Working Paper: NBER ID: w22478
Authors: David Molitor
Abstract: 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.
Keywords: physician migration; treatment decisions; healthcare disparities; cardiology
JEL Codes: H51; I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| environment (Q56) | physician behavior (I11) |
| physician migration (J61) | changes in treatment behavior (I12) |
| physician behavior before migration (I11) | physician migration (J61) |
| treatment intensity difference (C32) | physician behavior change (I11) |