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The Productivity of Professions: Evidence from the Emergency Department

Author

Listed:
  • David Chan
  • Yiqun Chen

Abstract

This paper studies the productivity of nurse practitioners (NPs) and physicians, two professions performing overlapping tasks but with starkly different backgrounds, training, and pay. Using quasi-experimental variation in patient assignment to NPs versus physicians in Veterans Health Administration emergency departments, we find that, on average, NPs use more resources and exhibit a higher 30-day preventable hospitalization rate than physicians. However, the NP-physician performance difference varies by case complexity and severity. Importantly, even larger productivity variation exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs outperform physicians in 38 percent of random pairs.

Suggested Citation

  • David Chan & Yiqun Chen, 2026. "The Productivity of Professions: Evidence from the Emergency Department," American Economic Review, American Economic Association, vol. 116(8), pages 2883-2927, August.
    • Handle: RePEc:aea:aecrev:v:116:y:2026:i:8:p:2883-2927
    DOI: 10.1257/aer.20241007
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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • 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
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • M53 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Personnel Economics - - - Training

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