Understanding Doctor Decision Making: The Case of Depression

48 Pages Posted: 17 Sep 2018

See all articles by Janet Currie

Janet Currie

Princeton University; National Bureau of Economic Research (NBER); Institute for the Study of Labor (IZA)

W. Bentley MacLeod

Columbia University - Department of Economics; National Bureau of Economic Research (NBER); IZA Institute of Labor Economics

Date Written: August 2018

Abstract

Treatment for depression is complex, requiring decisions that may involve tradeoffs between exploiting treatments with the highest expected value or experimenting with treatments with higher possible payoffs. Using patient claims data, we show that among skilled doctors, using a broader portfolio of drugs predicts better patient outcomes, except in cases where doctor’s decisions violate loose professional guidelines. We introduce a behavioral model of decision making guided by our empirical observations. The model’s novel feature is that the tradeoff between exploitation and experimentation depends on the doctor’s diagnostic skill. The model predicts that higher diagnostic skill leads to greater diversity in drug choice and better matching of drugs to patients even among doctors with the same initial beliefs regarding drug effectiveness. Consistent with the finding that guideline violations predict poorer patient outcomes, simulations of the model suggest that increasing the number of possible drug choices can lower performance.

Suggested Citation

Currie, Janet and MacLeod, William Bentley, Understanding Doctor Decision Making: The Case of Depression (August 2018). NBER Working Paper No. w24955. Available at SSRN: https://ssrn.com/abstract=3244238

Janet Currie (Contact Author)

Princeton University ( email )

Princeton, NJ 08544-1021
United States
6092587393 (Phone)

HOME PAGE: http://www.princeton.edu/~jcurrie

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Institute for the Study of Labor (IZA)

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

William Bentley MacLeod

Columbia University - Department of Economics ( email )

420 W. 118th Street
New York, NY 10027
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

IZA Institute of Labor Economics ( email )

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

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
32
Abstract Views
172
PlumX Metrics