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Does Experience Make Better Doctors?

Author

Listed:
  • Juan M. Contreras

    (Congressional Budget Office)

  • Beomsoo Kim

    (Department of Economics, Korea University, Seoul, South Korea)

  • Ignez M. Tristao

    (Congressional Budget Office)

Abstract

In this paper, we examine the ¡°learning-by-doing¡± hypothesis in medicine using a longitudinal census of laser in situ keratomileusis (LASIK) eye surgeries collected directly from patient charts. LASIK surgery has precise measures of presurgical condition and postsurgical outcomes. Unlike other types of surgery, the impact of unobservable underlying patient conditions on outcomes is minimal. Individual learning-bydoing is identified through observations of surgical outcomes over time based on the cumulative number of surgeries each surgeon has performed. Collective learning is identified separately through changes in a group adjustment rule determined jointly by all the surgeons through a structured internal review process. Our unique data set overcomes some of the measurement problems in patient outcomes encountered in other studies, and improves the possibility of identifying the impact of learning-by-doing separate from other effects. Our results do not support the hypothesis that the surgeon¡¯s individual learning improves outcomes, but we find strong evidence that experience accumulated by surgeons as a group in a clinic significantly improves outcomes.

Suggested Citation

  • Juan M. Contreras & Beomsoo Kim & Ignez M. Tristao, 2009. "Does Experience Make Better Doctors?," Discussion Paper Series 0902, Institute of Economic Research, Korea University.
    • Handle: RePEc:iek:wpaper:0902
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    File URL: http://econ.korea.ac.kr/~ri/WorkingPapers/w0902.pdf
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    References listed on IDEAS

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    1. Argote, L. & Epple, D., 1990. "Learning Curves In Manufacturing," GSIA Working Papers 89-90-02, Carnegie Mellon University, Tepper School of Business.
    2. C. Lanier Benkard, 2000. "Learning and Forgetting: The Dynamics of Aircraft Production," American Economic Review, American Economic Association, vol. 90(4), pages 1034-1054, September.
    3. Gary P. Pisano & Richard M.J. Bohmer & Amy C. Edmondson, 2001. "Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery," Management Science, INFORMS, vol. 47(6), pages 752-768, June.
    4. Robert S. Huckman & Gary P. Pisano, 2006. "The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery," Management Science, INFORMS, vol. 52(4), pages 473-488, April.
    5. K. J. Arrow, 1971. "The Economic Implications of Learning by Doing," Palgrave Macmillan Books, in: F. H. Hahn (ed.), Readings in the Theory of Growth, chapter 11, pages 131-149, Palgrave Macmillan.
    6. Ho, Vivian, 2002. "Learning and the evolution of medical technologies: the diffusion of coronary angioplasty," Journal of Health Economics, Elsevier, vol. 21(5), pages 873-885, September.
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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