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Do new cohorts of family physicians work less compared to their older predecessors? The evidence from Canada

Listed author(s):
  • Sarma, Sisira
  • Thind, Amardeep
  • Chu, Man-Kee

Although demographics, cohort, and contextual factors are expected to influence physician supply at the intensive margin, much of the literature has examined the demographics and very limited cohort analysis is undertaken. This paper employs a cross-classified fixed-effects methodology to examine the importance of age, period and cohort, and contextual factors in explaining the declining work hours of Canadian family physicians. We define cohorts with five-year intervals according to year of graduation from medical school. Contrary to the previous literature, we find no evidence of reduced hours of work provided by the new cohorts of physicians. Compared to the 1995-99 cohort, older male cohorts perform similar total hours of work per week except those who graduated in the 1960's while older female cohorts consistently perform fewer total work hours in the range of 3-10Â h per week. Consistent with the literature, it is found that female and older physicians provide fewer hours of work compared to the male and younger counterparts, respectively. Although there has been a decline in total hours of work for all physicians in the range of 2-3Â h per week in each period, we find a large decline in direct patient care hours (about 4-6Â h) and a marginal increase in indirect patient care (about 2-4Â h) over the period. Having children less than 6 years and children aged 6-15 years in the physician's family reduce the work hours of female family physicians by about 7Â h and 3Â h, respectively. A number of other contextual factors influence work hours of physicians in the expected direction.

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File URL: http://www.sciencedirect.com/science/article/pii/S0277953611002395
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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 72 (2011)
Issue (Month): 12 (June)
Pages: 2049-2058

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Handle: RePEc:eee:socmed:v:72:y:2011:i:12:p:2049-2058
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  1. Christopher Ferrall & Allan W. Gregory & William Tholl, 1998. "Endogenous Work Hours and Practice Patterns of Canadian Physicians," Canadian Journal of Economics, Canadian Economics Association, vol. 31(1), pages 1-27, February.
  2. Thomas F. Crossley & Jeremiah Hurley & Sung-Hee Jeon, 2009. "Physician labour supply in Canada: a cohort analysis," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 437-456.
  3. Yang Yang & Kenneth C. Land, 2008. "Age–Period–Cohort Analysis of Repeated Cross-Section Surveys: Fixed or Random Effects?," Sociological Methods & Research, , vol. 36(3), pages 297-326, February.
  4. Sisira Sarma & Rose Anne Devlin & William Hogg, 2010. "Physician's production of primary care in Ontario, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 14-30.
  5. Reither, Eric N. & Hauser, Robert M. & Yang, Yang, 2009. "Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States," Social Science & Medicine, Elsevier, vol. 69(10), pages 1439-1448, November.
  6. Devlin, Rose Anne & Sarma, Sisira, 2008. "Do physician remuneration schemes matter? The case of Canadian family physicians," Journal of Health Economics, Elsevier, vol. 27(5), pages 1168-1181, September.
  7. Harding, David J., 2009. "Recent advances in age-period-cohort analysis. A commentary on Dregan and Armstrong, and on Reither, Hauser and Yang," Social Science & Medicine, Elsevier, vol. 69(10), pages 1449-1451, November.
  8. Sarma, Sisira & Devlin, Rose Anne & Belhadji, Bachir & Thind, Amardeep, 2010. "Does the way physicians are paid influence the way they practice? The case of Canadian family physicians' work activity," Health Policy, Elsevier, vol. 98(2-3), pages 203-217, December.
  9. Sung-Hee Jeon & Jeremiah Hurley, 2007. "The Relationship Between Physician Hours of Work, Service Volume and Service Intensity," Canadian Public Policy, University of Toronto Press, vol. 33(s1), pages 17-30, January.
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