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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.

Suggested Citation

  • Brigitte Dormont & Anne-Laure Samson, 2008. "Medical Demography and Intergenerational Inequalities in General Practitioner's Earnings," IDEP Working Papers 0804, Institut d'economie publique (IDEP), Marseille, France, revised 10 Sep 2008.
  • Handle: RePEc:iep:wpidep:0804
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    1. Lazear, Edward P, 1981. "Agency, Earnings Profiles, Productivity, and Hours Restrictions," American Economic Review, American Economic Association, vol. 71(4), pages 606-620, September.
    2. 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.
    3. 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 703-732, October.
    4. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    5. 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.
    6. Russell Davidson & Jean-Yves Duclos, 2000. "Statistical Inference for Stochastic Dominance and for the Measurement of Poverty and Inequality," Econometrica, Econometric Society, vol. 68(6), pages 1435-1464, November.
    7. 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.
    8. repec:dau:papers:123456789/6891 is not listed on IDEAS
    9. Milton Friedman & Simon Kuznets, 1954. "Income from Independent Professional Practice," NBER Books, National Bureau of Economic Research, Inc, number frie54-1.
    10. Arnaud Lefranc & Nicolas Pistolesi & Alain Trannoy & 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., 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.
    12. Edward P. Lazear & Robert L. Moore, 1984. "Incentives, Productivity, and Labor Contracts," The Quarterly Journal of Economics, Oxford University Press, vol. 99(2), pages 275-296.
    13. Nijman, T.E. & Verbeek, M.J.C.M., 1992. "Testing for selectivity in panel data models," Other publications TiSEM 7ec34a6c-1d84-4052-971c-d, Tilburg University, School of Economics and Management.
    14. Brigitte Dormont & Anne-Laure Samson, 2007. "Intergenerational inequalities in GPs' earnings : experience, time and cohort effects," Working Papers 0704, University of Lausanne, Institute of Health Economics and Management (IEMS).
    15. 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.
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    Cited by:

    1. 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.
    2. Magali Dumontet & Carine Franc, 2015. "Gender differences in French GPs’ activity: the contribution of quantile regressions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(4), pages 421-435, May.
    3. Brigitte Dormont & Anne-Laure Samson, 2017. "Does it pay to be a doctor in France?," Working Papers hal-01518428, HAL.
    4. repec:dau:papers:123456789/11717 is not listed on IDEAS
    5. repec:dau:papers:123456789/12810 is not listed on IDEAS

    More about this item

    Keywords

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

    JEL classification:

    • C2 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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