Rochaix L
J Health Econ. 1989 Mar;8(1):53-84. doi: 10.1016/0167-6296(89)90009-x.
This paper offers an integrated approach to the physician-patient interaction based on the notion of a conditional demand function where the physician 'proposes' and the patient 'disposes'. The model specifies the information asymmetry between the physician and the patient mainly in terms of a differential in uncertainty about the patient's health status. An imperfect agency may result, leading some physicians to recommend more (less) treatment than the patient would have chosen, had the patient been fully informed. But patients are shown to exert pressure on their physician by potentially seeking a second opinion. In effect, patients' search for an adequate treatment becomes an ex ante monitoring technique, which induces physicians to act as 'better agents'. We further show, by means of a simulation, that it is enough for a small number of patients to be well informed for this result to hold.
本文基于条件需求函数的概念,提出了一种医患互动的综合方法,其中医生“提议”,患者“处置”。该模型主要从医患双方对患者健康状况不确定性的差异方面,明确了医患之间的信息不对称。可能会导致不完全代理问题,使得一些医生推荐的治疗比患者在完全知情的情况下会选择的更多(或更少)。但研究表明,患者可能会通过寻求第二种意见来对医生施加压力。实际上,患者寻求适当治疗的行为成为一种事前监督技术,促使医生成为“更好的代理人”。我们通过模拟进一步表明,只要有少数患者充分知情,这一结果就能成立。