Social Costs of Work Disruptions: Evidence from Physicians and their Patients

Women commonly take extended work leaves for caregiving. These absences impose costs on firms and employees, but their consequences for consumers are less understood. We study these effects in pediatric primary care, and analyze whether pediatricians’ childbirths impact their patients’ care utilization. Using linked California birth records and Medicaid claims, we find substantial and persistent reductions in young patients’ preventive care: two years after a PCP’s childbirth, mothers’ patients have 32% fewer well visits and score 0.12 standard deviations lower on an index of vaccinations and screening tests. Notably, we do not find a lasting impact on acute or chronic care, indicating that preventive care decisions are particularly susceptible to disruptions. We present evidence suggesting that these long-lasting effects reflect a lapse in families’ preventive care habits, rather than ongoing limitations in PCP access, and that incentives and reminders from government agencies can mitigate these adverse effects. We estimate that similar disruptions could affect one in five young children in Medicaid, implying 1 million foregone vaccines and 200,000 fewer screenings annually.