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

• Published in: Journal of public economics 2015-11, Vol.131, p.1-11
• Main Authors: Kesternich, Iris, Schumacher, Heiner, Winter, Joachim
• Format: Article
• Language: English
• Subjects: Allocation of medical resources; Altruism; Decision making; Health care expenditures; Norms; Physician patient relationships; Professional norms; Social preferences; Third party
• ISSN: 0047-2727; 1879-2316
• DOI: 10.1016/j.jpubeco.2015.08.009

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 their own profits, the patients' benefits, and the payers' expenses for medical care. Our data support the notion that professional norms derived from the Hippocratic tradition shift weight to the patient in physicians' decisions while decreasing their self-interest and efficiency concerns. •Professional norms restrain physicians' self-interest and introduce altruism towards patients.•We conduct a controlled experiment whose subjects are prospective physicians.•We analyze how professional norms affect trade-offs between profits, the patients' benefits, and payers' expenses.•Professional norms shift weight to the patient in physicians' decisions.•They decrease self-interest and efficiency concerns.