A Study On Patient-Physician Relations With The Framework Of Agency Theory: The Sample Of Isparta Province Center Hospitals

Year 2016, Volume: 2 Issue: 3, 1 - 6, 10.10.2017

Elif Akkaş Ramazan Erdem

Abstract

In the markets which information asymmetry exists, relationship of power of attorney occurs when the seller use this information on behalf of the association. In healthcare market, which is one of the the knowledge-intensive markets, relationship at power of attorney appears in the relationship of patient and physician. Physicians, who have one of the most important tasks to protect and upgrade the health of society, are competent at making decisions on behalf of patients by using their knowledge of medicine. Time to time ethical violations and abuse of authority occurs by using this competency and the moral hazard raise. Within the imperfect agency relationship, medical errors, unnecessary demand-creation behavior of physicians and efforts to obtain financial benefit, which are known as a kind of market failure, thought to be the reason of the decrease in confidence to physicians.

In this study, it is aimed to investigate the reasons of negative perceptions towards the physicians within the framework of agency theory. For this purpose, perceptions of patients and their physicians under these problems were evaluated.

Population of the research, composed of physicians who are working in hospitals in Isparta province center, and patients in these hospitals. In this context, 124 physicians and 303 patients were reached. As a data collection tool the questionnaire namely “Patient-Physician Relationship in the Framework of the Agency Theory” is used which is developed by the researcher. In questionnaire, there are 43 statements to measure the dimensions such as “lack of confidence to the physician", "ethical problems", "financial benefit", "unnecessary demand", " bad medical practice."

According to the survey results, there is a significant difference between the physicians' perspective to their colleagues and the view of patients to the physicians. It is found that, patients' confidence to their physicians is lower than the physicians? confidence to their colleagues. Negative perceptions of patients about the physicians based on the behavior of physicians to obtain financial benefit, tendencies to take informal payments, being source of ethical problems and bad medical practices. Also, perception of physician-patient relationship differs according to age, education and income level of the patients; and seniority and income level of physicians and the ownership of the hospital in which the physician works.

Keywords

atient-physician relations, agency theory, asymmetric information, trust in patient-physician relationship

References

• [1]Şahin, B., Sağlık Kaynaklarının Kullanımında Değişkenlik Sorunu: Neden Yönetemiyoruz? Nasıl Yönetebiliriz?, Hacettepe Sağlık İdaresi Dergisi, Cilt No 7, Sayı 2, s.201-232, 2004.
• [2] Foucault, M., Kliniğin Doğuşu, Çev: Keşoğlu, T., Doruk Yayınevi, 2002, Ankara.
• [3] Scott, A and S. V. Scottish, Patients, Doctors and Contracts: An Appliıcation of Principal-Agent Theory to The Doctor-5 Patient Relationship , Journal of Political Economy, Vol. 46, No 2, May 1999.
• [4] Vick, S., and A. Scott, Agency inHealth Care. Examining Patients’Preferences For Attributes of The Doctor–Patient Relationship, 17: 587-605, 1997.
• [5] Folland, S., C.A. Goodman and S.Miron,The Economics of Health and Health Care,Upper Saddle River, NJ : Prentice Hall,2010.
• [6] Adams, M. B., (1994), Agency Theoryand the Internal Audit, ManagerialAuditing Journal, Vol.: 9 No. 8, pp. 8-12.
• [7] Kan, İ., Biyoistatistik, UludağÜniversitesi, Basımevi, 3. Baskı, 1998,Bursa.