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

CIRPEE Working Paper No. 07-45

32 Pages Posted: 7 Dec 2007

See all articles by Etienne Dumont

Etienne Dumont

Laval University - Département d'économique; Centre interuniversitaire sur le risque, les politiques économiques et l'emploi (CIRPÉE)

Bernard Fortin

Université Laval - Département d'Économique; National Bureau of Economic Research (NBER); IZA Institute of Labor Economics

Nicolas Jacquemet

Paris School of Economics (PSE); Université Paris I Panthéon-Sorbonne

Bruce Shearer

Université Laval - Département d'Économique; IZA Institute of Labor Economics

Multiple version iconThere are 4 versions of this paper

Date Written: November 2007

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 physicians 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 these increase their time spent on teaching and administrative duties (tasks not remunerated under the fee-for-service system) by 7.9%.

Keywords: Physician payment mechanisms, multitasking, mixed-payment systems, incentive contracts, labour supply, self-selection, panel estimation

JEL Classification: I10, J22

Suggested Citation

Dumont, Etienne and Fortin, Bernard and Jacquemet, Nicolas and Shearer, Bruce, Physicians' Multitasking and Incentives: Empirical Evidence from a Natural Experiment (November 2007). CIRPEE Working Paper No. 07-45, Available at SSRN: https://ssrn.com/abstract=1056141 or http://dx.doi.org/10.2139/ssrn.1056141

Etienne Dumont

Laval University - Département d'économique ( email )

2325 Rue de l'Université
Ste-Foy, Quebec G1K 7P4 G1K 7P4
Canada

Centre interuniversitaire sur le risque, les politiques économiques et l'emploi (CIRPÉE)

Pavillon De Sève
Ste-Foy, Quebec G1K 7P4
Canada

Bernard Fortin (Contact Author)

Université Laval - Département d'Économique ( email )

2325 Rue de l'Université
Ste-Foy, Quebec G1K 7P4 G1K 7P4
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418-656-5678 (Phone)
418-656-7798 (Fax)

National Bureau of Economic Research (NBER)

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United States

IZA Institute of Labor Economics

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Germany

Nicolas Jacquemet

Paris School of Economics (PSE) ( email )

48 Boulevard Jourdan
Paris, 75014 75014
France

Université Paris I Panthéon-Sorbonne ( email )

17, rue de la Sorbonne
Paris, 75005
France

HOME PAGE: http://www.nicolasjacquemet.com/

Bruce Shearer

Université Laval - Département d'Économique ( email )

2325 Rue de l'Université
Ste-Foy, Quebec G1K 7P4 G1K 7P4
Canada
418-656-2131 (Phone)
418-656-7798 (Fax)

IZA Institute of Labor Economics

P.O. Box 7240
Bonn, D-53072
Germany

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