Selective Hearing: Physician-Ownership and Physicians' Response to New Evidence

Abstract

Physicians, acting in their role as experts, are often faced with situations where they must trade off personal and patient welfare. Physicians' incentives vary based on the organizational environment in which they practice. We use the publication of a major clinical trial, which found that a common knee operation does not improve outcomes for patients with osteoarthritis, as an "informational shock" to gauge the impact of physicians' agency relationships on treatment decisions. Using a 100% sample of procedures in Florida from 1998 to 2010, we find that publication of the trial reduced procedure volume, but the magnitude of the decline was smaller in physician-owned surgery centers. Incentives affected physicians' reactions to evidence.

Physician age and the abandonment of episiotomy

“…Our study contributes to the growing literature on the abandonment (or de‐adoption) of ineffective medical technologies . Understanding the factors that contribute to physician‐level variation and promote or retard the abandonment of ineffective treatments is important for designing interventions to better align evidence and practice.…”