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Professional norms and physician behavior: homo oeconomicus or homo hippocraticus?

  • Kesternich, Iris
  • Schumacher, Heiner
  • Winter, Joachim

Physicians' treatment decisions determine the level of health care spending to a large extent. The analysis of physician agency describes how doctors trade off their own and their patients' benefits, with a third party (such as the collective of insured individuals or the taxpayers) bearing the costs. Professional norms are viewed as restraining physicians' self-interest and as introducing altruism towards the patient. We present a controlled experiment that analyzes the impact of professional norms on prospective physicians' trade-offs between her own profits, the patients' benefits, and the payers' expenses for medical care. We find that professional norms derived from the Hippocratic tradition shift weight to the patient in the physician's decisions while decreasing his self-interest and efficiency concerns.

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Paper provided by Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University of Munich in its series Discussion Paper Series of SFB/TR 15 Governance and the Efficiency of Economic Systems with number 456.

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Date of creation: 13 Mar 2014
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Handle: RePEc:trf:wpaper:456
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  1. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-80, September.
  2. Godager, Geir & Wiesen, Daniel, 2013. "Profit or patients’ health benefit? Exploring the heterogeneity in physician altruism," Journal of Health Economics, Elsevier, vol. 32(6), pages 1105-1116.
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  7. Daniel J. Benjamin & James J. Choi & A. Joshua Strickland, 2010. "Social Identity and Preferences," American Economic Review, American Economic Association, vol. 100(4), pages 1913-28, September.
  8. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
  9. Heiner Schumacher & Iris Kesternich & Michael Kosfeld & Joachim Winter, 2014. "Us and Them: Distributional Preferences in Small and Large Groups," CESifo Working Paper Series 4657, CESifo Group Munich.
  10. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, MIT Press, vol. 123(2), pages 795-830, 05.
  11. Andreoni,J. & Vesterlund,L., 1998. "Which is the fair sex? : Gender differences in altruism," Working papers 10, Wisconsin Madison - Social Systems.
  12. James Andreoni & John Miller, 2002. "Giving According to GARP: An Experimental Test of the Consistency of Preferences for Altruism," Econometrica, Econometric Society, vol. 70(2), pages 737-753, March.
  13. Heike Hennig-Schmidt & Reinhard Selten & Daniel Wiesen, 2009. "How Payment Systems Affect Physicians´ Provision Behaviour – An Experimental Investigation," Bonn Econ Discussion Papers bgse29_2009, University of Bonn, Germany.
  14. Dirk Engelmann & Martin Strobel, 2004. "Inequality Aversion, Efficiency, and Maximin Preferences in Simple Distribution Experiments," American Economic Review, American Economic Association, vol. 94(4), pages 857-869, September.
  15. Messer, Kent D. & Poe, Gregory L. & Rondeau, Daniel & Schulze, William D. & Vossler, Christian A., 2008. "Social Preferences and Voting: An Exploration Using a Novel Preference Revealing Mechanism," Working Papers 51132, Cornell University, Department of Applied Economics and Management.
  16. Sohl, P. & Bassford, H. A., 1986. "Codes of medical ethics: Traditional foundations and contemporary practice," Social Science & Medicine, Elsevier, vol. 22(11), pages 1175-1179, January.
  17. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
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