Volume 26, Number 1 (Winter) 1991
Hurley, Jeremiah E. 1991. "Physicians' Choices of Specialty, Location, and Mode: A Reexamination Within an Interdependent Decision Framework." Journal of Human Resources 26(1):47-71.
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.
The author is an assistant professor in the Department of Clinical Epidemiology and Biostatistics, center for Health Economics and Policy Analysis; and an associate member of the Department of Economics, McMaster University. He would like to thank John Rust, Alan Day, Michael Anderson, and three anonymous referees for helpful comments. he takes responsibility for all errors. This investigation utilized data from the AAMC Longitudinal Study, a project conducted by the Association of American Medical Colleges, with partial support from the National Center for Health Services Research. The contribution of the American Medical Association to the project data base is also acknowledged. The design and interpretation of the research reported herein, however, are solely the responsibility of the author.
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