IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v28y2019i11p1356-1369.html
   My bibliography  Save this article

Recruiting and retaining dental labor in federal facilities: Harder than pulling teeth?

Author

Listed:
  • Michael R. Richards
  • Coady Wing

Abstract

The U.S. Veterans Administration (VA) is a large publicly financed health system that has long struggled with provider shortages. Shortages may arise at the VA because it offers different compensation than private sector employment options or because of differences in the way that labor is supplied to public versus private employers. In the mid‐2000s, the VA adopted a more generous and flexible pay schedule for its dentists. We exploit this salary schedule change to study the impact of a positive wage shock on dental labor supplied to the VA, within a difference‐in‐differences framework. We find limited effects on VA separation and new hire rates overall—though early career dentists appear more sensitive to the wage change. More generous pay has its clearest effects on employment type for VA dentists, reducing the likelihood of being part‐time by roughly 10%.

Suggested Citation

  • Michael R. Richards & Coady Wing, 2019. "Recruiting and retaining dental labor in federal facilities: Harder than pulling teeth?," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1356-1369, November.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:11:p:1356-1369
    DOI: 10.1002/hec.3949
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3949
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3949?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wing, Coady & Marier, Allison, 2014. "Effects of occupational regulations on the cost of dental services: Evidence from dental insurance claims," Journal of Health Economics, Elsevier, vol. 34(C), pages 131-143.
    2. Thomas C. Buchmueller & Sarah Miller & Marko Vujicic, 2014. "How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits," NBER Working Papers 20053, National Bureau of Economic Research, Inc.
    3. Andrew Clark & Fabien Postel-Vinay, 2009. "Job security and job protection," Oxford Economic Papers, Oxford University Press, vol. 61(2), pages 207-239, April.
    4. Shields, Michael A. & Ward, Melanie, 2001. "Improving nurse retention in the National Health Service in England: the impact of job satisfaction on intentions to quit," Journal of Health Economics, Elsevier, vol. 20(5), pages 677-701, September.
    5. Douglas O. Staiger & Joanne Spetz & Ciaran S. Phibbs, 2010. "Is There Monopsony in the Labor Market? Evidence from a Natural Experiment," Journal of Labor Economics, University of Chicago Press, vol. 28(2), pages 211-236, April.
    6. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    7. Thomas C. Buchmueller & Sean Orzol & Lara D. Shore-Sheppard, 2015. "The Effect of Medicaid Payment Rates on Access to Dental Care among Children," American Journal of Health Economics, University of Chicago Press, vol. 1(2), pages 194-223, Spring.
    8. Danyao Li & Michael R. Richards & Coady Wing, 2019. "Economic downturns and nurse attachment to federal employment," Health Economics, John Wiley & Sons, Ltd., vol. 28(6), pages 808-814, June.
    9. Sherry Glied & Matthew Neidell, 2010. "The Economic Value of Teeth," Journal of Human Resources, University of Wisconsin Press, vol. 45(2).
    10. Mark Duggan & Jonathan Gruber & Boris Vabson, 2018. "The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 153-186, February.
    11. Ann P. Bartel & Nancy D. Beaulieu & Ciaran S. Phibbs & Patricia W. Stone, 2014. "Human Capital and Productivity in a Team Environment: Evidence from the Healthcare Sector," American Economic Journal: Applied Economics, American Economic Association, vol. 6(2), pages 231-259, April.
    12. Mueller, Richard E., 1998. "Public-private sector wage differentials in Canada: evidence from quantile regressions," Economics Letters, Elsevier, vol. 60(2), pages 229-235, August.
    13. Benjamin Artz & Ilker Kaya, 2014. "Job insecurity and job satisfaction in the United States: the case of public sector union workers," Industrial Relations Journal, Wiley Blackwell, vol. 45(2), pages 103-120, March.
    14. Hamermesh, Daniel S & Biddle, Jeff E, 1994. "Beauty and the Labor Market," American Economic Review, American Economic Association, vol. 84(5), pages 1174-1194, December.
    15. Mark Duggan & Jonathan Gruber & Boris Vabson, 2015. "The Efficiency Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits," NBER Working Papers 21650, National Bureau of Economic Research, Inc.
    16. Bonin, Holger & Dohmen, Thomas & Falk, Armin & Huffman, David & Sunde, Uwe, 2007. "Cross-sectional earnings risk and occupational sorting: The role of risk attitudes," Labour Economics, Elsevier, vol. 14(6), pages 926-937, December.
    17. Jeffrey Clemens & Joshua D. Gottlieb, 2017. "In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 1-39.
    18. Max Schanzenbach, 2015. "Explaining the Public-Sector Pay Gap: The Role of Skill and College Major," Journal of Human Capital, University of Chicago Press, vol. 9(1), pages 1-44.
    19. Elliott, Robert F. & Ma, Ada H.Y. & Scott, Anthony & Bell, David & Roberts, Elizabeth, 2007. "Geographically differentiated pay in the labour market for nurses," Journal of Health Economics, Elsevier, vol. 26(1), pages 190-212, January.
    20. Kleiner, Morris M & Kudrle, Robert T, 2000. "Does Regulation Affect Economic Outcomes? The Case of Dentistry," Journal of Law and Economics, University of Chicago Press, vol. 43(2), pages 547-582, October.
    21. Morris M. Kleiner & Kyoung Won Park, 2010. "Battles Among Licensed Occupations: Analyzing Government Regulations on Labor Market Outcomes for Dentists and Hygienists," NBER Working Papers 16560, National Bureau of Economic Research, Inc.
    22. Decker, Sandra L. & Lipton, Brandy J., 2015. "Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health," Journal of Health Economics, Elsevier, vol. 44(C), pages 212-225.
    23. Ibrahim, S.A., 2007. "The Veterans Health Administration: A domestic model for a national health care system?," American Journal of Public Health, American Public Health Association, vol. 97(12), pages 2124-2126.
    24. Adamchik, Vera A. & Bedi, Arjun S., 2000. "Wage differentials between the public and the private sectors: evidence from an economy in transition," Labour Economics, Elsevier, vol. 7(2), pages 203-224, March.
    25. Michael Frakes & Jonathan Gruber, 2019. "Defensive Medicine: Evidence from Military Immunity," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 197-231, August.
    26. Don Bellante & Albert N. Link, 1981. "Are Public Sector Workers More Risk Averse Than Private Sector Workers?," ILR Review, Cornell University, ILR School, vol. 34(3), pages 408-412, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Wing, Coady & Marier, Allison, 2014. "Effects of occupational regulations on the cost of dental services: Evidence from dental insurance claims," Journal of Health Economics, Elsevier, vol. 34(C), pages 131-143.
    2. Xia, Xing, 2021. "Barrier to Entry or Signal of Quality? The Effects of Occupational Licensing on Minority Dental Assistants," Labour Economics, Elsevier, vol. 71(C).
    3. Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.
    4. Maczulskij, Terhi, 2013. "Employment sector and pay gaps: Genetic and environmental influences," Labour Economics, Elsevier, vol. 23(C), pages 89-96.
    5. Zhuravleva, Tatiana (Журавлева, Татьяна), 2015. "Analysis of the Factors of Wages Differentiation in the Public and Private Sectors of the Russian Economy [Анализ Факторов Дифференциации Заработной Платы В Государственном И Частном Секторах Эконо," Published Papers mn10, Russian Presidential Academy of National Economy and Public Administration.
    6. Buurman, Margaretha & Delfgaauw, Josse & Dur, Robert & Van den Bossche, Seth, 2012. "Public sector employees: Risk averse and altruistic?," Journal of Economic Behavior & Organization, Elsevier, vol. 83(3), pages 279-291.
    7. Rhea Molato, 2015. "Public-Private Wage Differentials and the Quality of Government Workers in the Philippines," Working Papers tax-mpg-rps-2015-06, Max Planck Institute for Tax Law and Public Finance.
    8. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    9. Knutsson, Daniel & Tyrefors, Björn, 2020. "The Quality and Efficiency Between Public and Private Firms: Evidence from Ambulance Services," Working Paper Series 1365, Research Institute of Industrial Economics, revised 01 Jul 2021.
    10. Lucia Rizzica, 2016. "Why go public? A study of the individual determinants of public sector employment choice," Questioni di Economia e Finanza (Occasional Papers) 343, Bank of Italy, Economic Research and International Relations Area.
    11. Schweri, Juerg & Hartog, Joop, 2017. "Do wage expectations predict college enrollment? Evidence from healthcare," Journal of Economic Behavior & Organization, Elsevier, vol. 141(C), pages 135-150.
    12. Rowena Crawford & Richard Disney & Carl Emmerson, 2015. "The short run elasticity of National Health Service nurses’ labour supply in Great Britain," IFS Working Papers W15/04, Institute for Fiscal Studies.
    13. Lipton, Brandy J., 2021. "Adult Medicaid benefit generosity and receipt of recommended health services among low-income children: The spillover effects of Medicaid adult dental coverage expansions," Journal of Health Economics, Elsevier, vol. 75(C).
    14. De Paola Maria, 2013. "The Determinants of Risk Aversion: The Role of Intergenerational Transmission," German Economic Review, De Gruyter, vol. 14(2), pages 214-234, May.
    15. Christian Pfeifer, 2011. "Risk Aversion and Sorting into Public Sector Employment," German Economic Review, Verein für Socialpolitik, vol. 12(1), pages 85-99, February.
    16. Benjamin Artz & Ilker Kaya, 2014. "Job insecurity and job satisfaction in the United States: the case of public sector union workers," Industrial Relations Journal, Wiley Blackwell, vol. 45(2), pages 103-120, March.
    17. Haynes, Jonathan B. & Sessions, John G., 2013. "Work now, pay later? An empirical analysis of the pension–pay trade off," Economic Modelling, Elsevier, vol. 30(C), pages 835-843.
    18. Jelena Lausev, 2014. "WHAT HAS 20 YEARS OF PUBLIC–PRIVATE PAY GAP LITERATURE TOLD US? EASTERN EUROPEAN TRANSITIONING vs. DEVELOPED ECONOMIES," Journal of Economic Surveys, Wiley Blackwell, vol. 28(3), pages 516-550, July.
    19. Morris M. Kleiner & Allison Marier & Kyoung Won Park & Coady Wing, 2016. "Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service," Journal of Law and Economics, University of Chicago Press, vol. 59(2), pages 261-291.
    20. Liran Einav & Amy Finkelstein & Yunan Ji & Neale Mahoney, 2020. "Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(32), pages 18939-18947, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:28:y:2019:i:11:p:1356-1369. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.