Patient preferences and physician availability based on physician nativity and international medical school attendance

• Many MDs are international medical grads (IMGs) or foreign-born physicians (FBPs). • We propose a theoretical model where patients disfavor IMGs/FBPs to US doctors. • These physicians consequently offer relatively better access to care in equilibrium. • Evidence from corresponding field experiments is consistent with these predictions. • Our results suggest underutilization of FBPs in a system constrained by shortages. Roughly a quarter of physicians in the United States are either international medical graduates (IMGs) or foreign-born physicians (FBPs). We propose a theoretical model where patient preferences that disfavor IMGs/FBPs may result in these physicians offering better access to their services compared with non-IMGs/FBPs in equilibrium. We use data from two field experiments to test the predictions from the model: one concerning patient preferences and the other concerning physician availability. In the patient preferences field experiment, we find that patients strongly prefer physicians educated in the United States to IMGs by more than 2-to-1. In the physician availability field experiment, we find that US-born physicians generally have lower levels of availability including offering fewer appointments and longer wait times. These results may indicate a substantial underutilization of FBPs relative to US-born physicians and suggest that greater acceptance of IMGs/FBPs will improve access to healthcare in a system that is constrained by supply shortages.

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Publication Details

Journal
Journal of Economic Behavior & Organization
Published
2024-11-13
DOI
https://doi.org/10.1016/j.jebo.2024.106813
Citations
2
Primary Topic
Global Health Workforce Issues
Type
article
Field-Weighted Citation Impact
1.49

Funders

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article

Patient preferences and physician availability based on physician nativity and international medical school attendance

Sarah Tinkler, Miron Stano, Brigham Walker, Rajiv Sharma et al.
2 citations
Journal of Economic Behavior & Organization
Global Health Workforce Issues
1.49
article

Patient preferences and physician availability based on physician nativity and international medical school attendance

Sarah Tinkler, Miron Stano, Brigham Walker, Rajiv Sharma, Janna Wisniewski
article en
2 citations

Abstract

• Many MDs are international medical grads (IMGs) or foreign-born physicians (FBPs). • We propose a theoretical model where patients disfavor IMGs/FBPs to US doctors. • These physicians consequently offer relatively better access to care in equilibrium. • Evidence from corresponding field experiments is consistent with these predictions. • Our results suggest underutilization of FBPs in a system constrained by shortages. Roughly a quarter of physicians in the United States are either international medical graduates (IMGs) or foreign-born physicians (FBPs). We propose a theoretical model where patient preferences that disfavor IMGs/FBPs may result in these physicians offering better access to their services compared with non-IMGs/FBPs in equilibrium. We use data from two field experiments to test the predictions from the model: one concerning patient preferences and the other concerning physician availability. In the patient preferences field experiment, we find that patients strongly prefer physicians educated in the United States to IMGs by more than 2-to-1. In the physician availability field experiment, we find that US-born physicians generally have lower levels of availability including offering fewer appointments and longer wait times. These results may indicate a substantial underutilization of FBPs relative to US-born physicians and suggest that greater acceptance of IMGs/FBPs will improve access to healthcare in a system that is constrained by supply shortages.

Journal of Economic Behavior & OrganizationVol. 228
Tulane University (US), Portland State University (US), Oakland University (US)
Tulane University, National Institute on Minority Health and Health Disparities
Openalex Percentile: Top 16%
Global Health Workforce Issues
1.49
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