title: Other-regarding behavior and motivation in health care provision: an experiment with medical and non-medical students.
abstract: Other-regarding motivation is a fundamental determinant of public service provision. In health care, one example is physicians who act benevolently towards their patients when providing medical services. Such patient-regarding motivation seems closely associated with a personal sacrifice that health service providers are willing to make. Surprisingly, evidence on physicians' motivation is rare. This paper contributes to the literature by investigating prospective physicians', in particular, medical students', motivations and behavior. We measure the willingness to sacrifice own profit in order to increase the patients' health benefit. We conduct the same analysis for non-medical students. In a controlled incentivized laboratory experiment, participants decide, in the role of physicians, on the provision of medical services under fee-for-service or capitation schemes. Overall, 42 medical students and 44 non-medical students participated in five experimental sessions conducted between 2006 and 2008. We find substantial differences under both payment systems: compared to medical students, students of non-medical majors are less patient-regarding, less willing to sacrifice their own profit, and they state less motivation to improve patients' health. This results in significantly lower patient health benefits. Some implications for health care policies in light of physician shortage and for physician payment systems are discussed.
authors.affiliation: bonneconlab, Laboratory for Experimental Economics, Department of Economics, University of Bonn, Adenauerallee 24-42, 53113 Bonn, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Hennig-Schmidt
authors.affiliation: Seminar of Personnel Economics and Human Resource Management, Faculty of Management, Economics, and Social Sciences, University of Cologne, Albertus-Magnus-Platz, 50923 Köln, Germany. Electronic address: wiesen@wiso.uni-koeln.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wiesen
mesh_terms: D000533:Altruism; D002204:Capitation Fee; D018588:Fee-for-Service Plans / Q000191:economics; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009042:Motivation; D010817:Physician-Patient Relations; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Germany; Laboratory experiment; Medical decision-making context; Patient-regarding motivations; Payment schemes; Willingness to sacrifice