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Time is up: increasing shadow price of time in primary‐care office visits
Author(s) -
TaiSeale Ming,
McGuire Thomas
Publication year - 2012
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.1726
Subject(s) - shadow price , premise , primary care , shadow (psychology) , margin (machine learning) , value of time , value (mathematics) , test (biology) , medicine , health care , actuarial science , family medicine , economics , psychology , travel time , computer science , mathematical optimization , paleontology , philosophy , linguistics , mathematics , machine learning , transport engineering , engineering , psychotherapist , biology , economic growth
SUMMARY A physician's own time is a scarce resource in primary care, and the physician must constantly evaluate the gain from spending more time with the current patient against moving to address the health‐care needs of the next. We formulate and test two alternative hypotheses. The first hypothesis is based on the premise that with time so scarce, physicians equalize the marginal value of time across patients. The second, alternative hypothesis states that physicians allocate the same time to each patient, regardless of how much the patient benefits from the time at the margin. For our empirical work, we examine the presence of a sharply increasing subjective shadow price of time around the ‘target’ time using video recordings of 385 visits by elderly patients to their primary care physician. We structure the data at the ‘topic’ level and find evidence consistent with the alternative hypothesis. Specifically, time elapsed within a visit is a very strong determinant of the current topic being the ‘last topic’. This finding implies the physician's shadow price of time is rising during the course of a visit. We consider whether dislodging a target‐time mentality from physicians (and patients) might contribute to more productive primary care practice. Copyright © 2011 John Wiley & Sons, Ltd.