A Doctor Will See You Now: Physician-Patient Relationships and Clinical Decisions
We estimate the effect of physician-patient relationships on clinical decisions in a setting where the treating physician is as good as randomly assigned. OBs are 25% (4 percentage points) more likely to perform a C-section when delivering patients with whom they have a pre-existing clinical relationship (their “own patients”) than when delivering patients with whom they had no prior relationship. OBs’ decisions are consistent with receiving greater disutility from their own patients’ difficult labors. After a string of difficult labors, OBs are more likely to perform C-sections on their own patients, and this can explain the entire own patient effect.
This paper has benefited from discussions with and comments by: Kate Baicker, Loren Baker, Paul Beaudry, Marika Cabral, Joe Doyle, Nicole Fortin, Richard Freeman, Nancy Gallini, Josh Gottlieb, David Green, Florian Hoffman, Mireille Jacobson, Brendan Nyhan, Torsten Persson, Heidi Williams, Crystal Yang, and participants at the Canadian Institute for Advanced Research, the Junior Health Economists Summit, the Robert Wood Johnson Scholars in Health Policy Conference (Michigan), and seminars at the University of British Columbia, the University of Victoria, and Wellesley College. We thank Tessa Johnson for excellent research assistance. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.