CeDEx Seminar - Glenn Dutcher (Ohio University)

Heterogeneity in U.S. doctors' decisions to accept or reject deceased donor kidneys

Policymakers focus on identifying allocation mechanisms to reduce the discard rate of deceased-donor kidneys; however, many leading solutions assume strategic behavior with full information, implying homogeneous choices by decision-makers. We constructed a novel data set to investigate the accuracy of the homogeneity assumption when on-call surgeons or nephrologists must decide if they will accept a deceased-donor kidney for their patient between January 1, 2016, and December 31, 2020.

Because surgeons within a transplant center have a pre-determined on-call schedule, and the on-call surgeon makes decisions for all patients in that center, variance in the choices within a center can be taken as a refutation of classical assumptions that physicians operate as perfect agents with full information. We find doctors at some centers to be more consistent than others. These results suggest various avenues for individual-level differences even when well-informed individuals are highly motivated and highly intelligent.