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Medical Demography and Intergenerational Inequalities in General Practitioner's Earnings

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Abstract

This article examines the link between restrictions on the number of physicians and general practitioners’ (GPs) earnings. Using a representative panel of 6016 French self-employed GPs over the years 1983–2004, we estimate an earnings function to identify experience, time and cohort effects. The estimated gap in earnings between ‘good’ and ‘bad’ cohorts can be as large as 25%. GPs who began their practices during the eighties have the lowest permanent earnings: they belong to the large cohorts of the baby-boom and face 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 practices 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 their careers, they will suffer from permanently lower earnings. To conclude, our results show that the policies aimed at reducing the number of medical students succeeded in buying up physicians’ permanent earnings.

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Bibliographic Info

Paper provided by Institut d'economie publique (IDEP), Marseille, France in its series IDEP Working Papers with number 0804.

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Length: 36 pages
Date of creation: 10 Sep 2008
Date of revision: 10 Sep 2008
Handle: RePEc:iep:wpidep:0804

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Keywords: GPs; self-employed; longitudinal data; earnings; stochastic dominance;

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References

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  1. Verbeek, Marno & Nijman, Theo, 1992. "Testing for Selectivity Bias in Panel Data Models," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 33(3), pages 681-703, August.
  2. 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.
  3. Davidson, R. & Duclos, J.-Y., 1998. "Statistical Inference for Stochastic Dominance and for the Measurement of Poverty and Inequality," G.R.E.Q.A.M. 98a14, Universite Aix-Marseille III.
  4. Lazear, Edward P & Moore, Robert L, 1984. "Incentives, Productivity, and Labor Contracts," The Quarterly Journal of Economics, MIT Press, vol. 99(2), pages 275-96, May.
  5. Milton Friedman & Simon Kuznets, 1954. "Income from Independent Professional Practice," NBER Books, National Bureau of Economic Research, Inc, number frie54-1, May.
  6. 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.
  7. Nijman, T.E. & Verbeek, M.J.C.M., 1992. "Testing for selectivity in panel data models," Open Access publications from Tilburg University urn:nbn:nl:ui:12-153280, Tilburg University.
  8. Dormont, Brigitte & Samson, Anne-Laure, 2007. "Intergenerational inequalities in GPs' earnings: experience, time and cohort effects," Economics Papers from University Paris Dauphine 123456789/6891, Paris Dauphine University.
  9. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
  10. Alain Trannoy & Nicolas Pistolesi & Arnaud Lefranc & Louis-André Vallet, 2004. "Le revenu selon l'origine sociale ; suivi d'un commentaire de Louis-André Vallet," Économie et Statistique, Programme National Persée, vol. 371(1), pages 49-88.
  11. 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.
  12. 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.
  13. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  14. Lazear, Edward P, 1981. "Agency, Earnings Profiles, Productivity, and Hours Restrictions," American Economic Review, American Economic Association, vol. 71(4), pages 606-20, September.
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Cited by:
  1. Samson, Anne-Laure & Dormont, Brigitte, 2014. "Does it pay to be a doctor in France?," Economics Papers from University Paris Dauphine 123456789/12810, Paris Dauphine University.
  2. Kuhn, Michael & Ochsen, Carsten, 2009. "Demographic and geographic determinants of regional physician supply," Thuenen-Series of Applied Economic Theory 105, University of Rostock, Institute of Economics.
  3. Franc, Carine & Dumontet, Magali, 2013. "Male and Female GPs incomes: A study of the determinants through quantiles regressions," Economics Papers from University Paris Dauphine 123456789/11717, Paris Dauphine University.

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