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Determinants of Physicians’ Decisions to Specialize

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Abstract

. In this paper, we study physician specialty decisions using several unique data sets which include information on almost all Canadian physicians who practised in Canada between 1989 and 1998. Unlike previous studies, we use a truly exogenous measure of potential income across general and specialty medicine to estimate the effect of income on physicians’ specialty choices. Furthermore, our estimation procedure allows us to purge the income-effect estimates of non-pecuniary specialty attributes which may be correlated with higher paying specialties. Understanding the effect of potential income (and other variables) on choices is necessary if the desired mix across generalists and specialists as well as across specialties is to be achieved. Our results show that physicians respond to differences in income when making their specialty decisions. More specifically, our simulation exercise suggests that provinces could increase the proportion of graduates who select a surgical specialty by increasing the fees they pay to them.

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  • Robert Gagné & Pierre Thomas Léger, 2003. "Determinants of Physicians’ Decisions to Specialize," Cahiers de recherche 03-01, HEC Montréal, Institut d'économie appliquée.
    • Handle: RePEc:iea:carech:0301
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    1. Jeremiah E. Hurley, 1991. "Physicians' Choices of Specialty, Location, and Mode: A Reexamination within an Interdependent Decision Framework," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 47-71.
    2. Sean Nicholson, 2002. "Physician Specialty Choice under Uncertainty," Journal of Labor Economics, University of Chicago Press, vol. 20(4), pages 816-847, October.
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    1. 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.
    2. Agnès Charpin & Josep Amer-Mestre & Noémi Berlin & Magali Dumontet, 2024. "Gender Differences in Early Occupational Choices: Evidence from Medical Specialty Selection," EconomiX Working Papers 2024-5, University of Paris Nanterre, EconomiX.
    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. Jeffrey E. Harris & Beatriz G. Lopez‐Valcarcel & Patricia Barber & Vicente Ortún, 2017. "Allocation of Residency Training Positions in Spain: Contextual Effects on Specialty Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 371-386, March.

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    More about this item

    Keywords

    Physician Specialty Choice;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • C30 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - General

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