Does Experience Make Better Doctors? Evidence from Lasik and Other Refractive Eye Surgeries

Ignez M. Tristao, Congressional Budget Office (CBO)
Juan M. Contreras-Tirado, Congressional Budget Office (CBO)
Beomsoo Kim, University of North Carolina at Greensboro

It is a common belief that experience improves the level of skills, which suggests that there may be some learning by doing with practice. Given its important policy implications, economists have tried to empirically determine the existence of learning by doing in medicine. However, patient’s selection and underlying conditions makes it difficult to disentangle learning by doing from other effects. In this paper, we use refractive eye surgery, an operation with a well-defined eligibility criterion and objective measures of previous condition and posterior outcome, which depend minimally on post-surgical care. The data used in this study was collected by us from individual’s patient chart and is a census of LASIK patients from a large surgery clinic in Colombia. Our findings suggest that learning comes more from the improvements in clinic’s ability to translate the surgical plan into the desired eyesight correction rather than from the accumulation of the physician experience.