The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration
Physician treatment choices for observably similar patients vary dramatically across regions. This paper exploits cardiologist migration to disentangle the role of physician- specific factors such as preferences and learned behavior versus environment-level factors such as hospital capacity and productivity spillovers on physician behavior. Physicians starting in the same region and subsequently moving to dissimilar regions practice similarly before the move. After the move, physician behavior in the first year changes by 0.6-0.8 percentage points for each percentage point change in practice environment, with no further changes over time. This suggests environment factors explain between 60-80 percent of regional disparities in physician behavior.
This paper is adapted from the first chapter of my dissertation. I am very grateful to my advisors Amitabh Chandra, Amy Finkelstein, and Jonathan Gruber for their guidance and support. I thank David Chan, Joseph Doyle, Mark Duggan, Iuliana Pascu, Michael Powell, Jonathan Skinner, Heidi Williams, and two anonymous referees for helpful comments. I also gratefully acknowledge feedback from seminar participants at Dartmouth College, Georgia State University, George Washington University, Harvard University, Northeastern University, Massachusetts Institute of Technology, RAND, Stanford University, the University of Illinois at Urbana-Champaign, the University of Pennsylvania, the University of Warwick, and Yale University. This research was supported by the National Institute on Aging, grant number T32-AG000186. The views expressed herein are those of the author and do not necessarily reflect the views of the National Bureau of Economic Research.
David Molitor, 2018. "The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration," American Economic Journal: Economic Policy, vol 10(1), pages 326-356.