Preferences of physicians for public and private sector work

Background: The 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.

Methods: A 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.

Results: Physicians 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.

Conclusions: Other 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.