Demanding Customers: Consumerist Patients and Quality of Care

51 Pages Posted: 23 Sep 2008 Last revised: 18 Sep 2010

See all articles by Hai Fang

Hai Fang

University of Miami

Nolan H. Miller

University of Illinois at Urbana-Champaign

John A. Rizzo

Stony Brook University - Department of Economics and Department of Preventative Medicine

Richard J. Zeckhauser

Harvard University - Harvard Kennedy School (HKS); National Bureau of Economic Research (NBER)

Multiple version iconThere are 2 versions of this paper

Date Written: September 2008

Abstract

Consumerism arises when patients acquire and use medical information from sources apart from their physicians, such as the Internet and direct-to-patient advertising. Consumerism has been hailed as a means of improving quality. This need not be the result. Consumerist patients place additional demands on their doctors' time, thus imposing a negative externality on other patients. Our theoretical model has the physician treat both consumerist and ordinary patient under a binding time budget. Relative to a world in which consumerism does not exist, consumerism is never Pareto improving, and in some cases harms both consumerist and ordinary patients. Data from a large national survey of physicians shows that high levels of consumerism are associated with lower perceived quality. Three different measures of quality were employed. The analysis uses instrumental variables to control for the endogeneity of consumerism. A control function approach is employed, since our dependent variable is ordered and categorical, not continuous.

Suggested Citation

Fang, Hai and Miller, Nolan and Rizzo, John A. and Zeckhauser, Richard J., Demanding Customers: Consumerist Patients and Quality of Care (September 2008). NBER Working Paper No. w14350. Available at SSRN: https://ssrn.com/abstract=1271382

Hai Fang

University of Miami ( email )

Coral Gables, FL 33124
United States

Nolan Miller

University of Illinois at Urbana-Champaign ( email )

1206 South Sixth Street
Champaign, IL 61820
United States
1-217-244-2847 (Phone)

HOME PAGE: http://www.business.illinois.edu/nmiller

John A. Rizzo

Stony Brook University - Department of Economics and Department of Preventative Medicine ( email )

N-637 Social and Behavioral Sciences Building
Stony Brook, NY 11794
United States

Richard J. Zeckhauser (Contact Author)

Harvard University - Harvard Kennedy School (HKS) ( email )

79 John F. Kennedy Street
Cambridge, MA 02138
United States
617-495-1174 (Phone)
617-384-9340 (Fax)

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States
617-495-1174 (Phone)
617-496-3783 (Fax)

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