Melbourne Institute of Applied Economic and Social Research - Research Publications

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    Public, private or both? Analyzing factors influencing the labour supply of medical specialists
    Cheng, TC ; Kalb, G ; Scott, A (WILEY, 2018-05-01)
    This paper investigates the factors influencing the allocation of time between public and private sectors by medical specialists. A discrete choice structural labour supply model is estimated, where specialists choose from a set of job packages that are characterized by the number of working hours in the public and private sectors. The results show that medical specialists respond to changes in earnings by reallocating working hours to the sector with relatively increased earnings, while leaving total working hours unchanged. The magnitudes of the own‐sector and cross‐sector hours elasticities fall in the range of 0.16–0.51. The labour supply response varies by gender, doctor’s age and medical specialty. Family circumstances such as the presence of young dependent children reduce the hours worked by female specialists but not male specialists.
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    What factors affect physicians' labour supply: Comparing structural discrete choice and reduced-form approaches
    Kalb, G ; Kuehnle, D ; Scott, A ; Cheng, TC ; Jeon, S-H (WILEY, 2018-02-01)
    Little is known about the response of physicians to changes in compensation: Do increases in compensation increase or decrease labour supply? In this paper, we estimate wage elasticities for physicians. We apply both a structural discrete choice approach and a reduced-form approach to examine how these different approaches affect wage elasticities at the intensive margin. Using uniquely rich data collected from a large sample of general practitioners (GPs) and specialists in Australia, we estimate 3 alternative utility specifications (quadratic, translog, and box-cox utility functions) in the structural approach, as well as a reduced-form specification, separately for men and women. Australian data is particularly suited for this analysis due to a lack of regulation of physicians' fees leading to variation in earnings. All models predict small negative wage elasticities for male and female GPs and specialists passing several sensitivity checks. For this high-income and long-working-hours population, the translog and box-cox utility functions outperform the quadratic utility function. Simulating the effects of 5% and 10% wage increases at the intensive margin slightly reduces the full-time equivalent supply of male GPs, and to a lesser extent of male specialists and female GPs.
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    A Man's Blessing or a Woman's Curse? The Family Earnings Gap of Doctors
    Schurer, S ; Kuehnle, D ; Scott, A ; Cheng, TC (WILEY, 2016-07-01)
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    Medicine in Australia: Balancing Employment and Life (MABEL)
    Yan, W ; Cheng, TC ; Scott, A ; Joyce, CM ; Humphreys, J ; Kalb, G ; Leahy, A (WILEY-BLACKWELL, 2011-03-01)
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    An empirical analysis of public and private medical practice in Australia
    Cheng, TC ; Joyce, CM ; Scott, A (ELSEVIER IRELAND LTD, 2013-06-01)
    The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types.
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    WHAT FACTORS INFLUENCE THE EARNINGS OF GENERAL PRACTITIONERS AND MEDICAL SPECIALISTS? EVIDENCE FROM THE MEDICINE IN AUSTRALIA: BALANCING EMPLOYMENT AND LIFE SURVEY
    Cheng, TC ; Scott, A ; Jeon, S-H ; Kalb, G ; Humphreys, J ; Joyce, C (WILEY-BLACKWELL, 2012-11-01)
    To date, there has been little data or empirical research on the determinants of doctors' earnings despite earnings having an important role in influencing the cost of health care, decisions on workforce participation and labour supply. This paper examines the determinants of annual earnings of general practitioners (GPs) and specialists using the first wave of the Medicine in Australia: Balancing Employment and Life, a new longitudinal survey of doctors. For both GPs and specialists, earnings are higher for men, for those who are self-employed and for those who do after-hours or on-call work. GPs have higher earnings if they work in larger practices, in outer regional or rural areas, and in areas with lower GP density, whereas specialists earn more if they have more working experience, spend more time in clinical work and have less complex patients. Decomposition analysis shows that the mean earnings of GPs are lower than that of specialists because GPs work fewer hours, are more likely to be female, are less likely to undertake after-hours or on-call work, and have lower returns to experience. Roughly 50% of the income gap between GPs and specialists is explained by differences in unobserved characteristics and returns to those characteristics.