Physician Discretion and Patient Pick-up: How Familiarity Encourages Multitasking in the Emergency Department

Forthcoming in Operations Research

25 Pages Posted: 29 Jun 2020 Last revised: 15 Jun 2022

See all articles by RJ Niewoehner

RJ Niewoehner

Kelley School of Business, Indiana University

Diwas Singh KC

Emory University - Goizueta Business School

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School

Date Written: April 29, 2022

Abstract

Background: Patient demand for emergency medical services continues to rise from all-time highs. Physicians generally respond to the rising demand by increasing their level of multitasking.

Aim: What leads Emergency Department physicians to select which patients, and how many patients, they will treat? Queuing models frequently assume individual servers operate independently of other servers. In contrast, we consider how familiarity between peer physicians affects patient selection and the chosen multitasking level, a process more commonly known in the ED as “patient pick-up."

Methods: Using empirical observations from two Emergency Departments, we explore whether familiarity alters patient pick-up behavior, we determine the effect of familiarity on multitasking, and we measure the combined impact of familiarity and multitasking on other ED outcomes.

Results: Among ED physicians, greater average familiarity leads to an increase in patient pick-up rate, observed multitasking, and shorter patient wait time -- with no identifiable, negative impact to patient processing time or length of stay. Moreover, the effects intensify at the end of a physician’s shift and for patients in severe condition.

Conclusion: Within more familiar groups, physicians appear willing to exert more effort. Our study clarifies how the benefits materialize and illustrates why researchers must consider server familiarity moving forward.

Keywords: Healthcare, Discretion, Productivity, Familiarity, Empirical Operations

Suggested Citation

Niewoehner, Robert J. and KC, Diwas Singh and Staats, Bradley R., Physician Discretion and Patient Pick-up: How Familiarity Encourages Multitasking in the Emergency Department (April 29, 2022). Forthcoming in Operations Research, Available at SSRN: https://ssrn.com/abstract=3618730 or http://dx.doi.org/10.2139/ssrn.3618730

Robert J. Niewoehner (Contact Author)

Kelley School of Business, Indiana University ( email )

Business 670
1309 E. Tenth Street
Bloomington, IL 47401
United States

Diwas Singh KC

Emory University - Goizueta Business School ( email )

1300 Clifton Road
Atlanta, GA 30322-2722
United States

Bradley R. Staats

University of North Carolina Kenan-Flagler Business School ( email )

McColl Building, CB#3490
Chapel Hill, NC 27599
United States

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