Provider altruism in health economics

We propose a first comprehensive overview of the main theoretical notions and empirical findings on altruism among physicians and other healthcare providers. While altruism in the behavioral and experimental economics literature is typically defined as a deviation from purely self-interested behavior, the theoretical health economics literature embeds the notion of physician altruism within the doctor–patient relationship. The altruism of physicians is typically defined as the weight in the doctor’s utility function attached to patient’s health benefits, besides the self-interested monetary considerations. We broadly group the empirical evidence into five main categories of evidence, gradually moving from low to high control in the settings and empirical strategies: evidence from i) survey and interview data, ii) discrete choice experiments, iii) prescriptions records, iv) field experiments, and, finally, v) laboratory experiments. Across each of those groups of studies and different methods, the evidence generally supports the theoretical notion that physicians largely behave ‘altruistically’ in their healthcare decisions. Some studies indicate, however, considerable heterogeneity in physicians’ altruistic preferences