Publication date: February 2019
Source: Social Science & Medicine, Volume 222
Author(s): Alastair Irvine, Marjon van der Pol, Euan Phimister
In a perfect agency relationship, doctors consider all information and select the patient’s ‘utility maximising’ option given the patient’s preferences. The patient’s time preferences are important as treatments vary in the timing and length of their benefits. However, doctors often do not have full information on patients’ preferences and may apply their own preferences. This has generated empirical interest in estimating doctors’ time preferences. However, these studies generally elicit doctors’ private preferences (preferences for their own health) rather than professional preferences (preferences for the patient). We hypothesise that private and professional preferences may differ. Professional time preferences may be ‘taught’ in medical school or learned through repeated interactions with patients. If preferences differ then estimates of doctors’ private preferences are less informative for medical decision-making. This study compares private and professional time preferences for health in a national sample of General Practitioners, using a between sample design. Time discounting is explored using exponential and quasi-hyperbolic models. We elicit time preferences using multiple price lists. We find no significant difference between the time preference for the self or the patient. This result holds for axiomatic discounting classification and maximum likelihood estimates. We do not find evidence of present-bias. There are a high proportion of increasingly impatient GPs, potentially implying a maximum ‘willingness to wait’ for treatment benefits. GPs value the health state differently between themselves or for a patient. These results suggest that we can use estimates of private preferences from doctors to inform medical decision-making.