Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics

▶ Expert patients have higher education, some of them in medicine. Controlling for a large set of diagnostic criteria, we show that expert mothers are more likely to give birth by means of Caesarean sections than non-experts. ▶ Data from the Medical Birth Registry of Norway show that the educational disparities were large in the late 1960, but that they have been almost eliminated during the subsequent decades. ▶ The gradual reductions in educational disparities appear to be the result of better diagnostic instruments, for example ultrasound and cardiotocography. The analysis shows that the difference between expert and non-expert mothers becomes smaller when maternity units introduce these technologies. ▶ Introduction of advanced diagnostic technology implies that doctors become less reliant on precise “signals” from the mothers, which lead to the reduction in educational disparities. We suggest that the empirical results lend support to the hypothesis of statistical discrimination, and not to agency theory.