Understanding Doctor Decision Making: The Case of Depression

Abstract

BCBS Axis®, the largest collection of commercial insurance claims, medical professional and cost of care information. BCBSA is an association of independent BCBS companies. The authors are solely responsible for the content of the paper. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

Medical Labour Supply and the Production of Healthcare

“…Currie and MacLeod () put forward a theoretical framework that captures both rational and norm‐based decision‐making. In their model, physicians differ both in the extent they like to experiment (measured by the concentration of different drugs they prescribe) as well as in their overall level of skill (higher‐skilled physicians learn quicker about the efficacy of new drugs).…”

“…This highlights the importance of a dynamic framework (e.g. Currie and MacLeod, ) to understand patterns in treatment decisions.…”

When Technological Advance Meets Physician Learning in Drug Prescribing

“…There is clearly too much clinical overlap between the groups to allow an easily observable distinction. Of course, in a different setup, it may be perfectly possible to reach this goal (Currie and MacLeod, 2018). In our case, doctors recommend switches in equipotency dose based on characteristics that we may not observe, even though we observe so many clinical characteristics.…”

“…Our paper contributes to a growing literature that evaluates how scientific and technological advance alter physicians' practice (Currie and MacLeod, 2018;Avdic et al, 2018). In particular, Currie and MacLeod (2018) investigate the variations in physician decision making in the context of depression, a pathology where finding an optimal treatment involves experimentation with different drugs over time and where physician diagnostic skills are crucial. They conclude that the optimal management of health care should consist of a combination of constraints upon some choices, while allowing or even promoting discretion over a set of patient-specific treatments.…”

“…Unlike Currie and MacLeod (2018), the decision making in our paper is affected by an exogenous informational shock and by physician diagnostic skill. Unlike Avdic et al (2018), who focus on stent implantation (a procedure that typically does not recur), we consider an asymptomatic (though potentially lethal) chronic condition managed over a prolonged period.…”