Physician Gender, Physician Marriage and the Supply and Distribution of Medical Services

1. Physician Gender, Physician Marriage and the Supply and Distribution of Medical Services Ann Boulis

2. Ideas and Research on Gender and Medical Service Supply & Distribution • Women physicians work less. • Women physicians are less likely to live in metropolitan areas. • The unique behavior of women physicians stems from their unique approach to work and family.

3. Key Articles • Cull, WL, HJ Mulvey, KG O'Connor, DR Sowell, CD Berkowitz, and CV Britton. 2002. "Pediatricians working part-time: past, present, and future." Pediatrics 109:1015-1102. • Colwill, JM and JM Cultice. 2003. "The future supply of family physicians: implications for rural America." Health Affairs 22:190-8.

4. Study Goals • Evaluate prevailing wisdom about women physicians and medical service supply and distribution. • Specifically: • Track trends in work effort and practice location of ALL physicians by gender. • Track trends in the work effort and practice location of MARRIED physicians by gender. • Use logistic regression to consider how spousal characteristics influence the behavior of male and female physicians.

5. Data and Variables • Sample: 1980, 1990 and 2000 5% Census Samples in the Integrated Public Use Microdata Series • Variables: Physicians are those who self identify and indicate that they have professional level education. • Married physicians are living with their spouse and legally married. • Resident Proxies Excluded

6. Figure 1: The Percent of Physicians Reporting Employment 1.00 .98 .98

7. Figure 2: The Average Work Week for Employed Physicians .86 .88 .92

8. Figure 3: The Percent of Employed Physicians Working <35 Hours Per Week 2.42 2.00 2.00

9. Figure 4: The Percent of Employed Physicians Working 50+ Hours Per Week .60 .60 .74 .74 .77 .77

10. Figure 5: The Percent of Employed Physicians in Non-Metropolitan Areas .63 .75 .73

11. Figure 6: The Percent of Employed Physicians who are Married .76 .81 .82

12. Figure 7: Female/Male Average Work Week by Marital Status

15. Conclusions: All Physicians • Employment: • The gender difference in employment is VERY limited. • Most physicians work regardless of gender. • Average Work Week: • The gender difference in average work week is closing slowly for all physicians. • Women’s work week is coming to more closely resemble men’s rather than the reverse.

16. Conclusions: All Physicians • Long & Short Work Weeks • Between 1980 and 2000, the frequency of ‘short’ weeks changed little for men or women. • The frequency of ‘long’ weeks increased slightly for men and substantially for women. • Location: • Between 1980 and 2000, the gender gap in the odds of rural practice closed somewhat. • Both the percent of men and the percent of women in rural areas declined between 1980 and 2000.

17. Conclusions: Married Physicians • Spousal Employment: • Women physicians’ work effort is more sensitive then men’s to spousal employment. • Men physicians’ work effort is growing more sensitive to spousal employment. • Spousal Education: • Women physicians’ location is more sensitive to spousal education. • Men physicians’ location is growing more sensitive to spousal education.

18. EXTRA SLIDES

19. Figure 1: The Percent of Physicians <65 Reporting Employment 99% 97% 98%

20. Figure 2: The Average Work Week for Employed Physicians < Age 65 85% 86% 89%

21. The Percent of Employed Physicians <65 Working <35 Hours Per Week

22. Figure 4: The Percent of Employed Physicians <65 Working 50+ Hours Per Week

23. The Percent of Employed Physicians <65 Living Outside of a Metro Area 61% 76% 74%

24. The Percent of Employed Physicians <65 who are Married with Spouse Present