The Relationship between Physician Labour Supply, Service Volume and Service Intensity

Surveys of Canadian physicians show that, on average, general/family physicians have been reducing hours of direct patient care in recent years. We currently have little understanding of how changing hours of work relate to service provision. This project examines this relationship using individual-level data for a random sample of Ontario FP/GPs which contains information on fee-for-service billing and hours of direct patient care. The analysis decomposes the variation in physicians' average billing into the variation in billings per hour and variation in the average number of working hours of patient care. The empirical findings reveal that the variation across physicians in total billing is dominated by the variation in hourly billing rather than by the variation in physicians' working hours. There is also negative correlation between average billing per hour and average number of hours of patient care. This pattern is also shown in analyses of sub-groups defined by the sex of the physician, by practice location and by years of graduation. Female rather than male, rural rather than urban, and graduated in the 70's or 80's rather than in the 50's or 60's show strong negative correlations between average hourly billings and average weekly hours of direct patient care.