Abstract:
Background and Aims: One of the controversial topics in the health economy is the theory of
induced demand. Physicians as experts enjoy superior knowledge and information and can use their extra
knowledge for persuading patients to use unnecessary healthcare. The objective of the present study
is to investigate the factors affecting on physicians’ behavior in induced demand using the experiences
of the experts in the Isfahan University of Medical Sciences. Materials and Methods: The research
is applied a qualitative method. Semi‑structured interview was used for data generation. Participants
in this study were people who had been informed in this regard and had to be experienced and
were known as experts. Purposive sampling was done for data saturation. Seventeen people were
interviewed, and criteria such as data “reliability of the information” and “stability” were considered.
The anonymity of the interviewees was preserved. The data are transcribed, categorized and then
used the thematic analysis. Results: In the present study, 41 sub‑themes and three main themes
were extracted. The three main themes included structural factors, factors due to statuses and
behaviors, and economic factors. Each of these themes had sub‑themes wh ich, for example, included
the authority of physicians, competition among physicians, regulative and legal affairs, ethical factors,
physician’s customer focus, and physicians’ tendency to maximizing profits. Conclusion: The results of
the present study represent a comprehensive image of the reasons effective on physicians’ behaviors
in occurring induced demand. The most obvious findings of this research included structural factors,
factors due to statuses and behaviors and economic factors. In the domain of structural factors;
improper supervision of medical indications, expectations of physicians to activate other medical
sections, physicians’ independency of insurance contracts, in the domain of factors due to statuses
and behaviors, physicians’ authority in patients’ compliance, competition among physicians, physicians’
customer focus physicians’ insufficient knowledge and skills, lack of commitment to ethics, and in the
domain of economic factors; physician’s tendency to maximizing profits, improper dependency of
physicians and other health services providers are among the factors of occurring induced demand
Machine summary:
For the lack of comprehensive medical examination, participants presented the following cases: "Inappropriate examination of patients, not allocating sufficient time for examination of patients, the lack of appropriate relationship between physicians and patients, the lack of observing appropriate procedure of diagnosing diseases, Factors affecting Physicians' Behaviors Structural factors Economic factors Maintaining the position of doctors Factors due to statuse s and be haviors Workflow of offices Physicians' independency of insurance contracts Physicians' freedom in providing different services Physician insecurities at the beginning of professional life Receiving a large number of patients more than physicians' ability Expected to enable the rest of the medical parts Earning more money Physicians' economic problems Compensating physicians' infringed rights Physicians' tendency to maximize profits Improper dependency of physicians and other health services providers Physicians' undesirability to provide proper services for patients in the public sector Improper relationship of physicians with institutes Ethical factors Physicians' easygoingness Being far from work conscience and commitment Physicians' lack of commitment to their real missions Putting pressure on physicians from various Commission and incentives to encourage physicians Physicians' financial par tnerships with other Competitions among physicians medical and diagnostics institutions Regulative and legal affairs Physicians' fear of regulatory authorities Patients' complaints and putting off patients to evade from possible errors Improper relationship of physicians with pharmaceutical companies Physicians' customer focus Lack of a comprehensive medical examination Attracting and maintaining patients Stimulating patients' preferences Inaccurate examination the Incorrect diagnosis of disease Improper relationship of physicians with equipment companies Using physicians as agents of selling services Improper relationship of physicians with diagnostics companies Not enough time to examine the patient Lack of proper communication betweenphysician and patient Failure to comply the correct diagnosis The approach of the easiest and most expensive way to treat Physicians' insufficient knowledge and skill Physicians' authority in patients' compliance Figure 1: Factors affecting physicians’ behaviors in induced demand using the easiest and most expensive therapy and incorrect diagnosis of diseases.