The Role of Preferences and Beliefs in Shaping Physician Careers
Equal access to qualified healthcare requires recruitment and retainment of specialists across geographic areas and medical specialties, as well as retainment of talent in medical research. We will investigate how physicians' preferences and preconceptions of career conditions influence their career and family choices.
At a time when the demand for physicians' expertise is increasing, the healthcare sector worldwide is challenged by unequal access to qualified medical care. Denmark is also challenged, as recruitment and retention of specialized physicians is easier around university cities. And within the medical profession, there is unequal access to research careers.
Our project, The Role of Preferences and Beliefs in Shaping Physician Careers, aims to identify the roles of individual preferences and beliefs, which could evolve over the career and determine geographical inequality in access to medical care, as well as barriers for physicians with different characteristics to pursue a research career.
"The sequence of career choices determines the future supply of qualified medical care - and thus citizens' access to qualified medical care," points out principal investigator Torben Heien Nielsen.
A lack of female researchers
Our hypothesis is that physicians' individual preferences, circumstances and beliefs are crucial for their career ambitions, their realized career and family formation choices – and ultimately for the treatment of patients across gender and socio-economic backgrounds.
"Even though men and women formally have the same opportunities at the onset of their careers, there is a clear gender divergence in the choices made as life as a physician unfolds," explains Torben Heien Nielsen.
The circumstances of younger physicians not only affect their choice of specialty and geographical location, but also if they continue into medical research career. In some areas, women are particularly under-represented.
"A lack of women in research affects the research questions that are asked and ultimately the invention of new treatment methods," says Torben Heien Nielsen.
We ask two overarching research questions:
1) How are physician beliefs about career and family trade-offs shaped over the life-cycle?
2) How do preferences, circumstances and beliefs impact aspirations and realized outcomes?
The contribution of our research proposal is twofold.
First, the answers can elucidate the dynamics of physician career aspirations and preferences for specialty, research, management, geographic location, patient types, and work-life balance. The novelty of the project is to assess whether and how preferences and beliefs are dependent on the environment to which physicians are exposed. This analysis has the potential to inform how physicians’ context-specific preferences for different patient types can affect physician-patient matches and ultimately affect inequality in patient health.
Second, the answers have the potential to challenge basic assumptions in economic research. Mainstream economic theory assumes that individuals’ fundamental preferences are stable across states of nature, e.g., different life circumstances and health status. This stability assumption is crucial for calculations in economic welfare analyzes. Economic lab experiments, however, point to situations where preferences and beliefs are malleable. If an individual’s fundamental preferences are also malleable in real-life settings—and could be altered by circumstances over the life-cycle—the economic profession should
pay more attention to models that can account for the state-dependency of preferences.
The project is anchored at University of Copenhagen. Torben Heien Nielsen (Department of Economics, UCPH) is principal investigator, and Frederik Plesner Lyngse (Department of Public Health, UCPH) and Itzik Fadlon (UC San Diego, Economics) are equal co-authors.
Researchers
| Name | Title | Job responsibilities | |
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| Frederik Plesner Lyngse | External Researcher |
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| Jonas Loft Skals | Research Assistant |
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| Torben Heien Nielsen | Professor | Health Behaviors; Health and Mortality Inequalities; Retirement and Savings; Health Measurement; Health Care Suppliers |
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Funded by:
The Role of Preferences and Beliefs in Shaping Physician Careers has received a 4½ year funding from DFF
Period: February 2024 - July 2028
Contact
Principal investigator Torben Heien Nielsen
External members:
| Name | Title | Phone | |
|---|---|---|---|
| Itzik Fadlon | Associate professor |