Chapter Six. Who Ordered That? The Economics of Treatment Choices in Medical Care

In the United States, two patients with the same medical condition can receive drastically different treatments. In addition, the same patient can walk into two physicians’ offices and receive equally disparate treatments. This chapter attempts to understand why. It focuses on three areas: the patient, the physician, and the clinical situation. Specifically, the chapter surveys patient or demand-side factors such as price, income, and preferences; physician or supply-side factors such as specialization, financial incentives, and professionalism; and situational factors including behavioral influences and systems-level factors that play a role in clinical decision making. This chapter reviews theory and evidence, borrowing heavily from the clinical literature.