesh, 2014. "Negative Tests and the Efficiency of Medical Care: What Determines Heterogeneity in Imaging Behavior?," NBER Working Papers 19956, National Bureau of Economic Research, Inc.
    10. 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.
    11. Amaral-Garcia, S. & Bertoli, P. & Grembi, V., 2014. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities," Health, Econometrics and Data Group (HEDG) Working Papers 14/23, HEDG, c/o Department of Economics, University of York.

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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