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David Chan
Journal Articles

Influence and Information in Team Decisions: Evidence from Medical Residency

David Chan
American Economic Journal: Economic Policy, 2021 February 1, 2021

I study team decisions among physician trainees. Exploiting a discontinuity in team roles across trainee tenure, I find evidence that teams alter decision-making, concentrating influence in the hands of senior trainees. I also demonstrate little convergence in variation of trainee effects despite intensive training. This general pattern of trainee effects on team decision-making exists in all types of decisions and settings that I examine. In analyses evaluating mechanisms behind this pattern, I find support for the idea that significant experiential learning occurs during training and that teams place more weight on judgments of senior trainees in order to aggregate information.

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Journal Articles

Provider Discretion and Variation in Resource Allocation: The Case of Triage Decisions

David Chan
American Economic Association: Papers and Proceedings, 2020 May 1, 2020

One of the most challenging environments in health care is the emergency department (ED) A key decision-maker in that context is triage nurses, who assess patient illness severity and influence wait times for medical attention. We gather novel data on the triage process across 108 EDs, including wait times, triage nurse identities and assessments, and detailed patient information and outcomes. Using quasi-random assignment to ED, we find a striking rate of "inversions," where patients who are sicker based on either ex ante information or ex post outcomes are scored as sicker and wait longer than their healthier counterparts.

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Working Papers

Learning on the Job: Evidence from Physicians in Training

David C. Chan
Stanford University, 2018 March 10, 2018

Abstract: Learning on the job creates a tradeoff in team decisions: Workers with less knowledge have less to contribute to team decisions, but experiential learning may require that trainees also have a stake in decisions to learn. This paper studies learning and influence in team decisions among physicians trainees. Exploiting a discontinuity in relative experience, I find reduced-form evidence of influence due to seniority between trainees.

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Working Papers

Industry Input in Policymaking: Evidence from Medicare

David Chan, David C. Chan, Michael J. Dickstein
Stanford University, 2018 February 14, 2018

Abstract: In setting prices for physician services, Medicare solicits input from a committee that evaluates proposals from industry. We investigate whether this arrangement leads to prices biased toward the interests of committee members. We find that increasing a measure of affiliation between the committee and proposers by one standard deviation increases prices by 10%, demonstrating a pathway for regulatory capture. We then evaluate the effect of affiliation on the quality of information used in price-setting.

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Journal Articles

Teamwork and Moral Hazard: Evidence from the Emergency Department

David Chan, David Chan
Journal of Political Economy, 2016 May 4, 2016

Abstract:  How does teamwork increase productivity? Considering teamwork as joint monitoring and management, I investigate this question by studying the same emergency physicians working in two organizational systems differing in the team-management of work: Physicians are assigned patients in a "nurse-managed" system but divide patients between themselves in a "self-managed" system. The self-managed system increases throughput productivity by reducing a "foot-dragging" moral hazard, in which physicians prolong patient stays with expected future work.

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