UMEM Educational Pearls

Title: Does physician altruism influence quality metrics?

Keywords: physician practice, morality, altruism, professionalism (PubMed Search)

Posted: 10/17/2024 by Steve Schenkel, MPP, MD (Emailed: 10/23/2024) (Updated: 10/23/2024)
Click here to contact Steve Schenkel, MPP, MD

Does physician altruism influence quality metrics? This study suggests yes.

45 physicians were defined as “altruistic” based on their willingness to share a $250 cash prize with a stranger in an on-line version of the dictator game, something you might have played in an economics class.

Of 250 physicians drawn from primary care and cardiology, 45 met the definition of altruistic and 205 did not.

Overall, patients of altruistic physicians:

Were less likely to experience ambulatory care sensitive admissions (absolute decrease of 1%, relative decrease of 38%, adjusted odds ratio 0.6 (0.38-0.97))
Were less likely to experience ambulatory care sensitive emergency department visits (absolute decrease of 1.5%, relative decrease of 41%, adjusted odds ratio 0.64 (0.43-0.94)
Had lower total spending (adjusted decrease of $800, relative change of -9.3% (16.2-2.3). [Note: the unadjusted results run in the other direction.]

The authors suggest that this difference may be on account of altruistic physicians being more willing to consider the appropriateness of tests or treatment or “devote more time and energy to their patients.”

They also note that while most physicians were categorized as not altruistic, at 18% this group of physicians exceeds the 5% of the general US population that would meet this definition.

Perhaps there is something quantitatively demonstrable to being a “good” doctor.

See https://jamanetwork.com/journals/jama-health-forum/fullarticle/2824419

References

Casalino LP, Kariv S, Markovits D, Fisman R, Li J. Physician Altruism and Spending, Hospital Admissions, and Emergency Department Visits. JAMA Health Forum. 2024;5(10):e243383. doi:10.1001/jamahealthforum.2024.3383