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Medical Demography and Intergenerational inequalities in GPs' earnings

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Author Info

  • Brigitte Dormont

    (LEGOS - Université Paris Dauphine - Paris IX, IEMS - Université de Lausanne)

  • Anne-Laure Samson

    ()
    (EconomiX - CNRS : UMR7166 - Université de Paris X - Nanterre)

Abstract

This article examines the link between restrictions on the number of physicians and general practitioners' earnings. Using a representative panel of 6,016 French self-employed GPs over the years 1983 to 2004, we show that the policies aimed at manipulating the number of places in medical schools strongly affect physicians' permanent level of earnings.We estimate an earnings function to identify experience, time and cohort effects. The cohort effect is very large: the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. GPs beginning during the eighties have the lowest permanent earnings: they belong to the baby-boom numerous cohorts and faced the consequences of an unlimited number of places in medical schools. Conversely, the decrease in the number of places in medical schools led to an increase in permanent earnings of GPs who began their practice in the mid nineties. A stochastic dominance analysis shows that unobserved heterogeneity does not compensate for average differences in earnings between cohorts. These findings suggest that the first years of practice are decisive for a GP. If competition between physicians is too intense at the beginning of career, she will suffer from permanently lower earnings. To conclude, our results show that the policies aimed at reducing the number of medical students succeeded in buoying up physicians' permanent earnings.

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Bibliographic Info

Paper provided by HAL in its series Post-Print with number halshs-00351781.

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Date of creation: 2008
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Publication status: Published, Health Economics, 2008, 17, 9, 1037-1055
Handle: RePEc:hal:journl:halshs-00351781

Note: View the original document on HAL open archive server: http://halshs.archives-ouvertes.fr/halshs-00351781/en/
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Related research

Keywords: General Practitioners; self-employed; longitudinal data; earnings; stochastic dominance;

References

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  1. Brigitte Dormont & Anne-Laure Samson, 2007. "Intergenerational inequalities in GPs’ earnings: experience, time and cohort effects," EconomiX Working Papers 2007-34, University of Paris West - Nanterre la Défense, EconomiX.
  2. Malik Koubi, 2003. "Les trajectoires professionnelles : une analyse par cohorte," Économie et Statistique, Programme National Persée, vol. 369(1), pages 119-147.
  3. Bolduc, Denis & Fortin, Bernard & Fournier, Marc-Andre, 1996. "The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis," Journal of Labor Economics, University of Chicago Press, vol. 14(4), pages 703-32, October.
  4. Rizzo, John A. & Zeckhauser, Richard J., 2007. "Pushing incomes to reference points: Why do male doctors earn more?," Journal of Economic Behavior & Organization, Elsevier, vol. 63(3), pages 514-536, July.
  5. Davidson, Russell & Duclos, Jean-Yves, 1998. "Statistical Inference for Stochastic Dominance and for the Measurement of Poverty and Inequality," Cahiers de recherche 9805, Université Laval - Département d'économique.
  6. Eric Delattre & Brigitte Dormont, 2003. "Fixed fees and physician-induced demand: A panel data study on French physicians," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 741-754.
  7. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
  8. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
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Cited by:
  1. Anne-Laure Samson, 2009. "Médecins généralistes à faibles revenus : une préférence pour le loisir ?," EconomiX Working Papers 2009-1, University of Paris West - Nanterre la Défense, EconomiX.

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