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

Etienne Dumont (), Bernard Fortin (), Nicolas Jacquemet () and Bruce S. Shearer ()
Additional contact information
Etienne Dumont: Université Laval
Bruce S. Shearer: Université Laval

No 3229, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: We analyse how physicians respond to contractual changes and incentives within a multitasking environment. In 1999 the Quebec government (Canada) introduced an optional mixed compensation system, combining a fixed per diem with a discounted (relative to the traditional fee-for-service system) fee for services provided. We combine panel survey and administrative data on Quebec physicians to evaluate the impact of this change in incentives on their practice choices. We highlight the differentiated impact of incentives on various dimensions of physician behaviour by considering a wide 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 per clinical service. Our results show that, on average, the reform induced physicians who changed from FFS to MC to reduce their volume of (billable) services by 6.15% and to reduce their hours of work 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 to increase their time spent on teaching and administrative duties (tasks not remunerated under the fee-for-service system) by 7.9%.

Keywords: self-selection; labour supply; incentive contracts; mixed-payment systems; multitasking; physician payment mechanisms; panel estimation (search for similar items in EconPapers)
JEL-codes: I10 J22 (search for similar items in EconPapers)
Pages: 33 pages
Date: 2007-12
New Economics Papers: this item is included in nep-hea and nep-lab
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (14)

Published - revised version published in: Journal of Health Economics, 2008, 27(6), 1436-1450

Downloads: (external link)
https://docs.iza.org/dp3229.pdf (application/pdf)

Related works:
Journal Article: Physicians' multitasking and incentives: Empirical evidence from a natural experiment (2008)
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 (2008)
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 (2008)
Working Paper: Physicians' Multitasking and Incentives: Empirical Evidence from a Natural Experiment (2007)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:iza:izadps:dp3229

Ordering information: This working paper can be ordered from
IZA, Margard Ody, P.O. Box 7240, D-53072 Bonn, Germany

Access Statistics for this paper

More papers in IZA Discussion Papers from Institute of Labor Economics (IZA) IZA, P.O. Box 7240, D-53072 Bonn, Germany. Contact information at EDIRC.
Bibliographic data for series maintained by Holger Hinte ().