Preferences of physicians for public and private sector work

Anthony Scott,Jon Helgeim Holte,Julia Witt

doi:10.1186/s12960-020-00498-4

Anthony Scott, Jon Helgeim Holte + Show 1 more

Open Access

https://doi.org/10.1186/s12960-020-00498-4

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Abstract

BackgroundThe public-private mix of healthcare remains controversial. This paper examines physicians’ preferences for public sector work in the context of dual practice, whilst accounting for other differences in the characteristics of jobs.MethodsA discrete choice experiment is conducted with data from 3422 non-GP specialists from the Medicine in Australia: Balancing Employment and Life (MABEL) panel survey of physicians.ResultsPhysicians prefer to work in the public sector, though the value of working in the public sector is very small at 0.14% of their annual earnings to work an additional hour per week. These preferences are heterogeneous. Contrary to other studies that show risk averse individuals prefer public sector work, for physicians, we find that those averse to taking career or clinical risks prefer to work in the private sector. Those with relatively low earnings prefer public sector work and those with high earnings prefer private sector work, though these effects are small.ConclusionsOther job characteristics are more important than the sector of work, suggesting that these should be the focus of policy to influence specialist’s allocation of time between sectors.

Highlights

The public-private mix of healthcare remains controversial
Dual practice can be controversial in the context of universal health care that usually aims to provide care that does not depend on ability to pay but the need for health care [1]
The aim of this paper is to examine physician’s preferences for working in the public or private sector within a given institutional setting that allows dual practice and a rich mix of public and private health care provision and financing

Summary

Introduction

This paper examines physicians’ preferences for public sector work in the context of dual practice, whilst accounting for other differences in the characteristics of jobs. The aim of this paper is to examine physician’s preferences for working in the public or private sector within a given institutional setting that allows dual practice and a rich mix of public and private health care provision and financing. Cheng et al [6] and Saether [7] focus on the role of earnings on sector choice We build on these studies by using a discrete choice experiment to capture a much richer set of job characteristics [8, 9].

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