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Game theory in healthcare

http://onlinelibrary.wiley.com/doi/10.1111/eci.12380/full

Game theory can be used to model the interactions between a doctor and patient. The link above uses the example of a patient seeking opioid medication. The doctor and patient are engaged in a game in which the patient is either in real pain or fake pain, and the doctor can either prescribe narcotics or not prescribe narcotics. According to the article, about 30% of a doctor’s pay is dependent on patient satisfaction. Whether the patient is faking or not, the patient is satisfied when the doctor prescribes narcotics – so in many cases the doctor’s dominant strategy is to do so. This exemplifies how interaction between doctors and patients are not always socially optimal. Prescribing drugs to an addict is not great, but refusing drugs to someone who really needs them is a huge deal and could potentially damage a doctor’s career.

 

Other variables such as liability can factor into a doctor’s strategy. There is risk of being sued if a doctor refuses to prescribe a medication that the patient demands. Liability also gives doctors incentive to order more tests, such as X-rays and blood tests. If a doctor does not ask to test for a certain illness, and the patient suffers from that illness, then the doctor could potentially face legal charges. Running expensive tests becomes a dominant strategy for doctors because whether the patient chooses to take the tests or not, the doctor will not be reprimanded for neglecting that test. When doctors follow this strategy, it is potentially detrimental to the patient and his/her insurance providers, as this increases the cost of care.

https://blogs.cornell.edu/info2040/2016/09/13/game-theory-in-the-health-care-industry/

A blog post from last year mentioned a similar game involving a doctor and an obese patient. The doctor can choose to give the patient ineffective medication over advice on healthy lifestyle choices. In many cases the patient may be more satisfied if given the medication, but the patient will not get what he or she exactly needs.

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