Health Care – Davidson

Professor Stephen M. Davidson
sdavidso@bu.edu
617-353-7422

Options: UROP, Credit

Influences on Physician Behavior:
Financial Incentives, Professionalism, and Codes of Ethics

By now it is well established that physicians respond to financial incentives like everyone else.  But they are influenced by other forces, as well, including a well-developed sense of professionalism and codes of ethics that admonish them to “do no harm” and to put the interests of patients before all others.  In a recent New Yorker article, Atul Gawande compared McAllen, Texas where the response to financial incentives produces the highest health care expenditures in the nation with another Texas city, El Paso, where doctors practice a much more restrained brand of utilization.  Whatever new legislation the reform debates produce, if any, the ability of Americans to obtain the care they need will depend to a large extent on the behavior of physicians.  In this project, we will address the following questions:  What are the relative strength of the several forces that influence physician utilization patterns?  And to what extent does physician professionalism act as a brake on financial incentives?