Healer or Gatekeeper? Physicians' Role Conflict When Symptoms are Non-Verifiable

31 Pages Posted: 1 May 2017

See all articles by Benedicte Carlsen

Benedicte Carlsen

University of Bergen - Rokkan Centre

Karine Nyborg

University of Oslo - Department of Economics; IZA Institute of Labor Economics

Abstract

Although physicians are often expected to be gatekeepers to health insurance benefits such as paid sick leave, research indicates a substantial reluctance to reject patient requests for sickness certificates. We show that private information on the patient's part creates a conflict between the healer and gatekeeper roles: if a patient reports subjective symptoms indicating a need for sick leave, the physician is unable to tell if the patient is truly sick or a shirker. We show that even if most physicians prefer to be good gatekeepers, all of them may trust their patients in Nash equilibrium. These ideas are illustrated using results from focus group interviews with Norwegian primary care physicians.

Keywords: sicklisting, subjective diagnoses, asymmetric information, focus group interviews

JEL Classification: D11, D21, H42, I11, I18

Suggested Citation

Carlsen, Benedicte and Nyborg, Karine, Healer or Gatekeeper? Physicians' Role Conflict When Symptoms are Non-Verifiable. IZA Discussion Paper No. 10735, Available at SSRN: https://ssrn.com/abstract=2960544 or http://dx.doi.org/10.2139/ssrn.2960544

Benedicte Carlsen (Contact Author)

University of Bergen - Rokkan Centre ( email )

Nyg°ardsgt. 5
Bergen, N-5015
Norway

Karine Nyborg

University of Oslo - Department of Economics ( email )

P.O.Box 1095 Blindern
Oslo, N-0317
Norway

HOME PAGE: http://folk.uio.no/karineny/

IZA Institute of Labor Economics ( email )

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

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
73
Abstract Views
540
Rank
580,727
PlumX Metrics