Health Care.

• Position: Program and Working Group Meetings

NBER's Program on Health Care met in Cambridge on November 12. Organizer Richard Frank, of Harvard Medical School and NBER, chose the following papers to discuss:

Ming Tai-Seale, Texas A&M University, and Tom McGuire, Harvard University, "Time is Up: The Increasing Shadow Price of Time in Primary Care Office Visits"

R.D. Cebul and Mark Votruba, Case Western Reserve University; James B. Rebitzer, Case Western Reserve University and NBER; and Lowell Taylor, Carnegie Mellon University, "Unhealthy Insurance Markets: Search Frictions and the Cost and Quality of Health Insurance" (NBER Working Paper No. 14455)

Jonathan Clark, Harvard University, and Robert Huckman, Harvard University and NBER, "Broadening Focus: Complementarities and the Benefits of Specialization in the Hospital Industry"

Claudio Lucarelli, Cornell University, and Sean Nicholson, Cornell University and NBER, "A Quality Adjusted Price Index for Colorectal Cancer Drugs"

Amy Finkelstein and Daron Acemoglu, MIT and NBER, and Matt Notowidigdo, MIT, "Income and Health Spending: Evidence from Oil Price Shocks"

Guy David and Seth Richards, University of Pennsylvania, and Sara Markowitz, Emory University and NBER, "The Effects of Pharmaceutical Marketing and Promotion on Adverse Drug Events and Regulation"

A physician's time is a precious resource in primary care, and the physician must constantly evaluate the gain from spending more time with the current patient versus moving on to address the health care needs of the next one. Tai-Seale and McGuire formulate the physician's decision problem and characterize two rules for deciding about when to end a visit. The first rule, which is labeled "efficient," has the physician end a visit when the estimated value of more time falls below a shadow price. Following the second "behavioral" rule, the physician terminates a visit when "time is up" and a target number of minutes have expired. The authors test for the behavioral rule against the alternative using video recordings of 385 visits by elderly patients to their primary care physician. The researchers structure the data at the "topic" level and find evidence consistent with the behavioral rule. Specifically, time elapsed within a visit is a very strong determinant of whether the physician decides this is the "last topic" to be discussed, thereby effectively ending the visit. The authors consider whether dislodging a target-time mentality from physicians (and patients) might contribute to...