Heterogeneity in physician's job preferences in a dual practice context - Evidence from a DCE

Bibliographic Data

ID4596812
AuthorsJosé Pestana (0000-0002-4543-780X, Universidade Nova de Lisboa), João Frutuoso (0000-0002-1536-6676, Centro Hospitalar de Lisboa Ocidental), Eduardo Costa (0000-0002-4347-6338, Universidade Nova de Lisboa), Filipa Breia Fonseca (Universidade Nova de Lisboa), Filipa Fonseca
Year2024
Volume343
Pages116551
Publication date2024-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2023.116551
PMID38242030
OpenAlexW4390278070
LanguageEN
Citations received1
References cited60

Many countries are facing challenges in recruiting and retaining physicians, particularly in regions where the public and private sectors compete for doctors. Understanding the factors influencing physicians' job choices can help inform policies aimed at attracting and retaining this valuable workforce. This study aims to elicit the strength of physicians' preferences regarding various job-related aspects, including earnings, time flexibility, discussion of clinical cases, frequency of facilities and equipment updates, training opportunities and autonomy in decision making. To achieve this, a Discrete Choice Experiment (DCE) was administered to 697 physicians. Each participant completed a series of eight choice tasks, where they had to choose between two hypothetical jobs differing in these attributes with levels mirroring positions in the public and private sectors in Portugal. The resulting choices were analysed using mixed logit, generalized multinomial logit and latent classes models to account for diverse unobserved variations in physicians' preferences and to explore preference heterogeneity across different observable characteristics. Jobs that offered more autonomy and training opportunities were strongly preferred, as physicians would require additional compensation to work with reduced autonomy (equivalent to 28.62% of gross income) or less frequent training (equivalent to 22.75%). This study also shows that the ranking of the job characteristics is similar between physicians working exclusively in the public sector and those engaged in dual practice. Nevertheless, public sector physicians place more emphasis on the availability of frequent training possibilities and frequent updates of facilities and equipment compared to their counterparts in dual practice. These findings contribute to existing knowledge by highlighting the significance of non-monetary attributes and shedding light on the preferences of physicians across various employment scenarios. They offer valuable insights for policy development aimed at influencing physicians' allocation of time between sectors

Autonomy · Business · Context (archaeology · Earnings · Economics · Logistic regression · Microeconomics · Mixed logit · Multinomial logistic regression · Political science · Preference · Private sector · Public sector · Vignette · Workforce · Economic and Environmental Valuation · Global Health Care Issues · Healthcare Policy and Management · Medicine · Psychology · Social Psychology · Accounting · Marketing

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