Challenging Encounters and Within-Physician Practice Variability
研究了医生在遇到新确诊癌症患者这类困难病例后，其后续诊疗决策的变化，发现医生会短期内增加常见检查的转诊，且该效应与患者选择或日程干扰无关。
Abstract We examine how physician decisions are affected by difficult cases—encounters with newly diagnosed cancer patients. Using detailed administrative data, we compare primary care physicians’ decisions in visits that occurred before and after difficult cases and matched comparison cases by the same physicians on other dates. Immediately following a difficult case, physicians increase referrals for common tests, including diagnostic tests unrelated to cancer. The effect lasts only for about an hour and is not driven by patient selection or schedule disruption. The results highlight difficult encounters as a source of variability in physician practice.