Heuristic thinking in the workplace: Evidence from primary care.

Area of Science:

• Medical decision-making
• Behavioral economics in healthcare

Background:

• Left digit bias is a cognitive bias where individuals round down numbers ending in a lower digit.
• Understanding physician decision-making is crucial for improving patient care and resource allocation.

Purpose of the Study:

• To investigate whether primary care physicians (PCPs) exhibit left digit bias concerning patients' ages.
• To determine if factors like patient familiarity and urgency influence this bias.

Main Methods:

• Utilized comprehensive administrative visit-level data from a large Israeli health maintenance organization (HMO).
• Employed a regression discontinuity framework to analyze medical examination intensity around decadal birthdays (ages ending in zero).

Main Results:

• No evidence of left digit bias was found in standard settings with clear patient information.
• PCPs were more likely to use basic diagnostic tests just above the decadal birthday threshold for unfamiliar patients seeking immediate care.

Conclusions:

• PCPs do not consistently exhibit left digit bias in routine care.
• Physician bias may emerge in specific contexts, such as when treating unfamiliar patients under time pressure, potentially influencing diagnostic test utilization.