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Research Article
Does doctors' experience matter in LASIK surgeries?
Article first published online: 21 JUN 2010
DOI: 10.1002/hec.1626
Copyright © 2010 John Wiley & Sons, Ltd.
Additional Information
How to Cite
Contreras, J. M., Kim, B. and Tristao, I. M. (2011), Does doctors' experience matter in LASIK surgeries?. Health Econ., 20: 699–722. doi: 10.1002/hec.1626
Publication History
- Issue published online: 31 MAR 2011
- Article first published online: 21 JUN 2010
- Manuscript Accepted: 30 APR 2010
- Manuscript Revised: 2 MAR 2010
- Manuscript Received: 3 DEC 2008
- Abstract
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- Cited By
Keywords:
- learning;
- experience;
- LASIK;
- volume
Abstract
In this article, we use a longitudinal census of laser in situ keratomileusis (LASIK) eye surgeries collected directly from patient charts to examine the learning-by-doing hypothesis in medicine. LASIK surgery has precise measures of presurgical condition and postsurgical outcomes. Unlike other types of surgery, the impact of unobservable underlying patient conditions on outcomes is minimal. Individual learning by doing is identified through observations of surgical outcomes over time, based on the cumulative number of surgeries performed. Collective learning is identified separately, through changes in a group adjustment rule determined jointly by all the surgeons in a structured internal review process. Our unique data set overcomes some of the measurement problems in patient outcomes encountered in other studies and improves the possibility of identifying and separating the impact of learning by doing from other effects. We cannot conclude that the outcome of LASIK surgery improves as an individual surgeon's experience increases, but we find strong evidence that experience accumulated by surgeons as a group in a clinic significantly improves outcomes. Copyright © 2010 John Wiley & Sons, Ltd.