Physician behavior: Experimental evidence from physician and patient perspectives

Abstract

Physician motives remain a hotly debated and sensitive topic. Given the sensitive nature of this issue, direct questions may elicit either dishonest responses or no response at all. To mitigate this risk, we carried out two list experiments between November 2022 and February 2023 to examine two important physician behaviors from both the physician and patient perspectives. In these experiments, participants in the control and treatment groups were shown a list of non-sensitive statements. Additionally, each treatment group received a sensitive statement related to either demand inducement or demand enablement behavior. Participants were then asked to report only the number of statements with which they agreed. The difference in the mean number of statements agreed upon between the control and treatment groups revealed the prevalence rates of sensitive behaviors. In the physician experiment, we observed a 25 % prevalence rate (standard error (SE) = 0.127, p = 0.046) for demand inducement behavior and a 65 % rate (SE = 0.125, p < 0.001) for demand enablement behavior. In the patient experiment, compared to the control group, 52 % of participants (SE = 0.074, p < 0.001) perceived that physicians exhibit demand inducement behavior, while 39 % (SE = 0.073, p < 0.001) demonstrated behavior consistent with demand enablement. These findings indicate that physicians are more prone to offer unnecessary medical services when patients actively participate, underscoring the significant influence of patients on physician behavior.