Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/34392
Authors: 
Dumont, Etienne
Fortin, Bernard
Jacquemet, Nicolas
Shearer, Bruce S.
Year of Publication: 
2007
Series/Report no.: 
IZA Discussion Papers 3229
Abstract: 
We analyse how physicians respond to contractual changes and incentives within a multitasking environment. In 1999 the Quebec government (Canada) introduced an optional mixed compensation system, combining a fixed per diem with a discounted (relative to the traditional fee-for-service system) fee for services provided. We combine panel survey and administrative data on Quebec physicians to evaluate the impact of this change in incentives on their practice choices. We highlight the differentiated impact of incentives on various dimensions of physician behaviour by considering a wide range of labour supply variables: time spent on seeing patients, time devoted to teaching, administrative tasks or research, as well as the volume of clinical services and average time per clinical service. Our results show that, on average, the reform induced physicians who changed from FFS to MC to reduce their volume of (billable) services by 6.15% and to reduce their hours of work spent on seeing patients by 2.57%. Their average time spent per service increased by 3.58%, suggesting a potential quality-quantity substitution. Also the reform induced these physicians to increase their time spent on teaching and administrative duties (tasks not remunerated under the fee-for-service system) by 7.9%.
Subjects: 
Physician payment mechanisms
multitasking
mixed-payment systems
incentive contracts
labour supply
self-selection
panel estimation
JEL: 
I10
Document Type: 
Working Paper

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