We are conducting a study which has a pre-post design. The unit of the study is the outpatient visit. In each visit, we study how patients and physicians interact.
Each physician will see between 3-6 patients and most of these patients (ie, except for dropouts) will be seen twice: once in the pre-phase, once in the post-phase.
Because the relation of patient to physician in any given visit is symmetric, it would seem to lead to two distinct ways to model the hierarchical structure. Starting from the root vertex of the (directed) tree:
A) study → physician → patient → pre/post
B) study → pre/post → physician → patient
Is there a scientific reason or stat. methodological issues to prefer one nesting over the other? What differences in results can we expect?
Any pointers to the literature are appreciated.