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How important are economic factors in choice of medical specialty?

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  • James Thornton

    (Department of Economics, Eastern Michigan University, Ypsilanti, Michigan, USA)

  • Fred Esposto

    (Department of Economics, Eastern Michigan University, Ypsilanti, Michigan, USA)

Abstract

An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are distributed across specialties, but there is much disagreement about whether economic or non-economic factors are most influential in determining this choice. We undertake an empirical investigation of two potentially important economic factors: income and leisure. To do so, we specify a two way error component regression model to estimate the effects of expected earnings and available leisure time, and uncertainty of earnings and leisure, on specialty choices of medical residents. Our findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and more certain work schedules. Our results suggest that employment contracts that provide generous annual vacation time and promise regular weekly work schedules may be more effective than increased earnings in correcting the current perceived shortage of primary care physicians. Copyright © 2002 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.682
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 12 (2003)
Issue (Month): 1 ()
Pages: 67-73

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Handle: RePEc:wly:hlthec:v:12:y:2003:i:1:p:67-73

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. 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.
  2. Frank A. Sloan, 1970. "Lifetime earnings and physicians' choice of specialty," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 24(1), pages 47-56, October.
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Cited by:
  1. Courty, Pascal & Marschke, Gerald, 2008. "On the Sorting of Physicians across Medical Occupations," IZA Discussion Papers 3862, Institute for the Study of Labor (IZA).
  2. Jeffrey E. Harris & Beatriz G. López-Valcárcel & Patricia Barber & Vicente Ortún, 2014. "Efficiency versus Equity in the Allocation of Medical Specialty Training Positions in Spain: A Health Policy Simulation Based on a Discrete Choice Model," NBER Working Papers 19896, National Bureau of Economic Research, Inc.
  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. Lin, Herng-Ching & Kao, Senyeong & Tang, Chao-Hsiun & Chang, Wen-Yin, 2005. "Using a population-based database to explore the inter-specialty differences in physician practice incomes in Taiwan," Health Policy, Elsevier, vol. 73(3), pages 253-262, September.

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