Working Paper: NBER ID: w21002
Authors: David C. Chan Jr.
Abstract: Work schedules play an important role in utilizing labor in organizations. In this study of emergency department physicians in shift work, schedules induce two distortions: First, physicians "slack off" by accepting fewer patients near end of shift (EOS). Second, physicians distort patient care, incurring higher costs as they spend less time on patients accepted near EOS. Examining how these effects change with shift overlap reveals a tradeoff between the two. Within an hour after the normal time of work completion, physicians are willing to spend hospital resources eight times more than their market wage to preserve their leisure. Accounting for overall costs, I find that physicians slack off at approximately second-best optimal levels.
Keywords: shift work; emergency department; physician behavior; patient care; work schedules
JEL Codes: D20; I10; L23; M50
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| shift end times (EOS) (C41) | patient acceptance rates (I11) |
| patient acceptance rates (I11) | patient care costs (I11) |
| shift end times (EOS) (C41) | duration of care (C41) |
| duration of care (C41) | hospital costs (I10) |
| overlap between shifts (J22) | patient care outcomes (I11) |
| workload (J29) | patient acceptance rates (I11) |