title: How important are economic factors in choice of medical specialty?
abstract: An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are distributed across specialties, but there is much disagreement about whether economic or non-economic factors are most influential in determining this choice. We undertake an empirical investigation of two potentially important economic factors: income and leisure. To do so, we specify a two way error component regression model to estimate the effects of expected earnings and available leisure time, and uncertainty of earnings and leisure, on specialty choices of medical residents. Our findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and more certain work schedules. Our results suggest that employment contracts that provide generous annual vacation time and promise regular weekly work schedules may be more effective than increased earnings in correcting the current perceived shortage of primary care physicians.
authors.affiliation: Department of Economics, Eastern Michigan University, Ypsilanti, Michigan 48197, USA. eco_thornton@online.emich.edu
authors.forename: James
authors.initials: J
authors.lastname: Thornton
authors.forename: Fred
authors.initials: F
authors.lastname: Esposto
mesh_terms: D002321:Career Choice; D003284:Contract Services; D004470:Economics, Medical; D006302:Health Services Research / Q000379:methods; D006280:Health Workforce; D006801:Humans; D007182:Income; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007899:Leisure Activities; D017059:Models, Econometric; D009042:Motivation; D010820:Physicians / Q000191:economics / Q000600:supply & distribution; D012456:Salaries and Fringe Benefits; D013038:Specialization; D014481:United States