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Physicians' Choices of Specialty, Location, and Mode: A Reexamination within an Interdependent Decision Framework

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  • Jeremiah E. Hurley

Abstract

In this paper, physicians' decisions regarding the specialty, community size, and mode of their first practices are analyzed in a simultaneous decision model using a nested logit specification. Physicians face a choice set consisting of eight specialties, seven community sizes, and three practice settings. Data come from the Longitudinal Survey of the Class of 1960. Income is found to be statistically significant and the average income elasticity is 1.05, which is considerably larger than previous estimates. However, the elasticity estimate is very sensitive to the assumed decision process. A series of policy simulations are then performed to estimate the effect of specified income-based policies on the predicted distribution of physicians across specialties, community sizes, and modes.

Suggested Citation

  • Jeremiah E. Hurley, 1991. "Physicians' Choices of Specialty, Location, and Mode: A Reexamination within an Interdependent Decision Framework," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 47-71.
    • Handle: RePEc:uwp:jhriss:v:26:y:1991:i:1:p:47-71
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    Cited by:

    1. Matthieu Cassou & Julien Mousquès & Carine Franc, 2020. "General practitioners’ income and activity: the impact of multi-professional group practice in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1295-1315, December.
    2. 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.
    3. George M. Holmes, "undated". "The Long Term Effect of the National Health Service Corps," Working Papers 0104, East Carolina University, Department of Economics.
    4. Holmes, George M., 2005. "Increasing physician supply in medically underserved areas," Labour Economics, Elsevier, vol. 12(5), pages 697-725, October.
    5. Robert Gagné & Pierre Thomas Léger, 2005. "Determinants of physicians' decisions to specialize," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 721-735, July.
    6. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    7. Beomsoo Kim, 2007. "The Impact of Malpractice Risk on the Use of Obstetrics Procedures," The Journal of Legal Studies, University of Chicago Press, vol. 36(S2), pages 79-119, June.
    8. Jeffrey E. Harris & Beatriz G. Lopez‐Valcarcel & Patricia Barber & Vicente Ortún, 2017. "Allocation of Residency Training Positions in Spain: Contextual Effects on Specialty Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 371-386, March.
    9. Terence Chai Cheng & Anthony Scott & Sung‐Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
    10. Ellyson, Alice M. & Robertson, Justin C., 2019. "Can malpractice pressure compel a physician to relocate?," International Review of Law and Economics, Elsevier, vol. 57(C), pages 37-48.
    11. Kuhn, Michael & Ochsen, Carsten, 2019. "Population change and the regional distribution of physicians," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    12. Steven Stern & Elizabeth Merwin & Emily Hauenstein & Ivora Hinton & Virgina Rovnyak & Melvin Wilson & Ishan Williams & Irma Mahone, 2008. "The E¤ect of Rurality on Mental and Physical Health," Virginia Economics Online Papers 381, University of Virginia, Department of Economics.
    13. Lin, Lee-Kai, 2022. "Effects of a global budget payment scheme on medical specialty workforces," Social Science & Medicine, Elsevier, vol. 309(C).

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