Physicians have professional obligations to care for their patients, and also deal with financial incentives that may not perfectly align with patient care. The paper below experimentally examines a sample of physicians for altruism, by observing their behavior in a dictator game over different budget constraints, and compares their measured altruism with the payments they recieve from pharma companies and the extent to which they respond to those payoffs by prescribing the brand name drugs those payments promote. Lower measures on altruism correspond to more prescription of promoted drugs.
The Role of Physician Altruism in the Physician-Industry Relationship: Evidence from Linking Experimental and Observational Data by Shan Huang, Jing Li & Anirban Basu. NBER Working Paper 33439, DOI 10.3386/w33439, January 2025
Abstract: Altruism is a key component of medical professionalism that underlies the physician's role as a representative agent for patients. However, physician behavior can be influenced when private gains enter the objective function. We study the relationship between altruism and physicians' receipt of financial benefits from pharmaceutical manufacturers, as well as the extent to which altruism mitigates physicians' responsiveness to these industry payments. We link data on altruistic preferences for 280 physicians, identified using a revealed preference economic experiment, with administrative information on their receipt of financial transfers from pharmaceutical firms along with drug prescription claims data. Non-altruistic physicians receive industry transfers that are on average 2,184 USD or 254% higher than altruistic physicians. While industry transfers lead to higher drug spending and prescribing on paid drugs, these relationships are entirely driven by non-altruistic physicians. Our results indicate that altruism is an important determinant of physicians’ relationships with and responses to industry benefits.
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