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Who Values Human Capitalists' Human Capital? The Earnings and Labor Supply of U.S. Physicians

Author

Listed:
  • Joshua D. Gottlieb
  • Maria Polyakova
  • Kevin Rinz
  • Hugh Shiplett
  • Victoria Udalova

Abstract

Is government guiding the invisible hand at the top of the labor market? We use new administrative data to measure physicians' earnings and estimate the influence of healthcare policies on these earnings, physicians' labor supply, and allocation of talent. Combining the administrative registry of U.S.~physicians with tax data, Medicare billing records, and survey responses, we find that physicians' annual earnings average $350,000 and comprise 8.6% of national healthcare spending. The age-earnings profile is steep; business income comprises one-quarter of earnings and is systematically underreported in survey data. There are major differences in earnings across specialties, regions, and firm sizes, with an unusual geographic pattern compared with other workers. We show that health policy has a major impact on the margin: 25% of physician fee revenue driven by Medicare reimbursements accrues to physicians personally. Physicians earn 6% of public money spent on insurance expansions. We find that these policies in turn affect the type and quantity of medical care physicians supply in the short run; retirement timing in the medium run; and earnings affect specialty choice in the long run.

Suggested Citation

  • Joshua D. Gottlieb & Maria Polyakova & Kevin Rinz & Hugh Shiplett & Victoria Udalova, 2023. "Who Values Human Capitalists' Human Capital? The Earnings and Labor Supply of U.S. Physicians," NBER Working Papers 31469, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:31469
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    References listed on IDEAS

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    1. Bell, Alex & Chetty, Raj & Jaravel, Xavier & Petkova, Neviana & Van Reenen, John, 2019. "Do tax cuts produce more Einsteins? The impacts of financial incentives vs. exposure to innovation on the supply of inventors," LSE Research Online Documents on Economics 121796, London School of Economics and Political Science, LSE Library.
    2. Patrick Kline & Neviana Petkova & Heidi Williams & Owen Zidar, 2019. "Who Profits from Patents? Rent-Sharing at Innovative Firms," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1343-1404.
    3. Diamond, Rebecca & Moretti, Enrico, 2021. "Where Is Standard of Living the Highest? Local Prices and the Geography of Consumption," Research Papers 3997, Stanford University, Graduate School of Business.
    4. Clemens, Jeffrey & Gottlieb, Joshua D. & Molnár, Tímea Laura, 2017. "Do health insurers innovate? Evidence from the anatomy of physician payments," Journal of Health Economics, Elsevier, vol. 55(C), pages 153-167.
    5. Sean Nicholson, 2002. "Physician Specialty Choice under Uncertainty," Journal of Labor Economics, University of Chicago Press, vol. 20(4), pages 816-847, October.
    6. Jayanta Bhattacharya, 2005. "Specialty Selection and Lifetime Returns to Specialization Within Medicine," Journal of Human Resources, University of Wisconsin Press, vol. 40(1).
    7. Dingel, Jonathan & Gottlieb, Joshua & Lozinski, Maya & Mourot, Pauline, 2023. "Market Size and Trade in Medical Services," CEPR Discussion Papers 18029, C.E.P.R. Discussion Papers.
    8. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2018. "Hospitals as Insurers of Last Resort," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 1-39, January.
    9. Kevin M. Murphy & Andrei Shleifer & Robert W. Vishny, 1991. "The Allocation of Talent: Implications for Growth," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(2), pages 503-530.
    10. Martha J Bailey & Hilary Hoynes & Maya Rossin-Slater & Reed Walker, 2024. "Is the Social Safety Net a Long-Term Investment? Large-Scale Evidence From the Food Stamps Program," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(3), pages 1291-1330.
    11. Marika Cabral & Colleen Carey & Sarah Miller, 2021. "The Impact of Provider Payments on Health Care Utilization of Low-Income Individuals: Evidence from Medicare and Medicaid," NBER Working Papers 29471, National Bureau of Economic Research, Inc.
    12. Bresnahan, Timothy F & Reiss, Peter C, 1991. "Entry and Competition in Concentrated Markets," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 977-1009, October.
    13. Frank A. Sloan, 1975. "Physician Supply Behavior in the Short Run," ILR Review, Cornell University, ILR School, vol. 28(4), pages 549-569, July.
    14. Matthew Smith & Danny Yagan & Owen Zidar & Eric Zwick, 2019. "Capitalists in the Twenty-First Century," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(4), pages 1675-1745.
    15. M. J. Andrews & L. Gill & T. Schank & R. Upward, 2008. "High wage workers and low wage firms: negative assortative matching or limited mobility bias?," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(3), pages 673-697, June.
    16. David Card & Jesse Rothstein & Moises Yi, 2025. "Location, Location, Location," American Economic Journal: Applied Economics, American Economic Association, vol. 17(1), pages 297-336, January.
    17. Morten Olsen & Joshua Gottlieb & David Hemous & Jeffrey Clemens, 2017. "The Spill-over Effects of Top Income Inequality," 2017 Meeting Papers 332, Society for Economic Dynamics.
    18. Sean Nicholson & Nicholas S. Souleles, 2001. "Physician Income Expectations and Specialty Choice," NBER Working Papers 8536, National Bureau of Economic Research, Inc.
    19. John M. Abowd & Francis Kramarz & David N. Margolis, 1999. "High Wage Workers and High Wage Firms," Econometrica, Econometric Society, vol. 67(2), pages 251-334, March.
    20. Glied Sherry & Prabhu Ashwin G & Edelman Norman, 2009. "The Cost of Primary Care Doctors," Forum for Health Economics & Policy, De Gruyter, vol. 12(1), pages 1-26, August.
    21. David Molitor, 2018. "The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 326-356, February.
    22. Esteves-Sorenson, Constança & Snyder, Jason, 2012. "The gender earnings gap for physicians and its increase over time," Economics Letters, Elsevier, vol. 116(1), pages 37-41.
    23. Jeffrey Clemens & Joshua D. Gottlieb, 2017. "In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 1-39.
    24. Steven T. Berry, 1994. "Estimating Discrete-Choice Models of Product Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 25(2), pages 242-262, Summer.
    25. David Card & Ana Rute Cardoso & Joerg Heining & Patrick Kline, 2018. "Firms and Labor Market Inequality: Evidence and Some Theory," Journal of Labor Economics, University of Chicago Press, vol. 36(S1), pages 13-70.
    26. Sherry Glied & Ashwin G. Prabhu & Norman Edelman, 2009. "The Cost of Primary Care Doctors," NBER Chapters, in: Frontiers in Health Policy Research, volume 12, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Kole Reddig, 2024. "Spillover between Medicare and Medicaid: Evidence from decreasing physician reimbursements," Contemporary Economic Policy, Western Economic Association International, vol. 42(2), pages 223-236, April.
    2. Denning, Jeffrey T. & Turner, Lesley J., 2025. "The graduation part II: Graduate program graduation rates," Journal of Public Economics, Elsevier, vol. 248(C).
    3. Lionel Wilner & Philippe Choné, 2025. "Physician Labor Supply, Financial Incentives, and Access to Healthcare," CESifo Working Paper Series 11947, CESifo.
    4. Kelli Marquardt, 2024. "Liran Einav and Amy Finkelstein: We’ve got you covered: rebooting American health care," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 59(3), pages 190-192, July.
    5. Pragya Kakani & Simone Matecna & Amitabh Chandra, 2025. "Expert Patients’ Use of Avoidable Health Care," NBER Working Papers 33573, National Bureau of Economic Research, Inc.

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    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • 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
    • J31 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Wage Level and Structure; Wage Differentials

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