Brendon P. Andrews

Publications
1. Andrews, Brendon P. 2024. "Medical ethics and physician motivations." Journal of Health Economics 98. Article No. 102933. https://doi.org/10.1016/j.jhealeco.2024.102933. [Open Access]. Link to Online Appendix.

2. Andrews, Brendon P. 2024. "Economic Evaluation Under Ambiguity and Structural Uncertainties." Journal of Benefit-Cost Analysis 15(3), 456-476. https://doi.org/10.1017/bca.2024.39. [Open Access]. Link to Online Appendix I. Link to Online Appendix II.

Working Papers

Physician Quality and the Flexner Report of 1910
If patients can be persuaded to switch between licensed providers on the basis of authoritative opinions, policy-makers can harness such reporting as a tool to implement incentives for high-quality care. I employ the landmark Flexner Report (1910) medical school evaluations to show that existing consumer beliefs and market-specific capital such as established reputations are primary threats to effective reporting. This historic report did not target specific physicians, but ruthlessly disparaged the quality of American medical schools and recommended the vast majority be closed. Using linked individual-level data from medical directories, I show that doctors who recently entered a local geographic market and who attended poorly-reviewed schools -- not just the recent graduates thereof -- were about three times more likely to relocate or retire after the report's release. Expert recommendations have considerably less impact when providers have established themselves in a local area, and no impact on market exit can be detected. These heterogeneous effects imply that policy-makers are unlikely to dramatically alter consumer demand with expert quality information when trust and reputation are important market features.

Physician Preferences for Consultation Restrictions in the Late 19th Century
Physicians often disagree on medical policies, but data limitations due to anonymous voting and coordinated action prevent understanding which doctors dissent. This paper harnesses a unique setting for which comprehensive individual-level data on physician support for a collective policy exists: whether regular doctors be permitted to consult with homeopaths in the early 1880s state of New York. As homeopaths and similar non-regular physicians represented more than 10% of the market for physician services, the pre-existing national ban was a significant restriction on physician behavior. Combining information from many sources, I use a novel dataset of about 5,000 physicians to show that physician eminence, distance to competitors, and private economic costs associated with a change in policy are associated with physician voting behavior. While contemporary arguments highlight patient welfare, the results suggest that at least some doctors: (i) value distant patient benefit to a lesser degree than local patient benefit; or (ii) exhibit minimal concern for all patients. Finally, I further demonstrate that prior exposure to homeopathy in the city where a physician attended medical school significantly increases their advocacy for liberalization in consultation policy, suggesting that increased social ties within a professional market can mitigate certain forms of collusive behavior. While it is not possible to determine if this relationship is driven by selection, I find that prior exposure increases political agitation among physicians favoring the ban, a result consistent with a polarization channel and the updating of physician beliefs.