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Diagnosing Expertise: Human Capital, Decision Making and Performance Among Physicians

Currie, Janet; MacLeod, William Bentley

Expert performance is often evaluated assuming that good experts have good outcomes. We examine expertise in medicine and develop a model that allows for two dimensions of physician performance: Decision making and procedural skill. Better procedural skill increases the use of intensive procedures for everyone, while better decision making results in a reallocation of procedures from fewer low risk to high risk cases. We show that poor diagnosticians can be identified using administrative data and that improving decision making improve birth outcomes by reducing C-section rates at the bottom of the risk distribution and increasing them at the top of the distribution.

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