TY  - RPRT
        AU  - Chodick, Gabriel
AU  - Goldstein, Yoav
AU  - Shurtz, Ity
AU  - Zeltzer, Dan
        TI  - Challenging Encounters and Within-Physician Practice Variability
        PY  - 2022/Jul/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 15441
        UR  - https://www.iza.org/index.php/publications/dp15441
        AB  - We examine how physician decisions are impacted 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.
        KW  - primary care
KW  - practice variation
KW  - intra-rater reliability
        ER  -