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Physician choice of medical specialty: do economic incentives matter?

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  • James Thornton

Abstract

In this paper, a probabilistic discrete choice approach is used to examine the influence of economic and non-economic factors on the choice of medical specialty by new physicians. A two level nested logit model is estimated that relaxes the independence from irrelevant alternatives assumption, and allows for a potentially more realistic pattern of substitution across specialty choices. The results from this specification are compared to those obtained from joint and conditional logit models. The findings, which are relatively robust across models, indicate that economic incentives play an important role in the specialty choice process, in particular, expected hours worked and medical school indebtedness. Physician tastes for specialties also appear to have an important influence.

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  • James Thornton, 2000. "Physician choice of medical specialty: do economic incentives matter?," Applied Economics, Taylor & Francis Journals, vol. 32(11), pages 1419-1428.
    • Handle: RePEc:taf:applec:v:32:y:2000:i:11:p:1419-1428
    DOI: 10.1080/00036840050151494
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    References listed on IDEAS

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    1. Bazzoli, Gloria J., 1985. "Does educational indebtedness affect physician specialty choice?," Journal of Health Economics, Elsevier, vol. 4(1), pages 1-19, March.
    2. McKay, Niccie L., 1990. "The economic determinants of specialty choice by medical residents," Journal of Health Economics, Elsevier, vol. 9(3), pages 335-357, November.
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    4. Frank A. Sloan, 1970. "Lifetime Earnings and Physicians' Choice of Specialty," ILR Review, Cornell University, ILR School, vol. 24(1), pages 47-56, October.
    5. Train, Kenneth E & Ben-Akiva, Moshe & Atherton, Terry, 1989. "Consumption Patterns and Self-selecting Tariffs," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 62-73, February.
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    Cited by:

    1. Judith Semeijn & Rolf van der Velden & Hans Heijke & Cees van der Vleuten & Henny Boshuizen, 2005. "The Role of Education in Selection and Allocation in the Labour Market: An Empirical Study in the Medical Field," Education Economics, Taylor & Francis Journals, vol. 13(4), pages 449-477.
    2. Li, Jing, 2018. "Plastic surgery or primary care? Altruistic preferences and expected specialty choice of U.S. medical students," Journal of Health Economics, Elsevier, vol. 62(C), pages 45-59.
    3. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    4. Jeffrey E. Harris & Beatriz G. Lopez‐Valcarcel & Patricia Barber & Vicente Ortún, 2017. "Allocation of Residency Training Positions in Spain: Contextual Effects on Specialty Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 371-386, March.
    5. Judith Semeijn & Rolf van der Velden & Hans Heijke & Cees van der Vleuten & Henny Boshuizen, 2005. "The Role of Education in Selection and Allocation in the Labour Market: An Empirical Study in the Medical Field," Education Economics, Taylor & Francis Journals, vol. 13(4), pages 449-477.
    6. Terence Chai Cheng & Anthony Scott & Sung‐Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
    7. Pascal Courty & Gerald R. Marschke, 2008. "On the Sorting of Physicians across Medical Occupations," NBER Working Papers 14502, National Bureau of Economic Research, Inc.
    8. Ellyson, Alice M. & Robertson, Justin C., 2019. "Can malpractice pressure compel a physician to relocate?," International Review of Law and Economics, Elsevier, vol. 57(C), pages 37-48.
    9. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    10. Geir Godager & Tor Iversen & Ching-To Ma, 2009. "Service motives and profit incentives among physicians," International Journal of Health Economics and Management, Springer, vol. 9(1), pages 39-57, March.
    11. John Whitehead, 2006. "A comparison of contingent valuation method and random utility model estimates of the value of avoiding reductions in king mackerel bag limits," Applied Economics, Taylor & Francis Journals, vol. 38(15), pages 1725-1735.
    12. William Choi & Lan Liang, 2007. "Reverse moral hazard of liability insurers: evidence from medical malpractice claims," Applied Economics, Taylor & Francis Journals, vol. 39(18), pages 2331-2340.
    13. Sabine Jokisch & Laurence J. Kotlikoff, 2007. "Simulating the Dynamic Macroeconomic and Microeconomic Effects of the FairTax1," Boston University - Department of Economics - Working Papers Series WP2007-026, Boston University - Department of Economics.
    14. Lin, Lee-Kai, 2022. "Effects of a global budget payment scheme on medical specialty workforces," Social Science & Medicine, Elsevier, vol. 309(C).

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