Endogenous Work Hours and Practice Patterns of Canadian Physicians.

Abstract

Using an extensive survey of Canadian physicians, this paper studies how physician practice patterns are shaped by demographic characteristics, physician specialty, and government policy. We model the simultaneous determination of group size, primary source of professional income (fee-for- service or salaried position), weekly hours of direct patient care, and total weekly hours of work. Coefficient estimates are precisely identified and are consistent with a life cycle model of self-employed professionals. Hours of work peak after about twenty years of practice and the probability of having a solo practice rises steadily with experience. With all else constant in the model, physicians who work under fee-for-service see patients 11 more hours each week than physicians who are primarily salaried, and yet fee-for-service physicians work only one or two hours more per week in total. Physicians in Quebec, the province with the strictest limits to physician billing in 1990, work significantly fewer hours than physicians in any of the other provinces and are more likely to work for a salary in large groups.PHYSICIANS;MEDICAL CARE