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APHA Scientific Session and Event Listing

Chiu-Fang Chou, MPA, Health Policy and Administration, Midwest Center for Health Workforce Studies, University of Illinois at Chicago, 1747 W. Roosevelt Road, Room 558, M/C 275, Chicago, IL 60608-1264, 312-622-1038, cchou4@uic.edu and Anthony T. LoSasso, PhD, Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 752 SPHPI, M/C 923, 1603 W Taylor St, Chicago, IL 60612-4310.

Background: Newly graduated physicians represent a highly dynamic segment of the supply of physicians, and their practice location decisions can have a lasting impact on the future healthcare workforce. Therefore, it is critical to have a better understanding of how new physicians establish their careers, provide medical care, and meet their own expectations in the 21st Century healthcare market. Given the concerns about the distribution of physicians relative to need, finding the most salient characteristics associated with new physicians' practice location would help state and national healthcare policymakers understand the needs of young physicians for strategic workforce planning.

Research Objective: This study is aimed at understanding how new physicians choose their initial practice locations. The objectives of this study are to assess whether malpractice premiums have an effect on new physicians' choice of practice location and to examine how other local characteristics affect where new physicians choose to practice.

Method: Statistical analysis involved conditional logit models to examine the factors affecting the choice of initial practice location by new physicians. Data are from a unique survey of exiting medical residents acquired by the HRSA-funded New York Workforce Center at SUNY Albany. These data are matched to data on malpractice premiums from Medical Liability Monitor. Additional location information is from the Area Resource File (ARF).

The sample consists of 9,137 physicians who just finished their residency training in New York and California in 1998-2003 and who are beginning their careers in patient care. The dependent variable is the choice of location among the 357 metropolitan statistical areas (MSAs) and non-metropolitan areas within each state in the United States. Where appropriate, independent variables have been weighted by area population. Other local market characteristics include hospital beds, per capital income, and the local unemployment rate.

Results: Preliminary conditional logit results indicate that malpractice premiums do not appear to be a deterrent to locating in a particular area, even for high malpractice specialties such as obstetrics and surgery.

Conclusions: Given that malpractice premiums do not appear to be an important factor affecting new physician location choices, our results suggest that other factors outweigh anticipated malpractice concerns. These other factors might include lifestyle variables that are difficult to measure. Our results could also suggest that salaries for new physicians might already compensate for high malpractice costs.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to
• • Understand the effect of malpractice premium on new physicians.
• • Discuss physicians’ first location choices that are impacted by location characteristics.

Keywords: Workforce, Physicians

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 408.0 kb)