The Formation and Evolution of Physician Treatment Styles: An Application to Cesarean Sections / Andrew Epstein, Sean Nicholson.

Format:

Book

Author/Creator:

Epstein, Andrew.

Contributor:

National Bureau of Economic Research.

Nicholson, Sean.

Series:

Working Paper Series (National Bureau of Economic Research) no. w11549.

NBER working paper series no. w11549

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Other Title:

The Formation and Evolution of Physician Treatment Styles

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2005.

Summary:

Small-area-variation studies have shown that physician treatment styles differ substantially both between and within markets, controlling for patient characteristics. Using a data set containing the universe of deliveries in Florida over a 12-year period with consistent physician identifiers and a rich set of patient characteristics, we examine why treatment styles differ across obstetricians at a point in time, and why styles change over time. We find that the variation in c-section rates across physicians within a market is two to three times greater than the variation between markets. Surprisingly, residency programs explain less than four percent of the variation between physicians in their risk-adjusted c-section rates, even among newly-trained physicians. Although we find evidence that physicians, especially relatively inexperienced ones, learn from their peers, they do not substantially revise their prior beliefs regarding how patients should be treated due to the local exchange of information. Our results indicate that physicians are not likely to converge over time to a community standard; thus, within-market variation in treatment styles is likely to persist.

Notes:

Print version record

August 2005.