Behavioral Economics and Physician Behavior

This study seeks to answer whether the availability heuristic leads physicians to utilize more medical care than is economically efficient. Do rare, salient events alter physicians' perceptions about the probability of patient harm? Do these events lead physicians to overutilize certain medical procedures? This study uses Pennsylvania inpatient hospital admissions data from 2009 aggregated at the physician level to investigate these questions. The data come from the 2009 Pennsylvania Health Care Cost Containment Council (PHC4). The study is divided into two parts. In Part I, we examine whether bad outcomes during childbirth (defined as maternal mortality, an obstetric fistula or a uterine rupture) lead physicians to utilize more cesarean sections on future patients. In Part II, we examine whether bad outcomes associated with appendicitis (defined as patient death, a perforated or ruptured appendix or sepsis) lead physicians to perform more negative appendectomies (appendectomies performed when the patient did not have appendicitis) on future patients. Overall the study does not find evidence to support the claim that the availability heuristic leads physicians to overutilize medical care on future patients. However, the study does find evidence that variations in health care utilization are strongly correlated with individual physician practice patterns. The results of the study also imply that physicians' financial incentives may be a source of variation in health care utilization.

Further Evidence for Hemisity Sorting During Career Specialization

Hemisity refers to binary thinking and behavioral style differences between right and left brain-oriented individuals. The inevitability of hemisity became clear when it was discovered by magnetic resonance imaging (MRI) that an anatomical element of the executive system was unilaterally embedded in either the right or the left side of the ventral gyrus of the anterior cingulate cortex in an idiosyncratic manner that was congruent with an individual's inherent hemisity subtype. Based upon the MRI-calibrated hemisity of many individuals, a set of earlier biophysical and questionnaire hemisity assays was calibrated for accuracy and found appropriate for use in the investigation of the hemisity of individuals and groups. It had been reported that a partial sorting of individuals into hemisity right and left brain-oriented subgroups occurred during the process of higher education and professional development. Here, these results were extended by comparison of the hemisity of a putative unsorted population of 1,049 high school upper classmen, with that of 228 university freshmen. These hemisity outcomes were further compared with that of 15 university librarians, here found to be predominantly left brain-oriented, and 91 academically trained musicians, including 47 professional pianists, here found to be mostly right brainers. The results further supported the existence of substantial hemisity selection occurring during the process of higher education and in professional development.