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


  • Sung-Hee Jeon

    () (Department of Economics, McMaster University)

  • Jeremiah Hurley

    () (Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University)


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.

Suggested Citation

  • Sung-Hee Jeon & Jeremiah Hurley, 2004. "The Relationship between Physician Labour Supply, Service Volume and Service Intensity," Centre for Health Economics and Policy Analysis Working Paper Series 2004-03, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  • Handle: RePEc:hpa:wpaper:200403

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    References listed on IDEAS

    1. Brown, M C, 1989. "Empirical Determinants of Physician Incomes--Evidence from Canadian Data," Empirical Economics, Springer, vol. 14(4), pages 273-289.
    2. 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.
    3. Rizzo, John A. & Blumenthal, David, 1994. "Physician labor supply: Do income effects matter?," Journal of Health Economics, Elsevier, vol. 13(4), pages 433-453.
    4. James Thornton & B. Kelly Eakin, 1997. "The Utility-Maximizing Self-Employed Physician," Journal of Human Resources, University of Wisconsin Press, vol. 32(1), pages 98-128.
    5. Lapan, Harvey E. & Brown, Douglas M., 1988. "Utility Maximization, Individual Production and Market Equilibrium," Staff General Research Papers Archive 10815, Iowa State University, Department of Economics.
    6. Feldstein, Martin S, 1970. "The Rising Price of Physicians' Services," The Review of Economics and Statistics, MIT Press, vol. 52(2), pages 121-133, May.
    7. Sung-Hee Jeon & Jeremiah Hurley, 2004. "The Relationship between Physician Labour Supply, Service Volume and Service Intensity," Centre for Health Economics and Policy Analysis Working Paper Series 2004-03, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    8. James Thornton, 1998. "The labour supply behaviour of self-employed solo practice physicians," Applied Economics, Taylor & Francis Journals, vol. 30(1), pages 85-94.
    9. Anthony Scott, 2005. "The Productivity of Doctors in Australia: The ‘Flat of the Curve’ and Beyond?," Melbourne Institute Working Paper Series wp2005n19, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    10. Brown, Douglas M & Lapan, Harvey E, 1979. "The Supply of Physicians' Services," Economic Inquiry, Western Economic Association International, vol. 17(2), pages 269-279, April.
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    Cited by:

    1. 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.

    More about this item


    Physician Labour Supply; Physician Service Volume; Physician Service Intensity;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


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