Patient preferences and physician availability based on physician nativity and international medical school attendance
研究发现患者更偏好美国本土培养的医生,导致海外培养或外国出生的医生反而提供更好的就医可及性,提示医疗系统未充分利用这些医生。
• 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.