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Journal of Labor Economics Vol. 35 No. 1 2017

Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians

Janet Currie1,2; W. Bentley MacLeod1

1 National Bureau of Economic Research · 2 Princeton University

Abstract

Expert performance is often evaluated assuming that good experts have good outcomes. We examine expertise in medicine and develop a model that allows for two dimensions of physician performance: decision making and procedural skill. Better procedural skill increases the use of intensive procedures for everyone, while better decision making results in a reallocation of procedures from fewer low-risk to high-risk cases. We show that poor diagnosticians can be identified using administrative data and that improving decision making improves birth outcomes by reducing C-section rates at the bottom of the risk distribution and increasing them at the top of the distribution.

DOI
10.1086/687848
Volume
35
Issue
1
Pages
1-43
Language
en
Sources
openalex crossref

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