The impact of patient shortage and service provision on patient movements in a list patient system

We study physician characteristics that contribute to patients switching physicians. In particular we are interested in studying whether physician characteristics that contribute to patient dissatisfaction also contribute to a high number of patient switches. We find that physicians who experience a shortage (deficit) of patients experience more patient switching. This result is in accordance with Lurås (2005) who finds that patient shortage is associated with patient dissatisfaction, as expressed in a nationwide survey. From theory we predict that physicians with a shortage of patients would compensate for unfavorable characteristics by providing more services, as longer and more frequent consultations, to their patients. Although GPs with patient shortage in general provide more services to their patients compared with GPs who have enough patients, we do not find that the level of service provision has an impact on the number of patients who decides to switch. We conclude that extra service provision does not compensate for negative characteristics (patients’ impression of competence, empathy etc) of less popular GPs. Hence, patients’ revealed preferences show that benefits are less than costs at the margin, and we suggest that the extra service provision is socially inefficient. JEL Classification: H42; I11; I18