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The Efficiency of Slacking off: Evidence From the Emergency Department


  • David C. Chan


Work schedules play an important role in utilizing labor in organizations. In this study of emergency department physicians in shift work, schedules induce two distortions: First, physicians “slack off†by accepting fewer patients near end of shift (EOS). Second, physicians distort patient care, incurring higher costs as they spend less time on patients assigned near EOS. Examining how these effects change with shift overlap reveals a tradeoff between the two. Within an hour after the normal time of work completion, physicians are willing to spend hospital resources more than six times their market wage to preserve their leisure. Accounting for overall costs, I find that physicians slack off at approximately second†best optimal levels.

Suggested Citation

  • David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
  • Handle: RePEc:wly:emetrp:v:86:y:2018:i:3:p:997-1030
    DOI: 10.3982/ECTA13565

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Sam Watson’s journal round-up for 25th June 2018
      by Sam Watson in The Academic Health Economists' Blog on 2018-06-25 11:00:28


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    Cited by:

    1. Diwas S. KC & Bradley R. Staats & Maryam Kouchaki & Francesca Gino, 2020. "Task Selection and Workload: A Focus on Completing Easy Tasks Hurts Performance," Management Science, INFORMS, vol. 66(10), pages 4397-4416, October.
    2. Gianni De Fraja & Jesse Matheson & James Rockey, 2020. "Zoomshock: The geography and local labour market consequences of working from home," Discussion Papers 20-31, Department of Economics, University of Birmingham.
    3. Maria R. Ibanez & Michael W. Toffel, 2020. "How Scheduling Can Bias Quality Assessment: Evidence from Food-Safety Inspections," Management Science, INFORMS, vol. 66(6), pages 2396-2416, June.
    4. Lawrence Jin & Rui Tang & Han Ye & Junjian Yi & Songfa Zhong, 2020. "Time Dependency in Physician Decision-Making," AEA Papers and Proceedings, American Economic Association, vol. 110, pages 284-288, May.
    5. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2020. "Capacity constraints and time allocation in public health clinics," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 324-336, March.
    6. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2019. "Capacity Constraints and the Provision of Public Services: The Case of Workers in Public Health Clinics," NBER Working Papers 25706, National Bureau of Economic Research, Inc.

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