AbstractAgency problems are a defining characteristic of healthcare markets. We present the results from a field experiment in the market for dental care: a test patient who does not need treatment is sent to 180 dentists to receive treatment recommendations. In the experiment, we vary the socio-economic status of the patient and whether a second opinion signal is sent. Furthermore, measures of market, practice and dentist characteristics are collected. We observe an overtreatment recommendation rate of 28% and a striking heterogeneity in treatment recommendations. Furthermore, we find significantly fewer overtreatment recommendations for patients with higher socio-economic status compared with lower socio-economic status for standard visits, suggesting a complex role for patients’ socio-economic status. Competition intensity, measured by dentist density, does not have a significant influence on overtreatment. Dentists with shorter waiting times are more likely to propose unnecessary treatment.
We present a newly designed market experiment to study regulatory measures in markets with advice inspired by two recently developed theoretical models. In line with our predictions, our experimental markets create conflicts of interest and unsuitable advice biased towards high‐commission products. We examine whether two frequently discussed regulation measures – disclosure and fines for ex post unsuitable advice – reduce commission payments and improve advice. None of the regulation measures result in lower commissions and more suitable advice, however, and advice is equally biased in all treatments. Furthermore, with disclosure, conflicts of interest are enlarged, offsetting the potentially restraining effects of disclosure. The potential impact of various behavioural factors is discussed to encourage further research.
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