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The impact of managed care on the gender earnings gap among physicians

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  • Alicia Sasser Modestino
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    Abstract

    Important differences in labor market characteristics suggest that men and women physicians may be viewed as imperfect substitutes in the labor market. Concerns about efficiency and cost-cutting, which have led to the adoption of managed care practices, may have (unintentionally) favored female physicians. Using data from the Young Physicians Survey, the author compares changes in the gender earnings gap for physicians in states with high versus low managed care growth during the 1980s. She finds that the gender gap in hourly earnings among physicians in states with high managed care growth narrowed by 10 percentage points relative to states with low managed care growth. Moreover, Census data show that this finding holds only for physicians and not for other professions requiring advanced degrees. Further analysis shows that managed care appears to affect the relative earnings of male and female physicians by compressing the overall distribution of physician earnings. Together, these results suggest that the spread of managed care has been a factor in improving the relative earnings of female physicians. More broadly, these results suggest that market changes can have important consequences for the gender earnings gap when there are large pre-existing differences between men and women within a profession.

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    Bibliographic Info

    Paper provided by Federal Reserve Bank of Boston in its series Working Papers with number 13-1.

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    Date of creation: 2013
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    Handle: RePEc:fip:fedbwp:13-1

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    Keywords: Wages - Women ; Medical care ; Career development - Sex differences;

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    1. Gunderson, Morley, 1989. "Male-Female Wage Differentials and Policy Responses," Journal of Economic Literature, American Economic Association, vol. 27(1), pages 46-72, March.
    2. Mincer, Jacob & Polachek, Solomon, 1974. "Family Investment in Human Capital: Earnings of Women," Journal of Political Economy, University of Chicago Press, vol. 82(2), pages S76-S108, Part II, .
    3. Francine D. Blau, 1997. "Trends in the Well-Being of American Women, 1970-1995," NBER Working Papers 6206, National Bureau of Economic Research, Inc.
    4. Alicia C. Sasser, 2005. "Gender Differences in Physician Pay: Tradeoffs Between Career and Family," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    5. Francine D. Blau & Lawrence M. Kahn, 2003. "Understanding International Differences in the Gender Pay Gap," Journal of Labor Economics, University of Chicago Press, vol. 21(1), pages 106-144, January.
    6. Victor R. Fuchs, 1978. "The Supply of Surgeons and the Demand for Operations," NBER Working Papers 0236, National Bureau of Economic Research, Inc.
    7. Goldin, Claudia, 1992. "Understanding the Gender Gap: An Economic History of American Women," OUP Catalogue, Oxford University Press, number 9780195072709, October.
    8. Jacob Mincer & Solomon Polacheck, 1974. "Family Investments in Human Capital: Earnings of Women," NBER Chapters, in: Economics of the Family: Marriage, Children, and Human Capital, pages 397-431 National Bureau of Economic Research, Inc.
    9. Suen, Wing, 1997. "Decomposing Wage Residuals: Unmeasured Skill or Statistical Artifact?," Journal of Labor Economics, University of Chicago Press, vol. 15(3), pages 555-66, July.
    10. Sandra E. Black & Philip E. Strahan, 2001. "The Division of Spoils: Rent-Sharing and Discrimination in a Regulated Industry," American Economic Review, American Economic Association, vol. 91(4), pages 814-831, September.
    11. Kathryn M. Langwell, 1982. "Factors Affecting the Incomes of Men and Women Physicians: Further Explorations," Journal of Human Resources, University of Wisconsin Press, vol. 17(2), pages 261-275.
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