Using administrative data from a large and diverse emergency department (ED), we examine the impact of race concordance between patients and physicians on physician decision-making and patient health outcomes. We find that patient-physician race concordance increases consultation time and decreases the probability of inpatient admission and diagnostic testing. Subsequently, race-concordant patients have lower revisit rates after ED discharge. The effect of race concordance is largely driven by patients who had less serious illnesses and whose diseases had nonspecific symptoms or less clear causes. The results are best explained by the informational and communication mechanism.

We examine path dependency in physician decisions in an emergency department setting, and find that physicians’ treatment decisions for the current and previous patients are positively correlated. We show that the positive autocorrelation is higher when the current patient is of greater medical uncertainty or more similar to the previous patient in terms of observed characteristics and when the physician is less experienced or more fatigued. We then show that these patterns are highly consistent with the memory and attention model, whereby the physician’s current decision is anchored to her previous decision. The results from both reduced-form analyses and structural estimations provide further support for the importance of memory and attention in physician decision-making.