Physicians' Choices of Specialty, Location, and Mode: A Reexamination within an Interdependent Decision Framework

In this paper, physicians' decisions regarding the specialty, community size, and mode of their first practices are analyzed in a simultaneous decision model using a nested logit specification. Physicians face a choice set consisting of eight specialties, seven community sizes, and three practice settings. Data come from the Longitudinal Survey of the Class of 1960. Income is found to be statistically significant and the average income elasticity is 1.05, which is considerably larger than previous estimates. However, the elasticity estimate is very sensitive to the assumed decision process. A series of policy simulations are then performed to estimate the effect of specified income-based policies on the predicted distribution of physicians across specialties, community sizes, and modes.