SHM Converge Scientific Abstract ePoster Gallery-Application of Game Theory to Hospitalist Clinical Decision Making

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This document applies game theory to hospitalist decision-making around opioid use disorder (OUD) and medication-assisted treatment (MAT), especially buprenorphine. It updates earlier work on emergency department physicians and argues that the dynamics differ in hospital medicine because hospitalists often see patients repeatedly, may have more incentive to address underlying OUD, and are less likely to face institutional pressure to prescribe opioids.<br /><br />The author uses simplified simultaneous and sequential move games to model interactions between physicians and patients. In the model, physicians generally prefer MAT or no opioid prescription, while patients prefer opioids over MAT and MAT over no prescription. Based on these preferences, the equilibrium in the initial model favors MAT, suggesting both parties may settle on buprenorphine rather than inappropriate opioid prescribing.<br /><br />The analysis also shows that conversation structure matters. In sequential interactions, if the physician is indifferent between giving opioids and not prescribing them, and the patient leads the discussion, the patient may be more likely to obtain opioids. This implies that when physicians do not clearly communicate their treatment preferences or do not control the conversation, inappropriate opioid prescribing becomes more likely.<br /><br />The conclusion is that game theory helps explain how physician-patient interactions shape prescribing behavior. To reduce inappropriate opioid prescriptions, physicians should clearly prefer and communicate MAT, or otherwise lead the discussion in ways that support that outcome.

Asset Subtitle

Robert W. Lampman

Meta Tag

Author List Robert W. Lampman

Category Innovations

Concept Game Theory

Concept Opioid Prescribing

Concept Medication-Assisted Treatment

Concept Physician-Patient Decision-Making

Concept Balance

Distinguished Non-Finalist

Presenter Organization University of North Carolina School of Medicine

Presenting Author Robert W. Lampman

Track Other

Keywords

game theory

hospitalist decision-making

opioid use disorder

medication-assisted treatment

MAT

buprenorphine

opioid prescribing

physician-patient interaction

hospital medicine

sequential and simultaneous games

Game Theory

Opioid Prescribing

Medication-Assisted Treatment

Physician-Patient Decision-Making

Balance