Power, broadly defined as the asymmetric control of resources, affects nearly all individual decision making. Yet there is little observational evidence on how power affects real-world behavior and resource allocation. Understanding such power dynamics is especially important in health care, where “powerful” physicians make decisions for patients in highly asymmetric information environments. To examine this question, we exploit the plausibly exogenous assignment of patients to physicians in U.S. military hospital emergency departments. Using the difference in military ranks between doctor and patient as a proxy for the power imbalance between them, we show that physician effort and resource use increases with the patient’s relative seniority. Furthermore, within-physician effort is significantly less for patients about to be promoted vs. those recently promoted to a given rank. We document other interesting effects such as the “power spillover”: when a physician attends to a higher-ranked patient, they concurrently decrease effort for their lower-ranked patients. Taken together, we conclude that the magnitude of the power imbalance in the doctor-patient relationship nontrivially affects patient care, and should be especially considered when making critical clinical decisions for vulnerable patients.

Co-hosted with Penn Medical Ethics and Health Policy.

Please note: In-person attendance at this event is preferred. Virtual access will be provided to registrants who are unable to be on campus.

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Speaker

Manasvini Singh, PhD is an Assistant Professor of Health Economics at the University of Massachusetts Amherst. Her interests lie at the intersection of decision theory and health policy. She is particularly interested in how physicians make decisions using individual and organizational information cues, and its effects on population health. Dr. Singh received her PhD in Health Economics and Policy from Emory University, and also holds a MSPH from Johns Hopkins University.

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Requirements for Event Attendance

Boxed lunches will be provided. The following requirements will apply to this event:

• All attendees must follow Penn’s current public health guidance.
• Requirements may change prior to or on the day of the event.