Physicians' Multitasking and Incentives: Empirical Evidence from a Natural Experiment

Etienne Dumont, Bernard Fortin (), Nicolas Jacquemet () and Bruce Shearer
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Etienne Dumont: CIRPEE - Université Laval
Bruce Shearer: CIRPEE - Université Laval

Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) from HAL

Abstract: We analyse how physicians respond to contractual changes and incentives within a multitaskingenvironment. In 1999 the Quebec government (Canada) introduced an optional mixed compensationsystem, combining a xed per diem with a partial (relative to the traditional fee-for-service system)fee for services provided. We combine panel survey and administrative data on Quebec physiciansto evaluate the impact of this change in incentives on their practice choices. We highlight thedierentiated impact of incentives on various dimensions of physician behaviour by considering awide range of labour supply variables: time spent on seeing patients, time devoted to teaching,administrative tasks or research, as well as the volume of clinical services and average time perclinical service. Our results show that, on average, the reform induced physicians who changedfrom FFS to MC to reduce their volume of (billable) services by 6.15% and to reduce their hours ofwork spent on seeing patients by 2.57%. Their average time spent per service increased by 3.58%,suggesting a potential quality-quantity substitution. Also the reform induced these physicians toincrease their time spent on teaching and administrative duties (tasks not remunerated under thefee-for-service system) by 7.9%.

Keywords: physician payment mechanisms; multitasking; mixed-payment systems; incentive con-tracts; labour supply; self-selection; panel estimation. (search for similar items in EconPapers)
Date: 2008-12
Note: View the original document on HAL open archive server: http://halshs.archives-ouvertes.fr/halshs-00305308/en/
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Published, Journal of Health Economics, 2008, 27, 6, 1436-1450

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Related works:
Working Paper: Physicians' Multitasking and Incentives: Empirical Evidence from a Natural Experiment (2007)
Working Paper: Physicians’ Multitasking and Incentives: Empirical Evidence from a Natural Experiment (2008)
Working Paper: Physicians’ Multitasking and Incentives: Empirical Evidence from a Natural Experiment (2007)
Journal Article: Physicians' multitasking and incentives: Empirical evidence from a natural experiment (2008)
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