The Efficiency of Slacking Off: Evidence from the Emergency Department

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 o ff" 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 eff ects 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 fi nd that physicians slack off at approximately second-best optimal levels.